Clinical study on relationship between intestinal permeability alteration and acute pancreatitis associated with SIRS in early period of acute pancreatitis

[Objective]To investigate the relationship between intestinal permeability alteration and acute pancreatitis (AP) associated with systemic inflammatory response syndrome (SIRS) in the early period of AP. [Methods] A prospective analysis was made in 62 patients with AP, by dividing the patients into mild acute pancreatitis (MAP) and severe acute pancreatitis (SAP). All the cases were divided into SIRS group and non-SIRS group. 30 healthy people were selected as control group. Serum D-lactic acid was seleeted as monitoring index of intestinal permeability alteration and the change of serum D-lactic acid, endotoxin and TNF-α were dynamicly observed. [Results] The total incidence of SIRS in AP group was 67.74%, of the total, the incidence of SIRS in MAP group was 52.38%, and it was 100% in SAP group. The serum D-lactic acid of SIRS group was signifantly higher than that of non-SIRS group and higher the level of D-lactic acid, longer the duration of SIRS, and more severe the degree of SIRS. The level of serum D-lactic acid, endotoxin and TNF-α of SIRS group was obviously higher than that of control group, and the serum D-lactic acid showed significant direct correlation with the level of endotoxin and TNF-α. [Conclusion] Intestinal permeability alteration could induce the ensuing SIRS in early period of AP. Intestinal permeability alteration could be one of the important pathological factor of the ensuing SIRS during the course of AP.