急性白血病患儿血清白细胞介素-18表达的临床意义

 目的　分析儿童急性白血病（AL）血清白细胞介素-18（IL-18）表达的临床意义。方法　采用ELISA法检测儿童AL患者血清中IL-18在化疗前后的水平。结果　AL未治组IL-18表达水平为（719.35±358.21）pg／ml，对照组为（311.80±146.64）pg／ml，差异有统计学意义（P＜0.01）；化疗后完全缓解组IL-18为（401.14±180.78）pg／ml，低于化疗前（P＜0.01）；未缓解组血清IL-18为（813.40±203.24）pg／ml，高于对照组和CR组（P＜0.01），与未治组差异无统计学意义（P＞0.05）。高危组IL-18为（878.64±405.86）pg／ml、中危组为（767.95±341.61）pg／ml，均高于低危组（P＜0.05）； IL-18在T-ALL为（1015.78±329.17）pg／ml，高于B-ALL（537.28±261.99）pg／ml（P＜0.05）。AL患者IL-18水平与骨髓幼稚细胞数呈正相关（r＝0.411，P＝0.005）。结论　儿童 AL患者IL-18高表达，并与骨髓幼稚细胞数、疗效相关，对疗效判断有意义，儿童AL患者血清IL-18水平与临床高危险因素相关。

Expression and clinical significance of serum interleukin-18 in children with acute leukemia

Objective To detect the change of interleukin-18 (IL-18) level in the serum of patients with acute leukemia (AL) in children, and explore the clinical significance of IL-18. Methods The level of IL-18 was measured by sandwich enzyme-linked immuno-sorbent assay (ELISA) in 45 patients with AL in children. Results The leverof IL-18 in pre-treatment AL group was 719.35±358.21pg/mL and significantly higher than that of normal-control group [(311.80±146.64)pg/mL P <0.01]. Mter treatment, the level of IL-18 was 401.14±180.78 pg/mL in post-treatment complete remission group, which was significantly lower than that of pre-treatment group(P <0.01). The level of IL-18 in non-remission group was higher than those of normal control and CR group (P<0.01);while pre-treatment group the difference was not significant (P >0.05). According to the clinical sub-group with risk factors in pre-treatment AL, the level of IL-18 in high risk(HR) and middle risk(MR) group was significantly higher than low risk(LR) group (P<0.05). The level of IL-18 in T-ALL group was significantly higher than that in B-ALL group (P<0.05). The levels of IL-18 in pre-treatment AL were markedly correlated to the count of blast cells in bone marrow (r=0.411, P=0.005). Conclusion The level of IL-18 in the patients of childhood AL was in a high expression, and related to the clinical treating effect and the count of blast cells in bone marrow, which would be taken as an index of treating effect. The level of IL-18 was closely related to the clinical risk factors in pre-treatment AL.