动态观察老年慢性肺源性心脏病患者血清IL-18的变化

The Changes of Serum Interleukin 18 Levels in the Patients with Chronic Corpulmonale in the Elder

目的了解老年慢性肺心病患者血清IL-18变化的意义及其与病情的关系。方法采用ELISA方法动态观察了60例老年慢性肺心病患者及20例老年健康对照者血清IL-18含量。结果老年慢性肺心病患者急性加重期及缓解期血清IL-18水平(176.15±30.42)ng/L及(120.33±22.75)ng/L明显高于对照组(64.81±14.33)ng/L,P<0.01);在急性加重期,患者心功能越差,血清IL-18含量越高,心功能Ⅳ级者〔(195.72±37.34)ng/L〕>心功能Ⅲ级者〔(163.32±25.45)ng/L〕>心功能Ⅱ级者〔(104.62±18.89)ng/L〕>对照组(P<0.01)。另外,患者血清IL-18含量与动脉血气中PaO2(5.19±2.73)kPa和pH值(7.28±0.29)均呈显著负相关(r分别为-0.63和-0.58,P<0.01),而与PaCO2(8.32±2.69)kPa呈显著正相关(r=0.73,P<0.01)。结论IL-18可能参与了老年人慢性肺心病的发病过程,测定血清IL-18含量,对评估老年慢性肺心病患者的病情变化及严重程度可能有一定意义,拮抗IL-18的治疗可能有助于缓解患者的病情。

Objective To investingate the potential effect of levels of serum interleukin(IL 18) in chronic cor pulmonale in the elderly. Method The levels of serum IL 18 in 60 elderly patients with chronic corpulmonale and 20 normal elderly were dynamically measured by ELISA. Results Serum IL 18 levels in the elderly patients during acute phase (176.15±30.42)ng/L and in the patients during recovery phase(120.33±22.75)ng/L were significantly higher than those in the normal controls (64.81±14.33)ng/L,respectively (P< 0.01).Meanwhile,the more serious the heart failure, the higher the levels of serum IL 18 in the patients during recovery phase, ie, the serum IL 18 concentrations in the patients with IV degree heart failure [(195.72±37.34)ng/L] >those in the patients with Ⅲ degree heart failure [(163.32±25.45)ng/L] >those in the patients with Ⅱ degree heart failure [(104.62±18.89)ng/L] >those in the normals (P< 0.01).Moreover,there were significantly negative correlations of the levels of serum IL-18 in the patients during acute phase with PaO2(5.19±2.73)kPa and pH(7.82±0.29) in the patients (r=-0.63 and -0.58,P< 0.01,respectively). The levels of serum IL 18, however were positively correlated with PaCO2(8.32±2.69)kPa in the patients (r=0.73,P< 0.01). Conclusion The data suggest that IL 18 may play an important role in the pathogensis of the inflammatory processs of chronic corpulmonale in the elderly patients ,and that measuring the levels of serum IL 18 may be helpful in monitoring the changes of the disease.