ITP患者激素治疗前后血清IL-18、CXCL10表达水平的变化及意义探讨

Changes and Significance of Serum IL-18 and CXCL10 Levels in Patients With ITP Before and After Hormone Therapy

目的研究原发免疫性血小板减少症(primary immune thrombocytopenia,ITP)患者血清中白细胞介素-18(Interleukin-18,IL-18)、CXC趋化因子配体10(CXC chemo-kine ligand-10,CXCL10)的表达水平,探讨其在ITP发病中的临床意义。方法采用酶联免疫吸附法(enzymelinked immunosorbent assay,ELISA)定量检测45例ITP患者、20例健康者(正常对照组)血清IL-18、CXCL10的水平。结果激素治疗前ITP患者血清IL-18、CXCL10的表达水平均高于正常对照组(t=5.126,6.576,P<0.05),治疗后两者与治疗前比较均有统计学差异(t=10.616,7.399,P<0.05)。激素治疗有效组IL-18、CXCL10的表达水平与正常对照组比较无统计学差异(q=0.521,0.871,P>0.05),而无效组IL-18的表达水平仍高于有效组和正常对照组(q=6.137,5.867,P<0.05);无效组CXCL10的表达水平同样高于有效组和正常对照组(q=8.933,7.642,P<0.05)。初发未治疗ITP患者血清IL-18、CXCL10表达呈正相关性(r=0.539,P<0.05)。结论 ITP患者不同时期血清中IL-18、CXCL10的表达水平不同,且两者具有显著相关性,提示其可能在ITP的发病及治疗过程中发挥一定的作用,联合检测有望在ITP的病情监测、预后判断等方面提供依据。

Objective To study the expression of Interleukin-18 （IL-18） and CXC chemo-kine ligand-10 （CXCL10） in primary immune thrombocytopenia （ITP） and clarify their clinical significance. Methods Enzyme-linked immunosorbent assay （ELISA） was used to detect the expression of IL-18 and CXCL10 in serum samples from 45 ITP patients, 20 volunteers （normal control group） served as controls. Results The expression levels of IL-18 and CXCL10 in ITP untreated group were significantly higher than normal control group （t=5.126, 6.576, P〈0.05）. Both IL-18 and CXCL10 of post-treatment group were significantly different with untreated group （t=10.616, 7.399, P〈0.05）. Additionally, the levels of IL-18 and CXCL10 in effective-treatment group were not significantly different with normal control （q=0.521, 0.871, P〉0.05）. However, the levels of IL-18 in ineffective-treatment group were still signiifcantly higher than effective-treatment group and normal control group （q=6.137, 5.867, P〈0.05）. The levels of CXCL10 in ineffective-treatment group were also significantly higher than effective-treatment group and normal control group （q=8.933, 7.642, P〈0.05）. There was positive correlation between serum expression levels of IL-18 and CXCL10 in ITP untreated group （r=0.539, P〈0.05）. Conclusion Different expressions of serum IL-18 and CXCL10 were found in ITP patients, which relfected they may play an important role in pathogenesis and therapy of ITP. United detection of serum IL-18 and CXCL10 may be used as reference indexes of ITP’ clinical stages and prognosis.