Diagnosis and prognostic significance of activity of phospholipase A2, аmylase, levels of histamine and endothelial-monocytic activating peptide II in the blood serum in various forms of an acute pancreatitis

Keywords: acute pancreatitis; phospholipase А2; histamin; аmylase

Abstract

Objective. To study the informative significance of various degree of the activity rising for phospholipase A2, аmylase, levels of histamine and endothelial-monocytic activating polypeptide ІІ (ЕМАP-ІІ) as markers of depth of pancreatic affection in an acute pancreatitis (AP).

Маterials and methods. Activity of phospholipase A2 (while applying kinetic method), аmylase, levels of histamine and (ЕМАP-ІІ) were determined (using immunoassay methods) during a stationary stay in 45 patients, who were operated for severe form of an AP, using laparoscopic investigation and revealing of diffuse enzymatic peritonitis with the necrotic zone drainage, and in 28 patients, suffering a middle severity AP, to whom conservative therapy was conducted.

Results. In an AP of a middle severity the amylase activity before therapy have raised up to (249.5 ± 16.2) U/l in 71.43% patients, and in a severe (destructive) one - up to (329.77 ± 24.2) U/L in 53.3% patients (р < 0.05). Аctivity of phospholipase A2 have raised up to (698,18 ± 9.70) ng/ml in all the examined patients, suffering destructive pancreatitis and up to (392.77 ± 15.59) ng/ml - in an AP of a middle severity (р < 0,05). Level of histamine in patients, suffering a middle severity AP have constituted (2,28 ± 0,12) ng/ml, and in pancreatic destruction - (5.10 ± 0.34) ng/ml (in healthy persons - (0.70 ± 0.11) ng/ml). Development of such complications, as pancreatogenic peritonitis, owes big possibility (OR constitutes 103.14) (p < 0.0001) if activity of the phospholipase A2 activity would be over 392.77 ng/ml.

Conclusion. High activity of phospholypase А2 and enhanced level of histamine in the blood serum in patients, suffering early stage of an AP, constitutes more prognostically probable markers for its course severity and the complications development.

Author Biographies

V. V. Mishchuk, Іvano-Frankivsk National Medical University

Mishchuk Vitaliy Vasylovich, PhD, Associate Professor

Department of General Surgery of the Stomatological Faculty,

Ivano-Frankivsk National Medical University

  1. Ivano-Frankivsk, Halytska Str., 2.

Tel: (0342) 53 32 95

Mob.Tel: +38-050-550-85-22

E-mail: mvv-79@ukr.net

ORCID identifier: https://orcid.org/0000-0002-0665-9514

N. Ya. Ivanochko, Іvano-Frankivsk National Medical University

Ivanochko Natalya Yaroslavivna, PhD, Associate Professor

Department of General Surgery of the Stomatological Faculty,

Ivano-Frankivsk National Medical University

  1. Ivano-Frankivsk, Halytska Str., 2.

Tel: (0342) 53 32 95

Mob.Tel: +38-096-023-17-17

E-mail: ivanochkon@ukr.net

ORCID identifier: https://orcid.org/0000-0002-1614-0513

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Published
2018-10-29
Section
General Problems of Surgery