血浆白细胞介素18对老年慢性心力衰竭诊断及预后判断的作用  

Plasma level of interleukin 18 as a prognostic predictor in elderly patients with chronic heart failure

作　　者：郭美姿[1] 王春[1] 刘燕[1] 杜昌兰[1] 杨立[1] 黄明敏[1] 杨海燕[1] 陈晓琳[1] 

机构地区：[1]南京大学医学院附属鼓楼医院老年科,南京210008

出　　处：《中华老年心脑血管病杂志》2009年第5期324-326,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：南京市医学科技发展项目(ZKX05017)

摘　　要：目的探讨血浆白细胞介素18(IL-18)对老年慢性心力衰竭(心衰)诊断及预后判断的作用。方法选择老年慢性心衰患者69例(心衰组)和同期健康体检老年人20例(对照组),采用ELISA法测定血浆IL-18、脑钠素(BNP)水平;用心功能分级(NYHA)标准对69例老年心衰患者的心功能进行分级,其中NYHAⅡ级22例,Ⅲ级27例,Ⅳ级20例。超声心动图测定LVEF。结果与对照组比较,心衰组患者血浆IL-18、BNP水平明显升高,LVEF明显降低,差异有统计学意义(P<0.01);与NYHAⅡ级比较,NYHAⅢ级和NYHAⅣ级患者血浆IL-18、BNP水平明显升高(P<0.01),LVEF明显降低(P<0.01);与NYHAⅢ级比较,NYHAⅣ级患者血浆IL-18、BNP水平明显升高(P<0.05,P<0.01)。心衰组患者血浆IL-18与BNP水平和NYHA分级呈正相关(r=0.689,P<0.01;r=0.730,P<0.01),与LVEF呈负相关(r=-0.598,P<0.01)。结论老年慢性心衰患者血浆IL-18水平明显升高,且与BNP、NYHA分级和LVEF具有较好的相关性。联合检测老年慢性心衰患者血浆IL-18、BNP水平有助于心衰诊断及判断预后。Objective To evaluate the role of plasma level of interleukin 18（IL-18） in diagnosis and predicting prognosis of elderly patients with chronic heart failure（CHF）. Methods The plasma levels of IL-18 and brain natriuretic peptide（BNP） were measured in 69 patients with CHF and 20 normal controls by enzyme-linked immunosorbent assay. Meanwhile, the cardiac function was assessed by NYHA standard and electrocardiogram. Results Plasma levels of IL-18 and BNP in patients with CHF were apparently higher than those in normal controls, the difference between two groups was statistically significant. With the increase in NYHA grade and progress of disease, the plasma levels of IL-18 and BNP significantly increased. Plasma levels of IL-18 and BNP in different NYHA grades had statistically significant difference. There was significant positive correlation between plasma IL-18 and BNP and NYHA grade. Reversely, there was a significant negative correlation between plasma IL-18 and left ventricular ejection fraction. By plotting the receiver operating characteristic curve,the area under the curve of IL-18 was 0. 916. Conclusions The plasma level of IL-18 increased with severity of CHF. There were good correlations among IL-18 and BNP,NYHA and LVEF. Combined levels of IL-18 and BNP help to make diagnosis and predict prognosis for elderly patients with chronic heart failure.

关 键 词：心力衰竭 充血性 白细胞介素18 利钠肽 脑 超声心动描记术 预后 

分 类 号：R541.6[医药卫生—心血管疾病]