甲基泼尼龙冲击治疗对肾炎患者临床疗效及肿瘤坏死因子的影响

EFFECTS OF METHYLPREDNISOLONE PULSE THERAPY ON TNFa LEVELS IN CHRONICNEPHRITIS

观察了甲基泼尼（ＭＰ）冲击治疗分别对狼疮性肾炎、膜增殖性肾炎及紫癜性肾炎共１９例患者的临床疗效及对肿瘤坏死因子（ＴＮＦａ）的影响，发现ＭＰ能明显改善肾炎患者的临床症状，并使上述患者血清、尿及淋巴细胞培养上清中ＴＮＦａ明显下降，从细胞因子水平探讨了ＭＰ的作用机理。

e examined the tumor necrosis factor(TNFa)bioactivity in patients with chronic glomerulonephritis(CGN)treated with methylprednisolone(MP)pulse therapy( 1 course of 1g/day × 3 days).TNFa bioac-tivity in CGN,including 5 cases of Membranoproliferative glomeralonephritis (MPGN ),8 lupus nephritis(LN )and 6 purpura nephritis,was determined by ELISA with TNFa monoclonal antibody. TNFa valuesin the serum,unine and cultured lymphocyte supernatant(CLS)of patients was significantly higher thanin control. (serum:131.6±20.2 vs 70. 4±13.8, urine:26.2±8. 2 vs 11. 2±2.0, P<0.05, CLS: 97.4±9.8 vs 59. 5±10.1, P<0. 05, pretreatment vs control),but it was markedly reduced after treated withMP therapy.(serum: 60. 2± 11.2vs 131. 6±20.2,P<0.05, urine: 10. 2± 1. 6 vs 26.2±8.2, P<0.05,CLS:54. 1±11.2 vs 97.4±9.8,P<0. 05,post treatment vs pretreatment).These results indicat-ed that TNFa levels in serum, urine and supernatant of lymphocyte were markedly higher in chronicnephritis, the MP pulse therapy possessed a striking effect on inhibiting the production of TNFa in periph-eral lymphocytes.