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.