Dataset Information

The Reduction of Peripheral Blood CD4+ T Cell Indicates Persistent Organ Failure in Acute Pancreatitis.

ABSTRACT:

Objective

Few data are available on the potential role of inflammatory mediators and T lymphocytes in persistent organ failure (POF) in acute pancreatitis (AP). We conducted a retrospective study to characterize their role in the progression of POF in AP.

Methods

A total of 69 AP patients presented within 24 hours from symptom onset developing organ failure (OF) on admission were included in our study. There were 39 patients suffering from POF and 30 from transient OF (TOF). On the 1st, 3rd and 7th days after admission, blood samples were collected for biochemical concentration monitoring including serum IL-1?, IL-6, TNF-? and high-sensitivity C-reactive protein (hs-CRP). The proportions of peripheral CD4(+) and CD8(+) T lymphocytes were assessed based on flow cytometry simultaneously.

Results

Patients with POF showed a significantly higher value of IL-1? and hs-CRP on day 7 compared with the group of TOF (P < 0.05). Proportions of CD4(+) T cells on days 1, 3, 7 and CD4(+)/ CD8(+) ratio on day 1 were statistically lower in the group of POF patients (P < 0.05). A CD4(+) T cell proportion of 30.34% on day 1 predicted POF with an area under the curve (AUC) of 0.798, a sensitivity with 61.54% and specificity with 90.00%, respectively.

Conclusions

The reduction of peripheral blood CD4(+) T lymphocytes is associated with POF in AP, and may act as a potential predictor.

SUBMITTER: Yang Z

PROVIDER: S-EPMC4418709 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

The Reduction of Peripheral Blood CD4+ T Cell Indicates Persistent Organ Failure in Acute Pancreatitis.

Yang Zhiyong Z Zhang Yushun Y Dong Liming L Yang Chong C Gou Shanmiao S Yin Tao T Wu Heshui H Wang Chunyou C

PloS one 20150504 5

<h4>Objective</h4>Few data are available on the potential role of inflammatory mediators and T lymphocytes in persistent organ failure (POF) in acute pancreatitis (AP). We conducted a retrospective study to characterize their role in the progression of POF in AP.<h4>Methods</h4>A total of 69 AP patients presented within 24 hours from symptom onset developing organ failure (OF) on admission were included in our study. There were 39 patients suffering from POF and 30 from transient OF (TOF). On th ...[more]

PMID: 25938229

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Project description:Neutrophil to lymphocyte ratio (NLR) has frequently been reported as a significant indicator of systemic inflammation in various medical conditions. The association underlying NLR and outcomes in patients with acute pancreatitis (AP) has not been evaluated after the publication of revised Atlanta classification.This was a single-center retrospective diagnostic accuracy study and a cohort outcome study. From 2009 to 2015, Asian Chinese patients with a diagnosis of AP presented within 72?hours from symptom onset and underwent neutrophil, lymphocyte assessment at presentation were included in this study. The outcomes were the occurrence of persistent organ failure (POF), intensive care unit (ICU) stay >7 days, and in-hospital mortality. The relationships of baseline neutrophil, lymphocyte count, and NLR with outcomes were assessed with multivariate Cox regression model.A total of 974 consecutive AP patients were clinically eligible. The mean neutrophils, lymphocytes, and NLR for the entire population were 10.23?±?4.76??×?10/L, 1.05?±?0.49??×?10/L, and 12.88?±?11.25. Overall, 223 (22.9%) of the patients developed with POF, 202 (20.7%) spent more than 7 days in ICU, and 58 (6.0%) died during hospitalization. The NLR had a superior predictive performance than neutrophils and lymphocytes. Using an NLR cutoff of 11, the area under the curves (AUC) were 0.76 for POF, 0.74 for longer ICU stay, and 0.79 for death during hospitalization. After multivariate analysis, NLR???11 was further identified as an independent prognostic factor (hazard ratio [HR] 1.37, 95% confidence interval [CI] 1.00-1.89; HR 1.44, 95% CI 1.03-2.00; HR 2.75, 95% CI 1.12-6.76; all P value?<?0.05). Following stratification according to quartiles of NLR, positive trends for the association across increasing NLR quartiles and the 3 outcomes were observed (P values for trends across quartiles were 0.007, 0.016, and 0.028, respectively). The adjusted HRs for highest NLR quartile versus the lowest were 2.80 (95% CI 1.42-5.51) (POF), 2.79 (95% CI 1.37-5.70) (ICU?>?7 days), and 2.22 (95% CI 0.49-10.05) (mortality), respectively.Our data show for the first time that an increased NLR is an independent risk factor for POF, longer ICU stay, and in-hospital mortality in AP.

Dataset Information

The Reduction of Peripheral Blood CD4+ T Cell Indicates Persistent Organ Failure in Acute Pancreatitis.

Objective

Methods

Results

Conclusions

Publications

The Reduction of Peripheral Blood CD4+ T Cell Indicates Persistent Organ Failure in Acute Pancreatitis.

Similar Datasets

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