中西医结合治疗对肾病综合征患儿血清肿瘤坏死因子-α的影响

Effect of TCM WM treatment on serum tumor necrosis factorα in nephrotic syndrome infants

目的：探讨肿瘤坏死因子α（ＴＮＦα）与儿童肾病综合征发病关系及中西医结合治疗对ＴＮＦα的影响。方法：采用放射免疫分析法，对２９例肾病综合征患儿（观察组）进行了治疗前后血清ＴＮＦα的测定，并以１６例健康儿童（对照组）作对照。结果：观察组治疗前ＴＮＦα（３８．５５±９．６１）ｐｍｏｌ／Ｌ显著高于对照组（２０．３７±３．４４）ｐｍｏｌ／Ｌ，Ｐ＜０．０１，且观察组治疗前显著高于治疗后（２２．８０±３．９０）ｐｍｏｌ／Ｌ，Ｐ＜０．０１；肾炎性肾病（４２．８２±５．９６）ｐｍｏｌ／Ｌ，高于单纯性肾病（３５．０６±１０．７２）ｐｍｏｌ／Ｌ，Ｐ＜０．０５；活动期伴感染者（４５．８５±５．１０）ｐｍｏｌ／Ｌ显著高于不伴感染者（３４．７１±９．３９）ｐｍｏｌ／Ｌ，Ｐ＜０．０１。结论：ＴＮＦα参与了儿童肾病综合征的病理损伤过程；用免疫抑制剂和清热解毒、补气活血中药联合可抑制ＴＮＦα的产生。

Objective:To explore the relationship between tumor necrosis factorα(TNFα) and infantile nephrotic syndrome and to observe the effect of TCM WM therapy on TNFα level.Methods:The serum TNFα level was measured with radioimmunoassay (RIA) in 29 cases of nephrotic syndrome(observe group) before and after treatment.On the other hand,16 cases of health children as control (control group).Results:In the observe group,the TNFα level 〔(3855±961)pmol/L〕 was higher before therapy than that in control group 〔(2037±344)pmol/L〕,P<001,and it was higher before therapy than after therapy 〔(2280±390)pmol/L〕,P<001.On the other hand,TNFα level was higher in nephritis nephrotic syndrome 〔(4282±596)pmol/L〕 than that in simple nephrotic syndrome 〔(3506±1072)pmol/L〕,P<005;complicated by infection at active stage 〔(4585±510)pmol/L〕was higher than that of no complicating infection 〔(3471±939)pmol/L〕,P<001.Conclusions:TNFα was contributed to pathologic damage process of infantile nephrotic syndrome.Immune suppressor and traditional Chinese herb (activating blood flow and removing blood stasis;clearing heat and removing toxin) could be inhibit TNFα production.