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Objective  Few data are available on the role of T lymphocytes and inflammatory cytokines in abdominal compartment syndrome (ACS) in severe acute pancreatitis (SAP). We conducted a retrospective study to assess the risk factors associated with ACS in SAP.    Methods  A total of 76 SAP patients who were admitted within 24 hours after symptom onset in our study. There were 36 patients suffering from ACS and 40 from intra-abdominal hypertension (IAH). On the 1 st , 3 rd  and 7 th  days after hospital admission, the following variables were assessed: serum value of C-reactive protein (CRP), and the proportions of peripheral CD4 +  and CD8 +  T lymphocytes. Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and computed tomography severity index (CTSI) score were assessed on days 1 and 7 after hospitalization.    Results  Compared with the patients with IAH, ACS patients showed statistically higher CRP value on 7 th  day after hospital admission, proportions of CD4 +  T cells on days 1, 3, 7 and CD4 +  / CD8 +  ratio on day 1 were significantly lower ( P  < 0.05, respectively). A CD4 +  T cell proportion of 30.3% on the 1 st  day indicated ACS with an area under the curve (AUC) of 0.774, a sensitivity with 82.5% and specificity with 72.0%, respectively. Sensitivity / specificity for predicting ACS in SAP patients on day 1 was 70.0% / 68.0% for CD4 +  / CD8 +  ratio, 72.2% / 65.0% for APACHE II score.    Conclusions  The reduction of peripheral blood CD4 +  T lymphocytes is associated with ACS in SAP, and may act as a potential predictor of ACS in SAP.

The Decrease of Peripheral Blood CD4+ T Cells Indicates Abdominal Compartment Syndrome in Severe Acute Pancreatitis