Evaluation of immunological disorder severity and prognosis of purulent complication development under acute destructive pancreatitis
Data analysis of the immunological studies of blood in 166 patients with acute pancreatitis on the 2 nd and 3rd day of illness showed changes in the immunological characteristic of the systemic infl ammatory response. Among patients without septic complications and favorable outcome of acute destructive pancreatitis changes in immunological homogeneity were revealed which had average values in the general population, and therefore they can be considered as “normal pathology”. For objective evaluation of an immune status the score scale assessment of immune response to the destructive process in the pancreas and parapancreatic tissue was developed. In patients with adequate immune response (score 0–5) prognosis is favorable, and in these cases immunocorrectors in treatment are not applied. In patients with inadequate pathological immune responses (score 12 or more) prognosis is poor. Immunocorrectors should be included in a set of treatment measures as early as possible. Using a method developed by scoring the state of immunity allowed to reduce significantly the number of septic complications from 49,3 to 32,5% and the mortality rate from 33,3 to 15% at the expense of reasonable and timely implementation of immunomodulatory therapy in acute destructive pancreatitis.