环磷酰胺和激素对重症狼疮肾炎血及尿白细胞介素-8的影响

The effect of cyclophosphamide and corticosteroid on urine and blood interleukin-8 level of severe lupus nephritis

目的探讨血、尿白细胞介素-8(IL-8)在重症狼疮肾炎(LN)发病中的作用及环磷酰胺(CTX)和激素治疗对血、尿IL-8的影响。方法对23例重症LN患者用CTX和激素治疗前后采用ELISA夹心法检测血、尿IL-8水平。结果治疗前血、尿IL-8水平明显高于健康对照组(P<0.01),血、尿IL-8水平与SLE活动指数(SLEDAl)和肾脏病理活动性指数(AI)呈显著正相关(n=23,r=0.690和0.700,P<0.01)。治疗后,血、尿IL-8水平比治疗前显著降低(P<0.01),与健康对照组比效差异无统计学意义(P>0.05)。结论CTX、糖皮质激素可能通过抑制IL-8产生,从而减轻免疫炎症损害。动态观测LN患者血、尿中IL-8水平,有助于了解LN活动性病变的情况和肾脏损害程度、治疗效果及为判断预后提供依据。

Objective To explore the role of serum and urine interleukin-8 （IL-8） in the pathogenesis of severe lupus nephritis （LN） and the effect of cyclophosphamide and corticosteroid on it. Method Both the serum and urine IL-8 level of 23 patients with severe LN were tested by ELISA before and after cyclophosphamide and steroid treatment. Result Before the treatment the blood and urine IL-8 level were obviously higher than healthy controls （P〈0.01）, The blood and urine IL-8 level was positively associated with the SLE activity index （SLEDAI） and the kidney pathology activity index （AI） （n=23, r=0.690 and 0.700, P〈 0.01 ）. After the treatment, the blood and urine IL-8 level were remarkably decreased compared to those before the treatment （P〈0.01）, but without significant difference compared with healthy controls （P〉0.05）, Conclusion CTX, and corticosteroid could relieve inflammation-mediated organ damage possibly through suppressing IL-8 production, The changes of LN patient blood and urine IL-8 level is helpful to understood the LN pathological changes and the severity of kidney damage, It also provides the basis for prognosis evaluation.