原发性肾病综合征患儿血尿IL-6和TNF-α含量变化及意义

Fluctuation of IL-6 and TNF-α contents in blood and urine and their clinical significance in patients with primary nephritic syndrome

目的 探讨白细胞介素 - 6 (IL - 6 )、肿瘤坏死因子 -α(TNF -α)含量变化在原发性肾病综合征 (PNS)中的临床意义。方法 应用酶联免疫技术对 49例PNS活动期患儿血尿IL - 6、TNF -α含量进行检测 ,并对其中 39例缓解期患儿血和尿中IL - 6、TNF -α等指标进行了复查。比较单纯型肾病与肾炎型肾病活动期和缓解期血尿IL - 6、TNF -α含量变化。结果 PNS活动期无论肾炎型肾病还是单纯型肾病 ,血和尿IL - 6、TNF -α含量均显著高于正常对照组。单纯型肾病组与肾炎型肾病组相比 ,血尿IL - 6含量无显著差异 (P >0 .0 5 ) ,而血尿TNF -α含量两组间差异明显 (P <0 .0 1)。PNS缓解期单纯型肾病组和肾炎型肾病组血和尿中IL - 6、TNF -α含量均较活动期显著下降 (P <0 .0 1) ,但肾炎型肾病组血尿IL- 6、TNF -α含量与单纯型肾病相比仍显著增高 (P <0 .0 1)。结论 血和尿IL - 6、TNF -α含量变化可作为判断PNS病变活动和估计预后的一项参考指标。血和尿TNF -α含量变化对临床上鉴别单纯型肾病与肾炎型肾病有一定帮助。

Objective To explore the clinical significance of changes of IL-6 and TNF-α in blood and urine in patients with primary nephritic syndrome(PNS). Methods The contents of IL-6 and TNF-α in serum and urine in 49 active stage PNS and 39 PNS patients in remission stage were examined by ELISA. Results In PNS active stage, the levels of IL-6 and TNF-α in serum and urine in the patients with simple or nephritis type of PNS were significantly higher than those in the normal controls (P<0.01). The levels of TNF-α in serum and urine of the patients with nephritis of PNS in two groups showed a statistically difference(P<0.01),but no difference for IL-6 in two groups of PNS(P>0.05).The consistency of IL-6, TNF-α in blood and urine in the patients with two types of PNS in remission stage were notebling lower than those in the patients in active stage(P<0.01), but levels of IL-6 and TNF-α in blood and urine in the patients with simple PNS was remarkeably higher than that of PNS patients with nephritis (P<0.01). Conclusions It is a referring index for judged the activity of PNS and estimated prognosis that changes of contents of IL-6 and TNF-α in blood and urine. The changing of levels of TNF-α in blood and urine is helpful to distinguish the type of PNS.