Artikel
Blood serum profile of proinflammatory cytokines in patients with biliary acute pancreatitis
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Autoren
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D. Karcz
- 2. Chirurgische Klinik der Jagiellonnen Universitat, Krakow, Polen
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M. Winiarski
- 2. Chirurgische Klinik der Jagiellonnen Universitat, Krakow, Polen
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J. Zasada
- 2. Chirurgische Klinik der Jagiellonnen Universitat, Krakow, Polen
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J. Panek
- 2. Chirurgische Klinik der Jagiellonnen Universitat, Krakow, Polen
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M. Matlok
- 2. Chirurgische Klinik der Jagiellonnen Universitat, Krakow, Polen
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A. Budzynski
- 2. Chirurgische Klinik der Jagiellonnen Universitat, Krakow, Polen
| Veröffentlicht: | 2. Mai 2006 |
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Gliederung
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Einleitung: One of the most important etiology of the acute pancreatitis (AP) is gallstone disease. In 80 - 85 % of patients the course of disease is mild but in remaining cases is severe and usually associated with complication including multiple organ disfunction syndrome (MODS) and higher death rate. The idea that prolonged cytokine stimulation is responsible for development of MODS becomes widely accepted.The aim of the study was to determine proinflammatory cytokine levels in blood serum of the patients with biliary AP.
Material und Methoden: There were 68 patients with biliary AP included to the study. 54 of them had mild and 14 with severe form of AP who developed of MODS. The diagnosis and the severity of the disease was establish according to clinical examination, laboratory findings (Amylase or Lipase level), imaging studies (USG, KT) and Atlanta Criteria, Ranson scale, and APACHE II scale. Blood specimen were harvested in 1st, 3rd, 5th and 7th day of the treatment to determined cytokines level. Cytokines TNF-α, IL-1β, IL-6, IL-8, IL-12p40 were measured.
Ergebnisse: In the group of patients with mild AP the mean level of TNF-α practically didn't changed between days. The level of remaining cytokines (IL-1β, IL-6, IL-8, IL-12p40) in this group was the highest in the day of admission and decreased during the next days. This process was most pronounced in the results of IL-6 and L-8. The differences between mean values of this cytokines in the 1st and 7th day of the treatment were statistically significant (p<0,05). In the group with severe AP we observed increase of mean level of TNF-α, IL-1β, IL-8, IL-12p40 as compared to starting-point, and the levels were the highest in 7th day (p<0,05). The mean level of IL-6 was the highest on admission day, was decreasing to the 5th day and rose again in 7th day.
Schlussfolgerung: The significant increase of the level of proinflamatory cytokines in the blood of patients with severe form of AP proved that they play an important role in development of MODS in AP.
