白细胞介素-18在IgA肾病中的作用

Action of Serum Interleukin-18 in Patients with IgA Nephropathy

目的:观察不同临床情况下的IgA肾病(IgA-N)患者的血清白细胞介素(IL)-18水平及与相关指标的关系,探讨其临床作用。方法:IgA-N患者分为3组:肾病组(24例)、肾炎组(20例)和肾衰组(18例)。另设正常对照组(20例)。用ELISA方法检测血清IL-18、肿瘤坏死因子(TNF)-α和超敏C反应蛋白(hs-CRP)水平。比较各组间的差别。结果:IgA-N患者的血清IL-18水平在肾病组[(368.2±84.4)pg/ml]和肾衰组[(497.7±120.7)pg/ml]较对照组[(163.9±42.2)pg/ml]和肾炎组[(196.3±61.8)pg/ml]显著升高(P<0.05),而肾衰组明显高于肾病组和肾炎组(P<0.05),肾病组明显高于肾炎组(P<0.05)。患者的血清IL-18水平与TNF-α、hs-CRP、血肌酐、24 h尿蛋白量、总胆固醇、甘油三酯呈显著正相关,与肾小球滤过率、血清总蛋白、白蛋白呈显著负相关。结论:有大量蛋白尿和肾功能衰竭的IgA肾病患者的血清IL-18水平显著升高。IL-18与IgA肾病的进展和微炎症状态有关。

Objective：To investigate the levels and the effect of serum interleukin（IL）-18 in patients with IgA nephropathy. Methods：Sixty-two patients with IgA nephropathy and twenty normal healthy persons were involvled in this study. The patients were divided into three groups ：patients with nephrotic syndrome （NS,24 cases）, patients with nephritic syndrome （n-NS,20 cases） and patients with chronic renal failure （CRF, 18 cases）. The levels of serum IL-18, tumor necrosis factor （TNF）-α and high sensitivity C-reactive protein（hs-CRP） were detected by means of ELISA. Differences in continuous variables between the three groups were evaluated. Results ：The levels of serum IL-18 were significantly increased in NS [（368.2±84.4） pg/ml] and CRF [（497.7±120.7） pg/ml] patients than those in healthy subjeers [（163.9±42.2） pg/ml] and n-NS patients [（196.3±61.8） pg/ml]（P〈0.05）. Further more,serum IL-18 levels in CRF patients were higher than those in NS and n-NS patients（P〈0.05）. Serum IL 18 levels in IgA nephropathy were positively related to serum TNF-α,hs CRP,serum creatinine, 24 h proteinuria,total cholesterol and triglyceride, and negatively related to GFR, serum total protein and albumin. Conclusions：The levels of serum IL-18 are markedly increased in patients with progress IgA nephropathy, and related to sub clinical inflammation of patients.