Significance on systemic inflammatory response syndrome and changes of serum cytokines in early stage of acute pancreatitis

Objective To study the onset, duration and severity of systemic inflammatory response syndrome (SIRS) in early stage of acute pancreatitis (AP) ,and to explore the role of cytokines in the progression of acute pancreatitis. Methods The subjects were 86 patients who were diagnosed as having acute pancreatitis in this hospital from 2000 to 2002, and 30 healthy volunteers (15 male and 15 female) as control group. The overall morbidity of SIRS in AP was calculated and compared with that in acute edematous pancreatitis (AEP) and in severe acute pancreatitis (SAP). Based on the presence or abgsence'of SIRS in the course, the AP patients were grouped as non-SIRS and SIRS based to compare the onset,duration and severity of SIRS in AP. Plasma TNF-α, IL-1β, IL-6 and IL-8 were determined by ELISA in AP patients. TNF-α, IL-1β, IL-6 and IL-8 were determined on alternative days in SAP patients to study the role of cytokines in the progression of acute pancreatitis. Results The morbidity of SIRS in SAP was higher than that in the mild form of AP(P0. 05). The mortality in AP patients increased with the severity of SIRS (P0. 01). The plasma levels of TNF-a, IL-1(3, IL-6 and IL-8 in AP patients were significantly higher than those in control group(P0. 05), and these changes were corresponding to the clinical symptoms. Conclusions The prognosis of AP is highly related to the morbidity of SIRS and the severity of SIRS. Cytokines are involved in the pathological progression of acute pancreatitis and are important factors of tissue injury.