The Decrease of Peripheral Blood CD4+ T Cells Indicates Abdominal Compartment Syndrome in Severe Acute Pancreatitis

Objective

Few data are available on the role of T lymphocytes and inflammatory cytokines in abdominal compartment syndrome (ACS) in severe acute pancreatitis (SAP). We conducted a retrospective study to assess the risk factors associated with ACS in SAP.

Methods

A total of 76 SAP patients who were admitted within 24 hours after symptom onset in our study. There were 36 patients suffering from ACS and 40 from intra-abdominal hypertension (IAH). On the 1^st, 3^rd and 7^th days after hospital admission, the following variables were assessed: serum value of C-reactive protein (CRP), and the proportions of peripheral CD4⁺ and CD8⁺ T lymphocytes. Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and computed tomography severity index (CTSI) score were assessed on days 1 and 7 after hospitalization.

Results

Compared with the patients with IAH, ACS patients showed statistically higher CRP value on 7^th day after hospital admission, proportions of CD4⁺ T cells on days 1, 3, 7 and CD4⁺ / CD8⁺ ratio on day 1 were significantly lower (P < 0.05, respectively). A CD4⁺ T cell proportion of 30.3% on the 1^st day indicated ACS with an area under the curve (AUC) of 0.774, a sensitivity with 82.5% and specificity with 72.0%, respectively. Sensitivity / specificity for predicting ACS in SAP patients on day 1 was 70.0% / 68.0% for CD4⁺ / CD8⁺ ratio, 72.2% / 65.0% for APACHE II score.

Conclusions

The reduction of peripheral blood CD4⁺ T lymphocytes is associated with ACS in SAP, and may act as a potential predictor of ACS in SAP.