白细胞介素18在体外循环手术后急性肺损伤中的作用宋仁举1李明亮2卢平方1程可洛2(通讯作者)(1广东医学院广东湛江524023)(2广东医学院附属医院广东湛江524000)【摘要】目的：探讨体外循环手术后患者血浆及支气管肺泡灌洗液(Bronchoalveolarlavagefluid,BALF)中白细胞介素18(interleukin-18,IL-18)的变化及其在急性肺损伤中的作用。方法：选择2014年3月至2015年6月在广东医学院附属医院行体外循环手术的50例患者为研究对象。根据术后是否发生急性肺损伤(Acutelunginjury,AU),将50例患者分为两组，ALI组：16例，男9例、女7例；对照组：34例，男19例、女15例，术后未发生ALI。分别在体外循环术前、术后lh、6h、12h、24h、48h采用酶联免疫吸附测定法检测患者血浆及BALF中IL-18水平表达，同时在上述各时间点测定动脉血气，并计算呼吸指数、氧合指数2种肺功能指标。结果：两组患者术前血清及BALF中IL-18无明显差异，术lh开始，血清及BALF中IL-18开始升高，术12h达高峰，持续至术后48h以上，术后各时间ALI组显著高于对照组。ALI组术后lh开始血浆IL-18水平高于BALF,对照组6h开始出现血浆IL-18水平高于BALF。两组患者手术后氧合指数较术前水平均显著降低，术后6h后AU组低于对照组。两组患者术后呼吸指数较术前升高，术后6h后AU组显著高于对照组，以上差异均具有统计学意义(P<0.05)o结论：体外循环术后IL-18在血清及BALF中表达水平增加并参与急性肺组织损伤过程，其水平表达高低与体外循环肺损伤程度密切相关。【关键词】体外循环；急性肺损伤；白细胞介素18【】R619【文献标识码】A【】2095-1752(2016)14-0213-03EffectofInterleukin-18onAcuteLungInjuryinpatientsaftersurgerywith---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---ExtracorporealCirculationSongRenju,LiMingliang,LuPingfang,ChengKeluo(1GuangdongMedicalCollege,Zhan激ang524000,Guangdong,P.R.China,2AffiliatedHospitalofGuangdongMedicalCollege,Zhan激ang524000,Guangdong,P.R.China)【Abstract】ObjectiveToinvestigatethechangesandtheclinicalsignificanceofinterleukin-18(IL-18)inpatientsaftersurgerywithextracorporealcirculation(ECC)atzheplasmaandbronchoalveolarlavagefluid(BALF).MethodsFiftypatientsundergoingsurgerywithECCintheAffiliatedHospitalofGuangdongMedicalCollegefromMarch2014toJune2015wereenrolledinthisstudy.Accordingtothepresenceofpostoperativeacutelunginjury/respiratorydistresssyndrome(AU/ARDS),allthefiftypatientsweredividedinto2groups.InALIgroup，therewere16patientsincluding9maleand7femalepatients.Inthecontrolgroup,therewere34patientswithoutpostoperativeALI，including19maleand15femalepatients.DynamicvariationsincludingchangesofIL-18andbloodgas?analysisofthesepatientswereexaminedwithenzyme-linkedimmunosorbentassayandcomparedbetweenthe2groups.ResultsInbothgroup，therewasnosignificantdifferenceof?IL-8betweenplasmaandBALF.IL-18inbothplasmaandBALFincreasedat1houraftersurgery(P<0.05)andreachedpeaklevelsat12hoursaftersurgeryandremainedforthenext36hours.ThelevelofIL-8inALI/ARDSgroupwashigherthanthatinthecontrolgroup(P<0.05).InALI/ARDSgroup,thelevelofIL-18inplasmawashigherthanthatinBALFat1houraftersurgery(P<0.05).Inthecontrolgroup,thelevelofIL-18inplasmawashigherthanthatinBALFat6hoursaftersurgery(P<0.05).Oxygenationindexofbothgroupsdecreasedsignificantlyaftersurgery(P<0.05)andoxygenationindexofALI/ARDSgroupwassmallerthanthatofthecontrolgroupat6hoursaftersurgery(P<0.05).Postoperativerespiratoryindexofbothgroupsincreased(P<0.05)andrespiratoryindexofALI/---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---ARDSgroupwaslargerthanthecontrolgroup(P<0.05).ConclusionIL-18inplasmaandBALFchangesignificantlyaftersurger...