阻塞性黄疸手术前后白介素-18的变化及其与免疫的关系

目的探讨阻塞性黄疸手术前、后白介素(IL)-18的变化及其与免疫的关系。方法选择22例进行有效减黄手术的阻塞性黄疸患者(研究组)和14例无黄疸择期手术患者(对照组)。于入院后第2天及术后3 d抽血检测总胆红素、白蛋白、球蛋白、免疫球蛋白(Ig)G、IgA、IgM、血清总补体活性(CH50)、补体(C)3、C4及IL-18水平。结果研究组术前IL-18和IgA分别为(369．60±96．57)μg／L和(2 975．38±1 613．34)mg／L,显著高于对照组[(219．49±80．52)μg／L和(1 803．33±866．88)mg／L,P值分别d0．01和0．05];IgG和CH50分别为(14．86±5．47)g／L和(68．47±16．13)kU／L,显著低于对照组[(23．79±11．65)g／L和(99．74±38．37)kU／L,P值分别<0．01和0．05]。研究组术后IL-18为(544．22±185．84)μg／L,显著高于术前(P<0．01);IgG、CH50、C3和C4分别为(11．29±6．50)g／L、(53．53±14．39)kU／L、(1008．67±322．66)mg／L和(205．00±122．02)mg／L,显著低于术前(P值分别<0．05或0．01)。IgG、CH50及C3与IL-18呈负相关(r值分别=-0．514、-0．361和-0．363,P值分别<0．05或0．01)。结论阻塞性黄疸患者手术前、后IL-18发生明显变化,并且与IgG、CH50、C3呈负相关,IL-18可能对机体的免疫功能产生一定影响。

Pre-and postoperative changes of plasma interleukin-18 in patients with obstructive jaundice

Objective To appraise the pre-and postoperative changes of plasma interleukin-18, immunoglobulin, and complements in patients with obstructive jaundice and their relationships. Methods Twenty-two patients with obstructive jaundice were operated and taken as the operative group. Their pre-and postoperative plasma samples were detected for the levels of interleukin-18, immunoglobulin G(IgG), IgA, IgM, complement C3, C4, CH50 were also detected. Fourteen patients with normal serum bilirubin were taken as the control group and the results of the two groups were compared. Results The level of postoperative plasma interleukin-18 was higher than the preoperative level, but the levels of postoperative plasma IgG, CH50, C3, C4 were lower. The levels of interleukin-18 were negatively correlated with IgG, CH50, C3, but with no relationship with C4. Conclusion Operation may affect plasma interleukin-18 level in patients with obstructive jaundice, showing negative correlation with IgG, CH50, C3. Interleukin-18 may pose more influence on immune function of these patients.