十二指肠溃疡球部粘膜IL-18,IFN-γ水平变化及其临床意义

The Levels of Interleukin-18?Interferon-γ and their Clinical Significances in Bulb Mucosa of Paients with Duodenal Ulcer

目的:探讨IL- 18,IFN- γ在十二指肠溃疡(DU)发生机制中的作用。方法:在洛赛克、克拉霉素、替硝唑一周三联疗法之前和之后4～6周从十二脂肠溃疡患者球部钳取粘膜组织,应用EL ISA法测定IL - 18,IFN-γ的含量。结果:三联疗法治疗前,DU患者球部粘膜IL- 18,IFN- γ的含量均显著高于对照组〔(12 7.76±18.75 ) pg/ ml,(78.2 9±10 .0 1) pg/ ml;(80 .4 1±10 .99) pg/ ml,(2 5 .6 1±7.38) pg/ ml,P<0 .0 1〕,且IL- 18,IFN- γ的含量呈正相关(r=0 .91,P<0 .0 1) ,治疗后IL-18,IFN-γ的含量均显著下降〔(73.34±9.74 ) pg/ ml,(2 3.88±5 .5 5 ) pg/ ml,P<0 .0 1)〕,且IL - 18,IFN-γ的含量也呈正相关(r=0 .92 ,P<0 .0 1)。结论:细胞因子IL- 18,IFN- γ可能在十二指肠溃疡发生机制中有重要作用。一周三联疗法治疗后,促炎细胞因子IL - 18,IFN-γ的分泌得到有效抑制,为粘膜修复重建创造有利环境。

Objective:To investigate the clinica l significances of interleukin-18(IL-18),interferon-γ(IFN-γ)in duodenal ulc er(DU).Methods:Duodenal mucosal specimens were got in patients wi th DU before and 4～6 weeks after the treatment with Losec 20 mg bid,clarithromy cin 500 mg bid,tinidazloe 500 mg bid for one week,the productions of IL-18,IFN -γ were determined by ELISA assay.Results:Prior to the triple therapy,the productions of IL -18?IFN-γ significantly increased more than those of control〔(127.76±18.75 )vs,(78.29±10.01)pg/ml;(80.41±10.99)vs,(25.61±7.38)pg/ml,P<0.01,resp etively〕.A positive relationship between the production of IL-18 and IFN-γ ( r=0.91, P<0.01); After the treatment, the productions of IL-18, IFN- γ decreased much〔(73.34±9.74)pg/ml,(23.88±5.55)pg/ml,P<0.01〕,respect ivly),and a positive relationship between the production of IL-18 and IFN-γ( r=0.92,P<0.01) appeared as weu.Conclusion:Cytokin es IL-18, IFN-γ may play important roles in DU.After one-week triple therapy with Losec,clarithromycin and tinidazole,the secretions of the proinflammatory c ytokine IL-18, IFN-γ were effctively restricted,to build the favorable enviro nment for mucosal reconstitution.