肾综合征出血热患者血浆白细胞介素-18水平动态变化研究  

Dynamic changes of plasma interleukin-18 level in patients with hemorrhagic fever with renal syndrome

作　　者：王军宁[1] 郭维娟 杜虹[1] 于海涛[1] 蒋伟[1] 白雪帆[1] 王平忠[1] 

机构地区：[1]第四军医大学唐都医院全军感染病诊疗中心,西安710038 [2]长安医院妇产科,西安710018

出　　处：《传染病信息》2015年第1期18-22,共5页Infectious Disease Information

基　　金：国家重大基础理论研究发展(973)计划项目(2012CB-518905);国家自然科学基金(81373118);唐都医院科技创新发展基金重大临床研究项目(2013)

摘　　要：目的检测肾综合征出血热(hemorrhagic fever with renal syndrome,HFRS)患者不同病期及不同临床型外周血中白细胞介素(interleukin,IL)-18浓度的变化,分析其与疾病的相关性,为研究HFRS的发病机制提供依据。方法收集唐都医院2011年10月—2014年1月81例不同临床型HFRS住院患者不同病期血样145份,同时选取15名健康志愿者作为正常对照,用酶联免疫吸附法检测其血浆中IL-18浓度,分析研究IL-18与其他检测指标的相关性。结果 HFRS患者血浆IL-18水平在发热期开始升高,少尿期达高峰,多尿期开始下降,但仍高于正常对照值;血浆IL-18水平在HFRS不同临床型之间都具有类似的变化趋势,急性期高于恢复期及正常对照值,恢复期高于正常对照值,且重型/危重型的变化更为明显。Spearman相关分析表明血浆IL-18水平与WBC和BUN水平呈中等程度正相关,与PLT呈中等程度负相关。结论 HFRS患者血浆IL-18水平与疾病严重程度及疾病进程密切相关,抑制IL-18的分泌可能会减轻机体的免疫病理损伤。Objective To measure the plasma level of interleukin（IL）-18 in patients with different phases and clinical types of hemorrhagic fever with renal syndrome（HFRS）, and to investigate the correlation between IL-18 and the progression of HFRS so as to provide evidence for the study of HFRS pathogenesis. Methods Totally 145 plasma samples were collected from 81 patients with different clinical types and different phases of HFRS, who were hospitalized in Tangdu Hospital from Oct. 2011 to Jan. 2014, and plasma samples from 15 healthy volunteers selected as controls（the control group） were collected as well. The plasma IL-18 level was measured using en-zyme-linked immunosorbent assay, and the correlations between IL-18 and other indicators were analyzed. Results Plasma IL-18 level began to rise at febrile stage of HFRS, reached the peak at oliguria stage, and began to decline at diuresis stage, but still higher than that of the control group. The plasma IL-18 level in patients with different clinical types of HFRS displayed a similar trend, that in patients at acute phase higher than that in patients at convalescent phase and that in the control group, and that in patients at convalescent phase higher than that in the control group, especially in severe/critical patients. Spearman correlation analysis indicated that the IL-18 level was positively correlated with WBC and BUN, and negatively correlated with PLT in HFRS patients. Conclusions Plasma IL-18 level is closely correlated with disease severity and progression in HFRS patients. Inhibition of IL-18 expression may alleviate the immune-mediated pathological injury in HFRS patients.

关 键 词：肾综合征出血热 白细胞介素-18 病人 

分 类 号：R512.8[医药卫生—内科学] R373.3[医药卫生—临床医学]