不同干预措施对急性冠脉综合征患者血清中白细胞介素-18浓度的影响

目的探讨急性冠脉综合征（ACS）患者在不同干预措施下，血清中自细胞介素-18（IL-18）浓度的变化及临床意义。方法63例ACS患者分为3个不同干预组：急诊经皮冠状动脉介入治疗（PCI）组15例、溶栓再通组12例及药物组36例，同时设立对照组20例，用酶联免疫吸附法（ELISA）测定ACS患者入院时，治疗24、72h及7d血IL-18水平。结果63例ACS患者入院时IL-18水平显著升高，与对照组比较差异有极显著性意义（P〈0．01）；24h IL-18浓度达峰值，此时，3个不同干预组间比较差异无显著性意义（P〉0．05）；72h后3个不同干预组IL-18浓度开始下降，治疗7d时，急诊PCI组下降最快，溶栓再通组次之，而药物组IL-18浓度与入院时比较差异无显著性意义（P〉0．05）。结论IL-18可能可以作为评价ACS患者治疗疗效及预测预后的临床观察指标。

Influence of Different Treatments on Serum Interleukin-18 Levels in Patients with Acute Coronary Syndrome

Objective To investigate the effects of different treatments on serum interleukin-18(IL-18) levels in patients with acute coronary syndrome(ACS) and the clinical significance.Methods Sixty-three patients who underwent ACS were divided into 3 groups receiving different treatments: emergent percutaneoua coronary intervention group(PCI group,n=15),intravenous thrombolytic therapy group(n=12),medicine treatment group(n=36) and the control group(n=20).Enzyme linked immunosorbent assay(ELISA) was used to detect the level of serum IL-18 on admission,and 24 h,72 h and 7 days after treatments.Results Compared with control group,the serum IL-18 level was obviously increased in patients with ACS on admission(P<0.01).There was no significant difference in peak level of IL-18 at 24th h among the three groups(P>0.05).Seventy-two h after treatment,the serum IL-18 levels were started to decrease in the 3 groups.On the 7th day after treatment,the serum IL-18 level in the PCI group was decreased most quickly,followed by the intravenous thrombolytic therapy group,but there was no significant difference in medicine treatment group from that on admission(P>0.05).Conclusion The IL-18 may be used as one of the sensitive clinical reference markers to evaluate the effectiveness and prognosis of the patients with ACS.