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目的了解老年慢性肺心病患者血清IL-18变化的意义及其与病情的关系。方法采用ELISA方法动态观察了60例老年慢性肺心病患者及20例老年健康对照者血清IL-18含量。结果老年慢性肺心病患者急性加重期及缓解期血清IL-18水平(176.15±30.42)ng/L及(120.33±22.75)ng/L明显高于对照组(64.81±14.33)ng/L,P<0.01);在急性加重期,患者心功能越差,血清IL-18含量越高,心功能Ⅳ级者〔(195.72±37.34)ng/L〕>心功能Ⅲ级者〔(163.32±25.45)ng/L〕>心功能Ⅱ级者〔(104.62±18.89)ng/L〕>对照组(P<0.01)。另外,患者血清IL-18含量与动脉血气中PaO2(5.19±2.73)kPa和pH值(7.28±0.29)均呈显著负相关(r分别为-0.63和-0.58,P<0.01),而与PaCO2(8.32±2.69)kPa呈显著正相关(r=0.73,P<0.01)。结论IL-18可能参与了老年人慢性肺心病的发病过程,测定血清IL-18含量,对评估老年慢性肺心病患者的病情变化及严重程度可能有一定意义,拮抗IL-18的治疗可能有助于缓解患者的病情。
Objective To understand the significance of serum IL-18 in elderly patients with chronic cor pulmonale and its relationship with the disease. Methods The serum levels of IL-18 in 60 elderly patients with chronic cor pulmonale and 20 healthy controls were measured by ELISA. Results The levels of serum IL-18 in acute exacerbation and remission stage in elderly patients with chronic pulmonary heart disease (176.15 ± 30.42ng / L and (120.33 ± 22.75) ng / L were significantly higher than those in control group (64.81 ± 14.33ng / L, P < 0.01). In the acute exacerbation stage, the worse the cardiac function was, the higher the level of serum IL-18, the level of cardiac function grade Ⅳ was (195.72 ± 37.34) ng / L, the grade Ⅲ of cardiac function was (163.32 ± 25.45) ng / L]> cardiac function grade [(104.62 ± 18.89) ng / L〕 control group (P <0.01). In addition, there was a significant negative correlation between serum IL-18 level and arterial blood gas PaO2 (5.19 ± 2.73) kPa and pH value (7.28 ± 0.29) (r = -0.63 and -0.58, respectively, P <0.01) (8.32 ± 2.69) kPa (r = 0.73, P <0.01). Conclusion IL-18 may be involved in the pathogenesis of chronic cor pulmonale in the elderly. Measuring serum IL-18 levels may have some significance in assessing the changes and severity of the disease in elderly patients with chronic cor pulmonale. Antagonism of IL-18 may be helpful To alleviate the patient’s condition.