Diagnostic significance of a number of markers of endothelial dysfunction as early predictors of severe acute pancreatitis

The objective was to determine the diagnostic relevance of a number of markers of endothelial dysfunction as early predictors of acute severe pancreatitis.

Materials and methods. 55 patients with acute pancreatitis were examined, which, depending on the severity of the disease, were divided into 2 groups: 1 group – 37 patients with a severe course of acute pancreatitis, 2 group – 18 patients with a less severe course of the disease. Endothelial dysfunction markers (vascular endothelial growth factor, syndecan-1 and intercellular adhesion molecules) and their dynamics within 14 days were analyzed.

Results. Critically ill patients with severe acute pancreatitis at all stages of the study, starting from the moment of hospitalization, are distinguished by high levels of vascular endothelial growth factor and their further growth (from 464.55 (291.78; 867.21) to 927.91 (243.36; 4958.56) pg/ml), as well as persistently high levels of syndecan-1 (5.13 (1.16; 9.82) – 5.71 (2.90; 23.94) ng/ml). During 5 days of hospitalization, the high level of intercellular adhesion molecules remained (62.19 (51.39; 87.96) – 71.54 (48.42; 91.86) ng/ml) with a further decrease by 10 days to 56.75 (46.44; 74.11) ng/ml. The mortality rate in patients with acute severe pancreatitis was 43.0%.

Conclusion. High levels of vascular endothelial growth factor, intercellular adhesion molecules and syndecan-1 at the time of hospitalization are early predictors of a severe course of acute pancreatitis and an unfavorable outcome of the disease. The severe course of the disease is accompanied by a further increase in the level of vascular endothelial growth factor, a consistently high level of syndecan-1 and a decrease in the level of inter cellular adhesion molecules.

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