Clinical Significance Of Neutrophil Extracellular Traps In Severe Acute Pancreatitis

Objective: In this study,we aimed to analyze the difference in general clinical status and plasma neutrophil extracellular traps(NETs)levels between patients with acute severe pancreatitis(SAP)and non-severe acute pancreatitis..Methods: Patients meeting the diagnostic criteria of acute pancreatitis who were admitted to our hospital for emergency treatment from January 2019 to November 2019 were selected as the research subjects.According to the Atlanta Severity C lassification Standard(2012 Revision),patients with persistent(≥48 hours)organ failure(single organ Modified Marshall score ≥ 2 points)were considered as the severe group,while others were in the non-severe group.We collected the clinical data from both groups.Plasma samples from 30 healthy subjects were collected as controls.Sandwich enzyme-linked immunosorbent assay(ELISA)was used to quantitatively detect Myeloperoxidase(MPO)-DNA complexes.The clinical data characteristics and differences between groups were analyzed.The predictive power of the scores and the differences in plasma MPO-DNA complex levels among patients with acute pancreatitis were analyzed..Results: A total of 72 patients with acute pancreatitis were enrolled,including 25 severe cases and 47 non-severe cases.There were statistically significant differences between the two groups in total protein,albumin,creatinine,urea,partial pressure of arterial oxygen and carbon dioxide,bicarbonate,C-reactive protein,fibrinogen,D-dimer,total serum calcium,free calcium iont.The MPO-DNA in both groups were significantly higher than that in healthy controls,while the plasma MPO-DNA level in severe group was lower than that in non-severe group(P<0.001).Univariate logistic regression showed that AP patients with higher MPO-DNA levels had a lower probability of developing acute severe pancreatitis.Plasma MPO-DNA level was significantly negatively correlated with CRP,D-dimer and lactic acid,while it showed no statistically significant correlation with white blood cell count and neutrophil count.Patients with peritoneal effusion showed lower MPO-DNA level than patients without peritoneal effusion(P=0.006).Conclusion: For patients with AP,NETs play the role of protection.When some patients are relatively deficient in N ETs and the defenses of NETs are weakened,the risk of developing SAP might increase...