同种异基因造血干细胞移植受者血清白介素18水平与急性移植物抗宿主病的关系论文.docVIP

　　同种异基因造血干细胞移植受者血清白介素18水平与急性移植物抗宿主病的关系论文 【摘要】 本研究探讨同种异基因造血干细胞移植(alloHSCT)受者血清白介素18(IL18)与急性移植物抗宿主病(aGVHD)的关系，查明血清IL18在aGVHD发病中的作用，为临床早期预测aGVHD提供可靠指标。采用双夹心酶联免疫吸附法(ELISA)检测62例alloHSCT患者移植前及移植后aGVHD发生前后血清IL18表达水平。62例患者被分为5组：A组为无aGVHD移植前组（28例），指移植后没有发生aGVHD的患者在移植前收集的标本;B组为有aGVHD移植前组（34例）, 指移植后发生aGVHD的患者在移植前收集的标本;C组为aGVHD症状前组（34例）, 指临床出现I-II级aGVHD症状前3-4天的标本；然后根据I-II级aGVHD患者治疗后，有无进展至III-IV级回顾性地将aGVHD前组患者分为疗效好组（18例）和疗效差组（16例）;D组为I-II级 aGVHD组；E组为III-IV级aGVHD组（16例）。结果表明： 34例患者发生I-II级aGVHD，其中16例aGVHD进展至III-IV级；发生aGVHD患者的血清IL18表达水平显著高于未发生aGVHD患者, 血清IL18表达水平上升发生在aGVHD临床症状出现前3天左右；血清IL18表达水平与aGVHD的严重程度呈正相关,与HLA配型、预处理方案及感染无关；aGVHD早期血清IL18表达水平与预后相关；血清IL18高表达者aGVHD容易进展至IIIIV级。结论： 血清IL18 与aGVHD的发病相关联,检测血清IL18 水平有助于aGVHD早期诊断，血清IL18表达水平可作为评估aGVHD病情、判断预后的指标。 【关键词】 同种异基因造血干细胞移植 白介素18 急性移植物抗宿主病 早期预测 Correlation bet Levels of IL18 and Acute Graft Versus Host Disease in Patients after Allogeneic Hematopoietic Stem Cell Transplantation Abstract This study ed to investigate the correlation bet levels of IL18 and acute graft versus host disease (aGVHD) in patients received allogeneic hematopoietic stem cell transplantation (alloHSCT)， and to explore the role of serum IL18 levels in the pathogenesis of aGVHD so as to provide a reliable and early indicator for the diagnosis of aGVHD. 62 patients received alloHSCT levels of IL18 en en en ent, these patients 16 patients (16/34) developed III-IV grade aGVHD. The serum levels of IL18 in these patients levels of IL18 started to increase. The serum levels of IL18 ens and disparity of HLAtyping. The serum levels of IL18 in the early stage of aGVHD levels of IL18 easy developed to IIIIV grade aGVHD. It is concluded that the serum level of IL18 in the patients received alloHSCT is related to the occurrence of aGVHD. Detections of serum IL18 are helpful for the early diagnosis of aGVHD, and the serum levels of IL18 may be considered as a reliable indicator to evaluate the prognosis and severity of aGVHD. Key atopoie