白芍总苷治疗狼疮性肾炎的疗效及对IL-18、IL-6含量的影响

Effects of total glucosides of Paeony on lupus nephritis and plasma content of IL-18 and IL-6

目的探讨白芍总苷(TGP)治疗狼疮性肾炎(LN)的疗效及其对血清白介素-18(IL-18)、白介素-6(IL-6)含量的影响。方法将LN患者随机分为治疗组和对照组各40例。对照组给予泼尼松及环磷酰胺(CTX),治疗组在泼尼松及CTX的基础上联合TGP治疗。观察治疗前及治疗3个月后血清IL-18、IL-6水平及24 h尿蛋白定量(24hupr)、肝肾功能、抗双链DNA抗体滴度(抗ds-DNA)、补体C3、狼疮疾病活动指数(SLEDAI)变化。结果 LN患者血清IL-18、IL-6水平较正常组明显升高(P<0.05),治疗后对照组明显下降(P<0.05),但治疗组下降更为显著(P<0.01)。治疗组24hupr、SLEDAI评分、抗ds-DNA水平及血Cr水平下降较对照组明显(P<0.05),而补体C3、白蛋白水平升高明显(P<0.05)。结论 TGP联合泼尼松、CTX治疗LN有显著疗效,其可能作用机制为降低血清IL-18、IL-6水平。

Objective To study the effects of total glucosides of Paeony （TGP） on lu- pus nephritis （LN） and expression of serum interleukin-18 （IL-18） and IL-6. Methods 80 patients were divided into 2 groups randomly： 40 eases in control group treated with prednisone and cyclophosphamide （CTX） and 40 cases in treatment group treated with CTX, prednisone and TGP. The changes of plasma IL-18, IL-6, 24hupr, functions of liver and kidney, anti-ds- DNA, complement C3 and the SLEDA ratings were observed after 3 months treatment. Results The levels of plasma IL-18 and IL-6 in LN patients were higher than the normal group （P〈0.05）. After treatment, IL-18 and IL-6 levels in control group were decreased significantly （P〈0.05）, but the decrease in treatment group was more significant（P〈0.01）. Compared with the control group, in treatment group 24hupr, the SLEDA ratings, anti-ds-DNA level and serum Cr decreased signifi- cantly（P〈0.05） while complement C3 and albumin levels significantly increased（P〈0.05）. Conclu- sion TGP combined with prednisone and CTX therapy has significant effects on LN and its mechanism may be to reduce IL-18 and IL-6 levels.