慢性心力衰竭患者血清白细胞介素-12及白细胞介素-18水平及意义

Study of the serum levels and roles of cytokines IL-12,IL-18 in patients with chronic heart failure

目的：检测慢性心力衰竭患者（CHF）外周血白细胞介素（IL）-12和IL-18的水平并探讨其意义。方法：CHF患者72例，按照NYHA心功能分级，分为HF1组（NYHA Ⅱ～Ⅲ级），HF2组（NYHA Ⅳ级）。按照病因分类，分为缺血性心脏病（IHD）组（43例）和非缺血性心脏病（NIHD）组（29例）。选取29例健康志愿者作为正常对照组（C组）。采用双抗体夹心酶联免疫吸附法（ELISA）检测血清中IL-12和IL-18的水平，用彩色多普勒超声诊断仪测定左室舒张末期内径（LVEDd）和左室射血分数（LVEF）。结果：HF1、HF2、IHD和NIHD组IL-12的水平显著升高，分别为（34．56±19．10），（35．12±15．18），（31．18±7．80），（32．73±11．54）ng／L，与C组（28．73±13．43）ng／L比较，均差异有统计学意义（P〈0．05），IL-18的水平分别为（39．50±5．66），（46．76±12、66），（40、58±13．10），（42．53±6．16）ng／L，明显高于C组（31．82±5．79）ng／L，均差异有统计学意义（P〈0．05或P〈0．01），HF2组血清IL-18水平显著高于HF1组（P〈0．05）。与C组比较，HF1、HF2、IHD和NIHD组的LVEDd明显增大，LVEF显著降低。IL-12水平与LVEDd呈低度正相关（P〈0．01），IL-18水平与LVEDd呈中度正相关（P〈0．01），与LVEF呈中度负相关。结论：IL-12和IL-18在CHF患者血清中表达升高；IL-12的水平与患者基础病因和心功能均无明显相关性；IL-18的水平与CHF的基础病因无明显相关性，但与患者的CHF程度呈正相关。

Objective：To investigate the serum levels of IL-12, IL-18 in patients with chronic heart failure, and explore the roles of the cytokines in the pathogenesis of chronic heart failure. Method： Seventy-two patients with chronic heart failure were divided into 2 groups according to the New York Heart Association （NYHA） classification system： group HF1 （ Ⅱ-Ⅲ ） and group HF2 （Ⅳ）, of which 43 patients with ischemic heart disease （group IHD）, 29 with non-ischemic heart disease （group NIHD）. Twenty-nine healthy donors were enrolled as group C. The serum levels of IL-12 and IL-18 in the patients and donors were detected by ELISA. Result： The results showed that：①The level of IL-12 in group IHD and NIHD is （31. 18±7.80）ng/L,（32.73± 11.54）ng/L; were significantly higher than group C （28.73±13.43）ng/L （P〈0.05）, so were in group HF1 and HF2 （HF1[34.56 ±19.10]ng/L; HF2 [35.12 ± 15.18] ng/L） compared with group C （P 〈 0.05）. But there was no significant difference between group HF1 and HF2, so were in group IHD and NIHD; ②The level of IL-18 is significantly higher in group IHD （40, 58±13, 10）ng/L and group NIHD （42.53±6.16）ng/L compared with group C （31.82 ±5.79）ng/L（ P〈0.05）, but there was no obvious difference between group IHD and NIHD while there was significant difference between group HF1 and HF2. Conclusion：The serum levels of IL-12 and IL-18 were elevated in chronic heart failure patients. The level of IL-18 was related with the heart function. Both IL-12 and IL-18 might participate in the development of heart failure.