The Clinical Significance Of The Change Of IL-18 In Chronic Severe Hepatitis Accepting Plasma Exchange

Object:Study the clinical significance of the change of the serum IL-18 in assessing prognosis of severe hepatisis by investigating IL-18 levels,TBIL,DBIL,CHE,ALB,ALT,PTA and clinical appearance of pantients with severe hepatitis accepting plasma exchangesMethods:The pantients with severe hepatitis were randomly divided into two groups:the therapeutic group(twenty-two patients)and controlled group(eighteen patients).The former group was operated by plasma exchange combined with basic therapy;The latter group was only accepted basic treatment.The levels of IL-18 in serum and hepatic function were detected before and after treating.Results:After plasma exchange the total of IL-18,TBIL and DBIL decreased,the serum levels of ALB, CHE and PTA increased;Comparing the total of IL-18,TBIL and DBIL before and after plasma exchanging,P﹤0.05.The relation of the decrease of IL-18 and the decrease of TBIL ,DBIL was positive mutuality,r﹦0.640, r﹦0.565;and the relation of decrease of IL-18 and the change of PTA was negative mutuality, r﹦-0.464. The total of ALT didn't change significantly before and after treament. The serum levels of IL-18, TBIL and DBIL in controlled group decreased ,comparing the levels before therapy, P﹤0.05;The serum levels of ALB, CHE and PTA increased,but comparing the total of ALB,CHE and PTA before and after therapy,P>0.05. The levels of IL-18 decreased with the increase of times of plasma exchange.Conclusions:1 IL-18 participate in liver damages and developments of severe hepatitis; The serum level of IL-18 is one of prognostic idioms of severe hepatitis,IL-18 affected progress of disease and played an important role in pathological damages. If we combine IL-18 with PTA in severe hepatitic patients, we could more accurately judge pathogenetic condition and prognosis.2 The decreased serum level of IL-18 is responsible for better of the hepatic function and clinical appearance of severe hepatitis. Artificial Liversupport treatment (plasma exchange) can decrease the serum level of IL-18 and alleviate liver damage involved by interleukins.It indicates that plasma exchange could make internal environment stable, avoid liver from the second strike and do good to liver regeneration.It suggested that plasma exchange was a better means for treatment of severe hepatitis.