原发性肾病综合征患者血、尿白细胞介素-18水平的检测及其意义

目的　探讨血、尿白细胞介素 18(IL 18)在原发性肾病综合征 (PNS)中的作用 ,了解PNS的发病机理。方法　应用酶联免疫吸附检测 (ELISA )法测定 11例正常人 (对照组 )、2 4例PNS患者血浆和尿液IL 18水平。结果　PNS患者尿液IL 18水平显著高于对照组 ,而血浆IL 18水平与对照组比较 ,差异无显著性。尿IL 18水平与 2 4h尿蛋白排泄量呈正相关 (r =0 .698,P <0 .0 1) ,与血浆白蛋白水平呈负相关 (r =-0 .75 6,P <0 .0 1) ,但尿IL 18水平与血清肌酐水平无相关性 (r =0 .3 2 8,P >0 .0 5 )。结论　IL 18参与PNS的发病过程 ,可能与肾小球滤过膜损伤有关。

Significance of plasma and urinary interleukin-18 determination in patients with primary nephrotic syndrome

Objective To investigate the role of interleukin 18 (IL 18) in patients with primary nephrotic syndrome (PNS) and to further explore the pathogenesis of PNS.Methods Plasma and urinary IL 18 were measured by enzyme linked immunosorbent assay (ELISA) in 11 normal subiects(control group)and 24 patients with PNS.Results Urinary concentrations of IL 18 from patients with PNS were significantly higher than in control group, whereas plasma levels of IL 18 were not statistically different in these two groups. There was a positive correlation between urinary IL 18 concentrations and 24 hour urinary protein quantity in patients with PNS. A very close correlation was also found between urinary IL 18 concentrations and plasma albumin levels. No significant correlation was found between urinary IL 18 levels and sera creatinine levels.Conclusion IL 18 involves in pathogenesis of renal lesion of PNS. The immunity disorder and inflammatory reaction in PNS may only localized within the kidneys, at least in the early phase of this disease,so it would be a good idea to treat PNS through local ways.