IL-18和 IL-33在不同发病期哮喘患者中的应用价值

Value of IL-18 and IL-33 in Pathogenesis of Asthma in Patients During Different Period

【目的】探讨白细胞介素-18（IL-18）、IL-33在支气管哮喘（简称哮喘）中表达及意义。【方法】选取125例哮喘患者（哮喘组），根据患者病情将其分为哮喘缓解48例（缓解组），急性发作期77例（急性期组），其中轻度组32例，中度组25例，重度组20例，另选取正常体检者48例（对照组），采用免疫吸附法测定各组IL-18、IL-33水平，同时观察第一秒用力呼气容积（FEV1）占预计值的百分比（FEV1％）及嗜酸性细胞（EOS）的变化。【结果】与对照组相比，哮喘组 IL-18，IL-33，EOS 水平显著升高，而 FEV1％水平显著下降，差异有统计学意义（ P ＜0．05）；与缓解组相比，急性期组IL-18，IL-33，EOS水平显著升高，而 FEV1％水平显著下降，差异有统计学意义（ P ＜0．05）；与轻、中度哮喘组相比，重度组患者 IL-18，IL-33，EOS水平较高，而 FEV1％水平较低，差异有统计学意义（ P ＜0．05）。急性期各组患者治疗后IL-18，IL-33，EOS水平显著低于治疗前，而FEV1％，高于治疗前，差异有统计学意义（ P ＜0．05）。【结论】IL-18、IL-33在急性哮喘发作过程中起到促炎作用，加强气道反应；对急性期患者应用激素治疗能有效抑制炎症，控制气道反应，改善患者预后。

[Objective]To explore the expressions and significance of interleukin-18（IL-18） and interleukin-33 （IL-33） in bronchial asthma（asthma） .[Methods]Totally 125 patients with asthma（asthma group） were chosen . According to the patients＆#39;condition ,all patients were divided into asthma remission group （ n=48） ,acute asthma group（ n=77） ,mild asthma group（n=32） ,moderate asthma group（ n=25） and severe asthma group（ n=20） . Other 48 normal subjects were selected as the control group .The levels of IL-18 and IL-33 in groups were meas-ured by immunosorbent method .Meanwhile ,the changes of the percentage of forced expiratory volume in one sec-ond（FEV1） of predictive value（FEV1% ） and eosinophils（EOS） were observed .[Results]Compared with control group ,the levels of IL-18 ,IL-33 and EOS in asthma group were markedly increased ,while FEV1% was markedly decreased ,and there was significant difference（ P〈0 .05） .Compared with asthma remission group ,the levels of IL-18 ,IL-33 and EOS in acute asthma group were markedly increased ,while FEV1% was markedly decreased , and there was significant difference（ P 〈0 .05） .Compared with mild and moderate asthma groups ,the levels of IL-18 ,IL-33 and EOS in severe asthma group were higher ,but FEV1% was lower ,and there was significant difference（ P 〈0 .05） .The levels of IL-18 ,IL-33 and EOS in groups in acute period after treatment were lower than those before treatment ,while FEV1% after treatment was higher than that before treatment ,and there was significant difference（ P〈0 .05） .[Conclusion]IL-18 and IL-33 may play the proinflammatory role during acute at-tack of asthma attack ,and can strengthen airway reaction .For patients treated with hormone therapy ,IL-18 and IL-33 can effectively inhibit inflammation ,control airway reaction and promote the prognosis of patients .