原发性膜性肾病患者血清IL-6与尿蛋白水平的相关性及其与中医证型关系的探讨

Correlation Between Serum Interleukin-6 and Urine Protein Levels in Patients with Primary Membranous Nephropathy and Relationship with Traditional Chinese Medicine Syndrome Patterns

目的:探究细胞因子与原发性膜性肾病(primary membranous nephropathy,PMN)患者尿蛋白、中医证型及预后的关系。方法:本研究为前瞻性研究,纳入2021年06月—2022年3月在中日友好医院行肾活检诊断为PMN的患者81例作为疾病组,另纳入健康人群22例为对照组。测量治疗前所有患者血清IL-6、IL-17的水平,并对疾病组进行中医辨证分型及长期随访。运用SPSS 26.0进行数据分析。结果:疾病组血清IL-6水平明显高于对照组(P<0.001),且其IL-6水平与尿蛋白存在相关性。两组在血清IL-17水平上未表现出明显差异。在中医证型上,IL-6升高组以脾肾阳虚证和血瘀证为多见,IL-6正常组多为气虚证。预后方面,相比于IL-6正常组,IL-6升高组的临床缓解率低,达到中位缓解的时间长。结论:PMN患者存在微炎症状态,血清IL-6水平与尿蛋白水平、中医证型及预后显著相关。

Objective:To investigate the relationship between cytokines and urine protein levels,Traditional Chinese Medicine syndrome patterns and prognosis in primary membranous nephropathy(PMN).Methods:This is a prospective study.Eighty-one patients with PMN confirmed by renal biopsy at China-Japan Friendship Hospital from June 2021 to March 2022 were included in the disease group and another 22 cases were included in the healthy population as a control group.Serum interleukin-6 and interleukin-17 levels were measured in all patients before treatment,and the disease group was subjected to Traditional Chinese Medicine syndromes classification and long-term follow-up.SPSS 26.0 was used for data analysis.Results:Serum interleukin-6 levels were significantly higher in the disease group than in the control group(P<0.001)and there was a correlation between interleukin-6 levels and urine protein.The two groups did not show significant differences in serum interleukin-17 levels.In terms of Traditional Chinese Medicine syndrome patterns,the elevated interleukin-6 group was more common in the Spleen-kidney Yang deficiency syndrome and Blood stasis syndrome,while the normal interleukin-6 group was more common in the Qi deficiency syndrome.Prognostically,the interleukin-6 elevated group had a lower rate of clinical remission and a longer time to achieve median remission compared to the interleukin-6 normal group.Conclusion:PMN patients had a micro-inflammatory state.Serum interleukin-6 levels correlated with urine protein levels,Traditional Chinese Medicine syndrome patterns,and prognosis.