雷公藤多苷对系膜增生性肾炎患者肿瘤坏死因子水平的影响

Effect of poly glycosides of Tripterygium wilfordii Hook on TNF α level in patients with mesangioproliferative glomerulonephritis

目的 观察系膜增生性肾炎 (MsPGN)患者应用雷公藤多苷前后血、尿TNFα变化。方法 检测了 80例MsPGN患者雷公藤多苷治疗前及用雷公藤多苷后 3,6 ,10周血、尿TNFα变化 ,并与 2 0例正常人血、尿TNFα进行比较。结果 MsPGN患者 80例治疗前血、尿TNFα明显增高 [血正常 (6 7± 2 1)kU/L ,MsPGN(4 4 2± 35 2 )kU/L ,尿正常 0MsPGN (2 18± 136 )kU/L ,P <0 .0 1],雷公藤多苷治疗后 6 0例患者显效 ,2 0例无效 ,显效率为 75 %。显效者血、尿TNFα早期即开始下降 [血治疗前 (4 4 2± 35 2 )kU/L ,治疗后 (2 89± 176 )kU/L ,尿治疗前 (2 18± 136 )kU/L ,治疗后 (10 6± 70 )kU/L ,P <0 .0 1],而雷公藤多苷治疗无效者血、尿TNFα无明显变化。结论 TNFα参与系膜增生性肾炎发病及疾病进展 ;雷公藤多苷治疗MsPGN有效 ,其作用机制可能与其抑制TNFα产生有关 ;血。

Objective To investigate the effect of polyglycosides of Tr ipterygium wilfordii Hook (TWG) on the plasma and urine levels of tumor necros is factor alpha(TNFα) in patients with mesangioproliferative glomerulonephritis (MsPGN).Methods Before and after the treatment with TWG,the plasma and urine levels of TNFα were tested in 80 patients and 20 healthy controls.Results Before the treatment,the plasma an d urine levels of TNFα in the patients were significantly higher than those in healthy controls [plasma normal (67±21) kU/L versus MsPGN (442±352) kU /L urine nonml O kU/L versus MsPGN (218±136) kU/L,(P<0.0 1)].Treatment with TWG was effective in 60 cases whose plasma and urine levels of TNFα decreased rapidly,but ineffective in 20 cases whose plasma an d urine levels of TNFα did not change (P>0.05).Conclusion TNFα is involved in invasion and progression of MsPGN. The effect and mechani sms of TWG are correlated with the inhibition of the production of TNFα. Plasma and urine levels of TNFα can serve as an index of the effect of TWG on patients with MsPGN.