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  

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

作　　者：张桦[1] 贾宁[1] 林琳[1] 郭军利[1] 周文英[2] 张慧涛[1] 汪悠悠[1] 

机构地区：[1]中山大学附属第五医院肾内科,广东省珠海市519000 [2]中山大学附属第五医院中心实验室,广东省珠海市519000

出　　处：《中国综合临床》2008年第11期1078-1080,共3页Clinical Medicine of China

基　　金：广东省医学科研基金立项课题（A2003254）

摘　　要：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ELISA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）ng／L]、血透组[（538．1±113．2）ng／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。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 hemodialysis （ 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 conventional 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 levels 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 ）. Furthermore,serum IL-18 levels in HD patients were higher than those 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.

关 键 词：慢性肾功能衰竭 白细胞介素-18 血液透析 腹膜透析 

分 类 号：R692.5[医药卫生—泌尿科学]