动态观察哮喘急性发作患儿血清IL-18和TNF-α改变的临床意义

The Clinical Significance of the Changes of Serum Interleukin-18 and Tumor Necrosis Factor-αLevels in the Children with Acute Asthma

目的了解哮喘急性发作患儿血清白细胞介素-18(IL-18)和肿瘤坏死因子(TNF-α)变化的临床意义及与病情的关系。方法采用ELISA法动态观察50例哮喘急性发作患儿及20例正常患儿血清IL-18和TNF-α的含量。结果哮喘发作患儿血清IL-18水平急性期犤(187.61±52.04)ng/L犦>缓解期犤(105.25±48.17)ng/L犦>对照组犤(58.42±21.43)ng/L犦,P均<0.01;哮喘发作患儿急性期血清TNF-α水平(103.37±44.28)ng/L明显高于缓解期血清TNF-α水平(41.76±16.67)ng/L及对照组(38.51±21.13)ng/L,P均<0.01,而缓解期与对照组之间比较则无显著性差别(P>0.05)。另外,急性期患儿血清IL-18含量分别与TNF-α水平之间呈显著正相关(r=0.811,P<0.01),与动脉血气中PaO2(5.85±3.67)kPa和pH值(7.28±0.29)均呈显著负相关(r分别为-0.653和-0.508,P均<0.01);急性期患儿血清TNF-α含量分别与PaO2和pH值均呈显著的负相关(r分别为-0.717和-0.613,P均<0.01)。结论IL-18和TNF-α可能参与了哮喘急性发作患儿的发病过程,测定血清IL-18和TNF-α含量,对评估哮喘急性发作患儿的病情变化及严重程度可能有一定的意义,拮抗IL-18和TNF-α的治疗可能有助于缓解患者的病情。

Objective To investigate the potential effect of levels of serum interleukin 18(IL-18)and tumor necrosis factorα(TNF-α)in the asthma children.Method The levels of serum IL-18and TNF-αin 50pediatric patients with asthma and 20normal children we re measured by ELISA.Results The serum IL-18levels in the asthma c hildren during acute phase(187.61±52.04)ng/L>those during recovery phase(105.25±48.17)ng /L>the normal controls(58.42±21.43)ng /L,P<0.01.Serum TNF-αlevels in the asthma children during acute phase(103.37±44.28)ng /L were significant higher than th ose during recovery phase(41.76±16.67)ng /L and in the normal controls(38.51±21.13)ng /L,P<0.01.Moreover,the level of serum I L-18was significantly correlated w ith that of TNF-αduring acute phase(r=0.811,P<0.01).The IL-18level was negatively corr elated with PaO 2 (5.85±3.67)kPa and pH(7.28±0.29)in the patients(r=-0.653and -0.508respectively,P<0.01).The level of serum TNF-αwas also negatively correlated with PaO 2 and pH in the patients during acute phase(r=-0.717and -0.613respectively,P<0.01).Conclusions The data suggested that IL-18and TNF-αmay play an important role in the path ogenesis of the inflammatory process of asthma in th e pediatric patients.Measuring the levels of serum IL-18and TNF-αmay be helpful in monitoring the changes of the disease.The therapy with anti-IL-18and anti-TNF-αtreatment may relief the symptom of asthma patients.