Significance of Change of Serum Interleukin-18 in Children with Severe Enterovirus 71 Infection

Objective To explore the changes of serum interleukin-18(IL-18) in severe cases with enterovirus 71(EV71) infection and its significance.Methods Forty-eight severe cases with EV71 infection were selected.The patients were divided into 3 groups accor-ding to the extent of severity of EV71 infection:central nervous system disease(CNSD) group(n=20),autonomic nervous system dysregulation(ANSD)group(n=23),and pulmonary edema(PE) group(n=5),and 15 healthy children were selected as healthy control group(NC group).The patients in ANSD group and PE group accepted mechanical ventilation support.The levels of serum IL-18 of patients in 3 groups were measured soon after admission to the hospital.The levels of serum IL-18 of patients in ANSD group and PE group were measured respectively on the 1st day,the 2nd day,and the 4th day after the mechanical ventilation.The level of serum IL-18 were measured by enzyme-linked inmunosorbent assay method.Results 1.The levels of serum IL-18 in PE group were extremely higher than those in ANSD group,CNSD group and NC group,and the differences were significant.There was no significant difference among other groups.2.The serum levels of IL-18 of patients of PE group and ANSD group gradually decreased with the alleviation of disease.In PE group,the serum levels of IL-18 on the 1st day were higher than those on the 2nd day and the 4th day after the mechanical ventilation(Pa0.005),and the serum levels of IL-18 on the 2nd day were higher than those on the 4th day after the mechanical ventilation(P0.05).In ANSD group,the serum levels of IL-18 on the 1st day were higher than those on the 2nd day and the 4th day after the mechanical ventilation(Pa0.005).And the serum levels of IL-18 on the 2nd day were higher than those on the 4th day after the mechanical ventilation(P0.05).Conclusions IL-18 can play an important role in the pathogenesis of EV71 infection and is closely associated with PE.Dynamic assay of serum IL-18 levels in patients with EV71 infection may facilitate the evaluation of severity and prognosis of the disease.