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目的:探讨高脂血症性急性胰腺炎（hyperlipidemia-induced acute pancreatitis, HLAP）患者外周血T淋巴细胞亚群和细胞因子的变化特点及预测病情预后的价值。方法:分析厦门大学附属第一医院2018年1月至2021年5月收治的急性胰腺炎患者184例。其中高脂血症（HLAP）组92例和非高脂血症（NHLAP）组92例；HLAP组根据病情再细分为重症（severe acute pancreatitis, SAP）亚组和非重症（非SAP）亚组。所有患者于入院第1、3、5天抽取外周静脉血，流式细胞术检测T淋巴细胞亚群，流式荧光法测定细胞因子。应用SPSS 19.0软件，相应采用独立样本n t检验或Mann-Whitney n U分析比较两组免疫指标的差异。采用Logistic回归分析HLAP组重症胰腺炎免疫指标危险因素；采用ROC曲线评价免疫指标对重症胰腺炎发生预测价值，以n P<0.05为差异有统计学意义。n 结果:HLAP组与NHLAP组比较：第1天，HLAP组CD4n +%低于NHLAP组，而IL-2高于NHLAP组（n P<0.05）；第3天，HLAP组CD4n +%低于NHLAP组，IL-4、IL-6、IL-10高于NHLAP组（n P<0.05）；第5天，HLAP组IL-6、IL-10高于NHLAP组（n P<0.05）。HLAP组SAP亚组与非SAP亚组比较：第1天，SAP亚组IL-10高于非SAP亚组（n P<0.05）；第3天，SAP亚组IL-2、IL-4、IL-6、IL-10、IFN-γ均高于非SAP亚组（n P<0.05）；第5天，SAP亚组CD4n +%低于非SAP亚组，IL-6、IL-10高于非SAP亚组（n P<0.05）。Logistic回归分析示：第1天的IL-10是HLAP组发生重症胰腺炎的独立危险因素（n OR=1.139, 95%n CI: 1.038~1.251, n P<0.05）；进一步行ROC曲线分析：IL-10预测重症胰腺炎发生的AUC=0.772，当IL-10为5.6 pg/mL时预测价值最高，敏感度及特异度分别为83.3%和68.8%。n 结论:与NHLAP相比，HLAP患者T淋巴细胞亚群与细胞因子变化不同；IL-10可以作为HLAP患者早期病情严重程度的一项预测指标。“,”Objective:To explore the characteristics of T lymphocyte subsets and cytokines in hyperlipidemia-induced acute pancreatitis (HLAP) and its prognostic value.Methods:This study included 184 patients with acute pancreatitis (AP) admitted to the First Affiliated Hospital of Xiamen University from January 2018 to May 2021. Based on disease etiology, there were 92 HLAP cases and 92 non-hyperlipidemia-induced AP (NHLAP) cases. Stratified by disease severity according to 2012 Atlanta classification criteria, the patients were divided into the severe subgroup (SAP) and non-severe subgroup (NSAP). Peripheral venous blood samples were taken from all patients on day 1, 3, and 5 after admission. T lymphocyte subsets were determined by flow cytometry, and cytokines were detected by flow fluorometry. The number of CD4n +% and CD8n +% and the expression of cytokines were compared by Student’s n t test or Mann-Whitney n U analysis. Logistic regression analyses were performed to identify risk factors for severe AP, and a receiver operating characteristic (ROC) curve was constructed to predict severe AP. Statistical significance was taken as n P<0.05.n Results:Compared with the NHLAP group, patients in the HLAP group had lower CD4n +%, while higher levels of IL-2 on day 1 (n P<0.05), and had also lower CD4n +%, while higher levels of IL-4, IL-6, and IL-10 on day 3 (n P<0.05). Furthermore, IL-6 and IL-10 levels of the HLAP group were significantly increased compared to the NHLAP group on day 5 (n P<0.05). IL-10 levels in the SAP subgroup were significantly higher than those in the NSAP subgroup on day 1 (n P<0.05). Compared with the NSAP subgroup, the SAP subgroup had elevated levels of IL-2, IL-4, IL-6, IL-10 and IFN-γ on day 3 (alln P<0.05), and had lower CD4n +%, while increased levels of IL-6 and IL-10 on day 5 (all n P<0.05). Multivariate Logistic regression analysis showed that IL-10 was an immune indicator of independent risk factor for severe AP in the HLAP group on day 1 (n OR=1.139, 95% n CI: 1.038-1.251, n P<0.05). Finally, ROC analysis showed that the area under the curve of IL-10 to assess HLAP with severe AP was 0.772, and the best cut-off value for predicting severe AP was 5.6 pg/mL, with a sensitivity of 83.3% and a specificity of 68.8%.n Conclusions:Changes of CD4n +% and cytokines are different between the HLAP and NHLAP groups. IL-10 can be used as a predictor of early disease severity in patients with HLAP.n