阻塞性黄疸血浆IL-18的变化及其意义  

Significance of Plasma Interleukin-18 Levels in Obstructive Jaundice

作　　者：房林[1] 孟洪波[1] 郑立君[1] 贺健[1] 徐蕾[1] 毛煜侃[1] 

机构地区：[1]同济大学附属第十人民医院普外科,上海200072

出　　处：《同济大学学报（医学版）》2005年第5期29-33,共5页Journal of Tongji University(Medical Science)

基　　金：国家自然科学基金资助项目(30370650)

摘　　要：目的 探讨阻塞性黄疸血浆1L-18的变化及其临床意义。方法 37例阻塞性黄疸患者(良性阻塞性黄疸25 例,恶性12例);低胆红素组21例,高胆红素组16例;其中22例进行减黄手术,并作术前术后自身对照。16例总胆 红素正常择期手术患者作对照。分别抽血测定:谷丙转氨酶、总胆红素、碱性磷酸酶、谷氨酰转肽酶、白蛋白、前白蛋 白、转铁蛋白、C反应蛋白、IL-18等。结果 良性阻塞性黄疸组、恶性阻塞性黄疸组、低胆红素组、高胆红素组、术前 组和术后组的C反应蛋白和IL-18等较正常组升高,白蛋白、前白蛋白、转铁蛋白较正常组降低。术后组的C反应 蛋白和IL-18等较术前组升高。结论 阻塞性黄疽患者IL-18水平升高具有重要意义,可能参与内毒素引起的肝功 能损害,同时IL-18也可能作为一种急性期反应物,对判断疾病的严重程度有一定意义。Objective To study the changes of plasma interleukin-18 and its clinical slgnlncance in acute obstructive jaundice. Methods ① Thirty-seven patients with obstructive jaundice （ twenty-five patients with benign obstructive jaundice, twelve patients malignant） were enrolled in the study. ② These patients were still divided into severe obstructive jaundice group （twenty-one patients） and mild obstructive jaundice group （sixteen patients）. ③Among the twenty-two patients operated, preoperative plasma samples and postoperative plasma samples were compared. Sixteen patients （with normal serum bilirubin） were taken as control group. The levels of interleukin-18, C-reactive protein, transferrin, and prealbumin in plasma were measured. Results The levels of plasma interleukin-18 and C-reactive protein rose in obstructive jaundice group. The levels of plasma transferrin, and prealbumin decreased in obstructive jaundice group. The levels of plasma interleukin-18 and C-reactive protein in postoperative group were higher than that in preoperative group. The levels of plasma transferrin,and prealbumin in postoperative group were lower than that in preoperative group. The levels of interleukin-18 was positively correlated with C-reactive protein and negatively correlated with transferrin and prealbumin. Conclusion Interleukin-18 may be an indicator for evaluating the severity and the prognosis of obstructive jaundice. It may also play an important role in liver function damage caused by endotoxin.

关 键 词：阻塞性黄疽 IL-18 C反应蛋白 前白蛋白 急性期反应蛋白 

分 类 号：R656[医药卫生—外科学]