[The role of immune disorders in formation of local and systemic complications of severe acute pancreatitis].
There were studied the factors, which initiate the immune response in severe acute pancreatitis, in 57 patients of both gender ageing from 16 to 66 years, in whom the acute pancreatitis severity had constituted 3 marks and more (according to the Ranson criterions). In majority of the patients the combined type of the immune disorders had prevailed. The first stage of the disease was characteristic for metabolic hyperactivity occurrence with raising of HLA-DR+ level as well as of immunoregulating coefficient at the expense of the T-helpers quantity increase. In 47.1% of the patients with aseptic pancreonecrosis also the HLA-DR1 leukocytic antigens were revealed in combination with normal phagocytic activity of neutrophils present in 85.3% of them. In these patients also most frequently were revealed such antigens as HLA-A1 (in 20.6% of observations), HLA-A9 (in 29.4%), HLA-B13 (in 30.4%), HLA-B16 (in 20.6%). In 51.2% of patients, suffering infectionized pancreonecrosis, there was revealed HLA-DR2 lymphocytic phenotype. In them there were noted high suppressive activity of T-lymphocytes, lowering of phagocytic activity of neutrophils, activation of the aberrant adhesion molecules (ICAM-1, ICAM-3) on the background of higher concentration of interleukin-8 present in the blood serum in comparison with such in patients, suffering aseptic pancreatic necrosis.