血清白细胞介素-18在慢性肾功能衰竭患者中的表达及其意义

目的 观察慢性肾功能衰竭(CRF)患者血清白细胞介素(IL)-18水平的变化及与相关指标的关系,探讨其临床意义.方法 入选的CRF患者60例,分为肾功能衰竭非透析组(肾衰组)18例、血透组22例、腹透组20例.另设正常对照组20例.用EusA方法 检测血清IL-18、肿瘤坏死因子(TNF)-α和超敏C-反应蛋白(hs-CRP)水平,常规实验室方法 检测血清白蛋白(ALB)、TC、TG和血肌酐(SCr),根据简化的肾病饮食改良(MDRD)公式计算肾小球滤过率(GFR).比较各组间的差别.结果 CRF患者的血清IL-18水平在肾衰组(497.7±120.7)ns/L]、血透组(538,1 ±113.2)ns/L]、腹透组(565.7±122.1)ng/L]均较正常对照组(163.9±42.2)ng/L]显著升高(均P<0.01),而腹透组明显高于肾衰组(P<0.05),血透组和肾衰组之间的差异无统计学意义(P>0.05).患者的血清IL-18水平与TNF-α、hs.CRP、SCr呈显著正相关(r值分别为0.636、0.436、0.367,均P<0.01),与GFR呈显著负相关(r=-0.515,P<0.05).结论 CRF患者无论透析还是非透析,其血清IL-18水平均显著升高,并与TNF-α、CRP、GFR等因素有关.因此IL-18可能是CRF患者亚临床炎症的一种标志物.

Expression and significance of interleuldn-18 in patients with chronic renal failure.

Objective To investigate the levels of serum interleukin(IL)-18 in patients with chronic renal failure (CRF)and its relationship with relevant indexes. Methods Sixty patients with CRF were divided into three groups: patients with CRF (CRF group, n = 18) ,patients with bemedialysis (HD group, n = 22) and patients with peritoneal dialysis (PD group,n = 20). 20 healthy subjects were taken as controls. The levels of serum IL-18, tumor necrosis factor (TNF)-α and high sensitivity C-reactive protein (hs-CRP) were detected by means of ELISA. Serum albumin (ALB) ,total cholesterol (TC) ,triglyceride (TG) and serum creatinine (SCr) levels were detected by con-ventional means. The GFR was measured by using the abbreviated Modification of Diet in Renal Disease study (MDRD) equation. Differences in continuous variables between the three groups were evaluated. Results The lev-els of serum IL-18 were significantly increased in CRF(497.7 ± 120.7) ng/L], HD(538.1 ± 113.2) ng/L] and PD(565.7 ± 122.1) ng/L] patients than those in healthy subjects(163.9±42.2) ng/L] (P <0.01). Further-more,serum IL-18 levels in HD patients were higher than these in CRF patients (P <0.05). Serum IL-18 levels in CRF were positively related to serum TNF-α,hs-CRP and SCr(r =0. 636,0.436,0.367,P <0.01) ,and negatively related to GFR(r = -0.515 ,P <0.05). Conclusion The levels of serum IL-18 are markedly increased in patients with CRF,HD and PD,and related to the levels of TNF-α,hs-CRP and GFR,so IL-18 might be an important marker of sub-clinical inflammation in patients with chronic renal failure.