ABSTRACT
Acute necrotic pancreatitis was followed by disorders of intestinal functions in 96.7% of patients and in 68% its failure was occurred what had directly influenced on frequency of purulentseptic complication and mortality rate. It was proved that citrulline plasma level had been objectively reflected the severity of enteral failure and served as independent lethality criteria in patients with acute necrotic pancreatitis.
Subject(s)
Citrulline/blood , Enteritis/diagnosis , Pancreatitis, Acute Necrotizing/diagnosis , Peritonitis/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers/blood , Enteritis/blood , Enteritis/etiology , Enteritis/mortality , Female , Humans , Male , Middle Aged , Pancreas/metabolism , Pancreas/pathology , Pancreatitis, Acute Necrotizing/blood , Pancreatitis, Acute Necrotizing/complications , Pancreatitis, Acute Necrotizing/mortality , Peritonitis/blood , Peritonitis/etiology , Peritonitis/mortality , Prognosis , Survival AnalysisABSTRACT
In 70 patients, suffering an acute necrotic pancreatitis (ANP), and 10 practically healthy persons a content of presepsin in a blood plasm, using immunochemiluminescent method and conducted bacteriological investigations, were analyzed. The infection occurrence is accompanied by plausible upgrading of a presepsin level in a blood plasm, depending on activity and severity of a septic process: in local infection--up to (677 ± 30) pg/ml, sepsis--up to (988 ± 47) pg/ml, severe sepsis--up to 2668 pg/ml; in an ANP without infection it have constituted (332 ± 38) pg/mI at average, in practically healthy persons--(184 ± 16) pg/mI. A presepsin level correlates with a state severity in accordance to APACHE I scale, what permits to estimate the patients state severity objectively, to prognosticate a favorable and unfavorable consequences of treatment, rapidly changing, depending on efficacy of treatment.
Subject(s)
Lipopolysaccharide Receptors/blood , Pancreas/metabolism , Pancreatitis, Acute Necrotizing/diagnosis , Peptide Fragments/blood , Sepsis/diagnosis , APACHE , Adolescent , Adult , Aged , Biomarkers/blood , C-Reactive Protein/metabolism , Case-Control Studies , Female , Humans , Male , Middle Aged , Pancreas/pathology , Pancreas/surgery , Pancreatitis, Acute Necrotizing/blood , Pancreatitis, Acute Necrotizing/complications , Pancreatitis, Acute Necrotizing/mortality , Prognosis , Sepsis/blood , Sepsis/etiology , Sepsis/mortality , Severity of Illness Index , Survival AnalysisABSTRACT
Examination and treatment of 70 patients, suffering an acute necrotic pancreatitits, was conducted. Content of presepsin, procalcitonin, Сreactive protein and interleukin6 (ÐL6) in the patients' blood plasma was determined, and bacteriological investiga' tions, contrastenhanced CT were conducted as well. Positive results of bacteriologi' cal investigations were noted in 43 patients. Level of presepsin and procalcitonin in patients, suffering purulentseptic complications, in 3 4 times exceeded such in a sterile pancreonecrosis. Presersin level,exceeding over 632 pg/ml, have permitted to confirm the presence of local and systemic infection with high specificity and sensitivi' ty, and this have exceeded diagnostic possibilities of the procalcitonin content determi' nation. High level of ÐL6 and Сreactive protein is characteristic for the systemic inflammatory response syndrome (SIRS) of infective and noninfective origin.
Subject(s)
Interleukin-6/blood , Lipopolysaccharide Receptors/blood , Pancreatitis, Acute Necrotizing/diagnosis , Peptide Fragments/blood , Sepsis/diagnosis , Systemic Inflammatory Response Syndrome/diagnosis , Adolescent , Adult , Aged , Biomarkers/blood , C-Reactive Protein/metabolism , Case-Control Studies , Female , Humans , Male , Middle Aged , Pancreatitis, Acute Necrotizing/blood , Pancreatitis, Acute Necrotizing/complications , Pancreatitis, Acute Necrotizing/pathology , Procalcitonin/blood , Prospective Studies , ROC Curve , Sepsis/blood , Sepsis/complications , Sepsis/pathology , Systemic Inflammatory Response Syndrome/blood , Systemic Inflammatory Response Syndrome/complications , Systemic Inflammatory Response Syndrome/pathology , Tomography, Emission-ComputedABSTRACT
There were examined 113 patients, in whom an acute necrotic pancreatitis was diagnosed. While admittance to hospital a constant organ insufficiency was revealed in 50 (44%), a transient one--in 63 (56%) patients. In total 31 (27.4%) patients died. Respiratory insufficiency have occurred in 67% patients, and almost with similar rate--cardio-vascular (in 59%), renal (in 56%) and enteral (in 54%), dominating in the lethality structure. The BISAP (Bedcide Index for Severity in Acute Pancreatitis) scales applied permit with high probability to prognosticate the organ insufficiency and lethality in patients, suffering an acute necrotic pancreatitis.
