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目的:检测慢性心力衰竭患者(CHF)外周血白细胞介素(IL)-12和IL-18的水平并探讨其意义。方法:CHF患者72例,按照NYHA心功能分级,分为HF1组(NYHAⅡ~Ⅲ级),HF2组(NYHAⅣ级)。按照病因分类,分为缺血性心脏病(IHD)组(43例)和非缺血性心脏病(NIHD)组(29例)。选取29例健康志愿者作为正常对照组(C组)。采用双抗体夹心酶联免疫吸附法(ELISA)检测血清中IL-12和IL-18的水平,用彩色多普勒超声诊断仪测定左室舒张末期内径(LVEDd)和左室射血分数(LVEF)。结果:HF1、HF2、IHD和NIHD组IL-12的水平显著升高,分别为(34.56±19.10),(35.12±15.18),(31.18±7.80),(32.73±11.54)ng/L,与C组(28.73±13.43)ng/L比较,均差异有统计学意义(P<0.05),IL-18的水平分别为(39.50±5.66),(46.76±12.66),(40.58±13.10),(42.53±6.16)ng/L,明显高于C组(31.82±5.79)ng/L,均差异有统计学意义(P<0.05或P<0.01),HF2组血清IL-18水平显著高于HF1组(P<0.05)。与C组比较,HF1、HF2、IHD和NIHD组的LVEDd明显增大,LVEF显著降低。IL-12水平与LVEDd呈低度正相关(P<0.01),IL-18水平与LVEDd呈中度正相关(P<0.01),与LVEF呈中度负相关。结论:IL-12和IL-18在CHF患者血清中表达升高;IL-12的水平与患者基础病因和心功能均无明显相关性;IL-18的水平与CHF的基础病因无明显相关性,但与患者的CHF程度呈正相关。
Objective: To detect the levels of interleukin (IL) -12 and IL-18 in peripheral blood of patients with chronic heart failure (CHF) and to explore its significance. Methods: Seventy - two CHF patients were divided into three groups: NYHA class Ⅱ (NYHA Ⅱ ~ Ⅲ) and NYHA Ⅳ class (HF2) according to NYHA functional class. According to the etiological classification, the patients were divided into two groups: ischemic heart disease (IHD) group (43 cases) and non-ischemic heart disease (NIHD group) (29 cases). Twenty-nine healthy volunteers were selected as normal control group (C group). The levels of IL-12 and IL-18 in serum were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA), the left ventricular end-diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF) were measured by color Doppler sonography ). Results: The levels of IL-12 in HF1, HF2, IHD and NIHD groups were significantly increased (34.56 ± 19.10, 35.12 ± 15.18, 31.18 ± 7.80, 32.73 ± 11.54 ng / L, The levels of IL-18 were (39.50 ± 5.66), (46.76 ± 12.66), (40.58 ± 13.10) and (42.53) in the control group (28.73 ± 13.43 ng / L, P <0.05) ± 6.16) ng / L, which was significantly higher than that of C group (31.82 ± 5.79) ng / L (P <0.05 or P <0.01). The level of IL-18 in HF2 group was significantly higher than that in HF1 group P <0.05). Compared with group C, the LVEDd of HF1, HF2, IHD and NIHD group increased significantly and LVEF decreased significantly. There was a low positive correlation between IL-12 level and LVEDd (P <0.01). IL-18 level had a moderate positive correlation with LVEDd (P <0.01) and a moderate negative correlation with LVEF. Conclusions: The expression of IL-12 and IL-18 in sera of patients with CHF increased; the level of IL-12 had no significant correlation with the underlying etiology and cardiac function; the level of IL-18 had no significant correlation with the underlying etiology of CHF , But positively correlated with the degree of CHF in patients.