目的:探讨CD4+T淋巴细胞内三磷酸腺苷(ATP)含量在重症急性胰腺炎(SAP)感染期的变化。方法:将南开医院收治的42例SAP患者(SAP组)及36名健康志愿者(对照组)纳入研究。SAP组入院后于1,4,7,14,21 d用ImmuKnowTM免疫细胞功能测定试剂盒检测CD4+T淋巴细胞内ATP值,对照组以相同的时间间隔做相同的检测。之后根据SAP组是否进入感染期分为感染组(18例)和非感染组(24例)。分析和比较3组ATP含量的变化,并用受试者工作特征(ROC)曲线分析ATP含量变化对判断SAP继发感染的价值。结果:对照组CD4+T淋巴细胞ATP含量保持稳定。两个SAP组的ATP含量变化趋势基本一致,入院后第1,4天两组的ATP含量明显高于对照组(P<0.05),第7天两组ATP含量明显降低,均于第14天降至最低水平,其中感染组下降程度明显大于非感染组(P<0.05),随后两组ATP含量开始回升,第21天非感染组ATP含量已基本接近对照组,但感染组仍低于对照组(P<0.05)。ROC曲线分析表明,当CD4+T细胞内ATP值降低(<151.55 ng/mL)时,SAP继发感染的机率明显增加;ATP含量的降低对判断SAP继发感染的敏感度为0.810,特异度为0.605。结论:CD4+T淋巴细胞内ATP含量可较准确地反映SAP患者的整体细胞免疫功能状况和继发感染的风险。 Objective: To investigate the changes of ATP content in CD4 + T lymphocytes during severe acute pancreatitis (SAP) infection. Methods: Forty-two SAP patients (SAP group) and 36 healthy volunteers (control group) were enrolled in Nankai Hospital. In the SAP group, the ATP value of CD4 + T lymphocytes was detected by ImmuKnowTM immune cell functional assay kit on the 1st, 4th, 7th, 14th and 21st days after admission. The control group was tested at the same time interval. According to whether the SAP group entered the infection period, it was divided into infection group (18 cases) and non-infected group (24 cases). The changes of ATP content in three groups were analyzed and compared. The changes of ATP content were analyzed with receiver operating characteristic (ROC) curves to determine the value of secondary infection of SAP. Results: The ATP content of CD4 + T lymphocytes in the control group remained stable. The changes of ATP content in the two SAP groups were basically the same. ATP levels in the two groups were significantly higher than those in the control group on the first and the fourth day after admission (P <0.05) (P <0.05). The content of ATP in the two groups started to rise again. The content of ATP in non-infected group on day 21 was basically close to the control group, but the infection group was still lower than the control group Group (P <0.05). ROC curve analysis showed that when the ATP value in CD4 + T cells was reduced (<151.55 ng / mL), the probability of secondary infection was significantly increased. The decreased ATP content was 0.810 for determining the secondary infection of SAP. The specificity Is 0.605. Conclusion: The content of ATP in CD4 + T lymphocytes can accurately reflect the overall cellular immune function and the risk of secondary infection in SAP patients.