Combined determination of serum C-reactive protein,lipase,interleukin-1[beta],and intercellular adhesion molecule1 in early identification of severity of acute pancreatitis

Objective To evaluate the value of combined determination of various indices in the clinical diagnosis of acute pancreatitis( AP) through dynamic measurements of the levels of peripheral serum C- reactive protein( CRP),lipase( LPS),interleukin- 1[beta]( IL-1[beta]),and intercellular adhesion molecule 1( ICAM- 1),as well as changes in their levels,in patients with AP. Methods A total of 86 patients with AP who were treated in Fourth Affiliated Hospital of China Medical University from January 2010 to December 2012 were selected,among whom there were 39 patients with severe acute pancreatitis( SAP) and 47 patients with mild acute pancreatitis( MAP). Serum samples were collected from these patients on days 1,3,5,and 7 of admission. Twelve healthy subjects were selected as controls. Enzyme- linked immunosorbent assay was applied to measure the levels of CRP,IL- 1[beta],and ICAM- 1,and the dry slides method was applied to measure the concentration of serum LPS. The t test and [chi]2test were applied for comparison of continuous data and categorical data between groups,respectively. Results On day 1 of admission,the patients in MAP group had significantly higher levels of CRP,IL- 1[beta],and LPS than those in control group( t =- 74. 126,- 60. 135,and- 364. 153,respectively; all P < 0. 001); on day 1 of admission,the patients in SAP group had significantly higher levels of CRP,ICAM- 1,IL- 1[beta],and LPS than those in control group( t =- 121. 355,- 25. 728,- 89. 422,and- 415. 840,respectively; all P < 0. 001). The peak concentration of each index appeared on day 1 or 3 of admission,and decreased progressively in the course of therapy. The patients in SAP group had significantly higher levels of serum CRP,LPS,IL- 1[beta],and ICAM- 1 than those in MAP group( all P < 0. 05). Conclusion Combined determination of serum CRP,LPS,IL- 1[beta],and ICAM- 1levels has a certain clinical value in early identification of severity of AP.