IL-18在原发性高血压危象中改变的意义研究

Study of Clinical Significance of the Change of Serum Interleukin-18 Level in Essential Hypertensive Crisis

目的 探讨IL-18在原发性高血压危象中改变的临床意义。方法 采用酶联免疫分析法(ELISA)动态检测 40例原发性高血压危象患者和30例健康对照者血清IL-18的含量,并用简单相关分析血清IL-18的含量变化与血压的相关性。结果 原发性高血压危象患者血清IL-18的含量显著高于健康对照组(191.34±56.28ng/L vs 64.81±14.33ng/L,P<0.01);治疗后12h后患者血清IL-18的含量则明显下降(191.34±56.28ng/L vs 144.63±54.33ng/L,P<0.05),但仍显著高于对照组(144.63±54.33ng/L vs 64.81±14.33ng/L,P<0.01);治疗3d后病人的血清IL-18的含量则基本恢复致正常水平,与对照组比较则无显著性差异(81.67±37.53ng/L vs 64.81±14.33ng/L,P>0.05)。且危象期患者的血清IL-18的含量与收缩压呈明显的正相关性(r=0.48,P<0.05),但与舒张压之间则无明显的相关性(r=0.24,P>0.05)。血清IL-18的含量随高血压患者的病情危重而升高,血压下降而下降,且与其收缩血压呈明显的正相关性。结论 高血压患者存在免疫功能紊乱,IL-18可能参与了原发性高血压危象的发病机制,检测患者的血清IL-18的含量可能有助于判断患者的病情变化和预后效果。

Objective To explore the clinical significance of the change of serum interleukin-18 (IL-18) level in essential hypertensive crisis. Methods To measure the serum IL-18 level of 40 essential hypertensive crisis patients and the control group of 30 health persons by ELISA, and analyze the correlation of IL-18 level and blood pressure by simple correlation analysis. Results The levels of serum IL-18 of essential hypertensive patients were significantly higher than that of the control group (191.34±56.28ng/L vs 64.81±14.33ng/L, P<0.01); the levels of serum IL-18 of essential hypertensive crisis patients decreased obviously at 12 hours of post-treatment (191.34±56.28ng/L vs 144.63± 54.33ng/L, P<0.05), but still significantly higher than that of the control group(144.63±54.33ng/L vs 64.81± 14.33ng/L, P<0.01). The levels of serum IL-18 of the patients returned to normal range 3 days post-treatment, and there was no significant difference between these patients and the control group (81.67±37.53ng/L vs 64.81± 14.33ng/L, P>0.05). There is a positive correlation between the serum IL-18 level of patients during hypertensive crisis period and the systolic pressure (r=0.48, P<0.05), but it is not statistically correlated to patients' diastolic pressure (r=0.24, P>0.05). The serum IL-18 level of essential hypertensive crisis patients increases along with patients' condition getting worse, and decreases while patients' blood pressure descent. Conclusion There is immunological function disorder in hypertension patients. IL-18 may take part in the pathogenesis of essential hypertensive crisis. Therefore, detection of serum IL-18 levels of essential hyperiensive crisis patients may be useful to predict the patients' prognosis.