Ability to determine the level of lymphocytes and immunoglobulins of class g in predicting the development of local complications of acute pancreatitis

Abstract

The aim of the work: determining the diagnostic and prognostic value of the level of lymphocytes and immunoglobulins of class G to predict the development of local complications of acute pancreatitis, the risk of their infection and the need for appropriate correction of therapeutic tactics.

Materials and Methods. 30 patients were examined. Laboratory and immunological studies were carried out three times: first research – upon admission; second research – on the 7th day; third research – before discharge. An enzyme-linked immunoglobulin analysis of IgG subclasses (G1, G2, G3, G4) was performed in the main study group. Analysis on the homogeneity of the main group and the control group showed that in the distribution of patients in groups, depending on age and sex, no significant differences were found (p>0.05). which indicates their correctness and comparability for discrepancies in other parameters.

Results and Discussion. According to the ROC analysis, a conclusive proof was made of the ability to predict intra- and peripacreatic fluid accumulation in patients with acute pancreatitis of the subclass of IgG2 immunoglobulin. IgG1, IgG3 IgG4 and total IgG do not have sufficient prognostic ability (p> 0.05) and can not be used in clinical practice for this purpose. The area under the ROC curve for the prognostic ability of IgG2 and the level of lymphocytes has a statistically significant value (p <0.05) and can be estimated as mean and good, respectively. A pair comparison of ROC curves of IgG2 and the level of lymphocytes among themselves showed a lack of significant differences between them, hence they have almost identical diagnostic capabilities. A pair comparison of ROC curves of IgG2 and lymphocyte levels with regard to the prediction of the need for surgical interventions did not reveal significant differences between them and confirmed the best performance characteristics of lymphocytes.

Conclusions. In order to predict intra-and peripancreatic collections, infection and the need for surgical interventions in patients with acute pancreatitis, only IgG2 and lymphocyte levels should be effectively investigated. These indicators have the same diagnostic capabilities. In order to predict infection it is expedient to use the level of lymphocytes. In clinical practice, the prediction of the need for surgical interventions is sufficient to determine the level of lymphocytes due to the lack of statistical differences between this index and the level of IgG2.