目的探讨血清中白细胞介素-18(IL-18)及其受体(IL-18R)水平在煤工尘肺(CWP)中的变化及意义。方法采用酶联免疫吸附测定法检测134例CWP患者(CWP组)和68例矽肺患者(矽肺组),具有与CWP组相同接尘条件的57例0+矿工(0+组)和64例健康井下接尘矿工(接尘对照组),50例非接尘井上健康人员(正常对照组)血清中IL-18及IL-18R含量,并根据CWP期别及有无合并症、并发症进行分析。结果与正常对照组比较,接尘对照组血清IL-18水平明显降低(P<0.01);CWP组血清IL-18水平显著高于接尘对照组,IL-18R水平显著高于正常对照、接尘对照和0+组(P<0.01);CWP并发肺结核组血清IL-18R水平显著高于单纯CWP组(P<0.01);与Ⅰ期CWP患者比较,Ⅱ期+Ⅲ期CWP患者血清IL-18R水平明显增高,Ⅰ期矽肺患者血清IL-18和IL-18R水平也均明显增高(均P<0.05);而不同接尘年限CWP和矽肺患者血清IL-18和IL-18R水平比较,差异均无显著性(均P>0.05)。CWP组血清IL-18和IL-18R呈正相关(r=0.230,P<0.01),其他各组两者均无相关性。结论IL-18和IL-18R共同参与CWP的发生发展过程,且可能有助于早期CWP病理分型;IL-18R可能预示CWP的严重程度和病情进展。 Objective To investigate the changes and significance of interleukin-18 (IL-18) and its receptor (IL-18R) in coal worker’s pneumoconiosis (CWP). Methods Totally 134 CWP patients (CWP group) and 68 silicosis patients (silicosis group) were detected by enzyme-linked immunosorbent assay (ELISA), and 57 cases of 0 + miners (0+ group) and 64 healthy The levels of IL-18 and IL-18R in sera of underground dust miners (dust control group) and 50 healthy non-dust wells (normal control group) were analyzed according to CWP stage and with or without complications and complication . Results Compared with the normal control group, serum IL-18 level in the dust control group was significantly lower (P <0.01). The level of IL-18 in CWP group was significantly higher than that in the control group, and IL-18R level was significantly higher than that in the control group (P <0.01). The level of IL-18R in CWP complicated pulmonary tuberculosis group was significantly higher than that in pure CWP group (P <0.01). Compared with stage I CWP patients, the level of IL- 18R and IL-18R levels in patients with stage I silicosis were also significantly increased (all P <0.05), while the level of IL-18 and IL-18R in patients with stage I silicosis were significantly higher No significant (P> 0.05). There was a positive correlation between serum IL-18 and IL-18R in CWP group (r = 0.230, P <0.01), but no correlation was found between the other groups. Conclusion IL-18 and IL-18R are involved in the development and progression of CWP, and may contribute to the early pathological classification of CWP. IL-18R may predict the severity and progression of CWP.