[Interleukin 17--prognostic marker of severe acute pancreatitis].
OBJECTIVE
The evaluation of the interleukin 17 capacity as precociously predictive marker of the severe forms of acute pancreatitis.


METHODS
This prospective and diagnosis study took place during 01.01.2006-31.03.2008 on a sample of 83 subjects hospitalized with acute pancreatitis. Among these, 48 have submitted forms mild disease and formed batch A. Subjects with severe acute pancreatitis formed batch B (n=16), to whom it was applied peritoneal lavage extended by laparoscopic method and batch C (n=19), who have used conventional methods of treatment. Were determined serum concentrations of interleukin 17 in the first and tenth days of admission for the subjects of A and C lots and in the first, third and tenth day at then subjects of B lot, they were dosage and levels peritoneal or lavage fluid in the third, sixth and tenth days of admission. At the same time were determined interleukin 6 levels.


RESULTS
Interleukin 17 has proved a sensitivity of 97% and a specificity of 94% in early identification forms of severe acute pancreatitis, the correlation coefficient is 0.81. The correlation was good even in combination with organic disfunction (0.66) and the risk of death (0.54). The predictive capacity of sepsis has been reduced (0.44). The dynamics of this cytokines show a significant decrease in concentrations forms mild disease (batch A) and in severe forms treated with peritoneal extended lavage (lot B). In conversely, the subjects treated by conventional methods (lot C) the decrease was not significant between the first and tenth days of admission. A similar dynamic has been recorded after short peritoneal lavage, lasting three days. At large in, the concentrations of interleukin 17 have evolved in parallel with those of interleukin 6.


CONCLUSIONS
Interleukin 17 is an important predictive marker of early forms of severe acute pancreatitis. Also, serum concentrations are correlated with the risk of organic disfunction development and the fatal evolution. The dynamics of this cytokine is depending on the therapeutic measures that attenuates the body's inflammatory response.
Botoi
G
G
Spitalul Judeţean de Urgenţă, Baia-Mare. grigbotoi@yahoo.com
Andercou
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004322:Drainage / Q000379:methods; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D020381:Interleukin-17 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy; D010533:Peritoneal Lavage / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome
D015415:Biomarkers; D020381:Interleukin-17; D015850:Interleukin-6