The decrease of peripheral blood CD4+ T cells indicates abdominal compartment syndrome in severe acute pancreatitis

Abstract

Objective: Few data are available on the role of T lymphocytes and inflammatory cytokines in abdominal compartment syndrome (ACS) in severe acute pancreatitis (SAP). We conducted a retrospective study to assess the risk factors associated with ACS in SAP. Methods: A total of 76 SAP patients who were admitted within 24 hours after symptom onset in our study. There were 36 patients suffering from ACS and 40 from intra-abdominal hypertension (IAH). On the 1 st, 3 rd and 7 th days after hospital admission, the following variables were assessed: serum value of C-reactive protein (CRP), and the proportions of peripheral CD4 + and CD8 + T lymphocytes. Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and computed tomography severity index (CTSI) score were assessed on days 1 and 7 after hospitalization. Results: Compared with the patients with IAH, ACS patients showed statistically higher CRP value on 7th day after hospital admission, proportions of CD4 + T cells on days 1, 3, 7 and CD4 + /CD8 + ratio on day 1 were significantly lower (P < 0.05, respectively). A CD4 + T cell proportion of 30.3%on the 1 st day indicated ACS with an area under the curve (AUC) of 0.774, a sensitivity with 82.5% and specificity with 72.0%, respectively. Sensitivity/specificity for predicting ACS in SAP patients on day 1 was 70.0%/68.0% for CD4 + /CD8 + ratio, 72.2%/65.0% for APACHE II score Conclusions: The reduction of peripheral blood CD4 + T lymphocytes is associated with ACS in SAP, and may act as a potential predictor of ACS in SAP. Copyright: