狼疮方联合西药治疗狼疮性肾炎的临床观察  

Clinical Observation of Lupus Nephritis Treated by Traditional Chinese Medicine and Western Medicine

作　　者：陈雪兰[1] 郑京[1] 邵丹[2] 陈旭珍[2] 郑春盛[1] 刘芳[2] 丘余良[1] 

机构地区：[1]福建中医学院附属人民医院,福建福州350004 [2]福建中医学院,福建福州350108

出　　处：《福建中医学院学报》2009年第2期4-8,共5页Journal of Fujian College of Traditional Chinese Medicine

基　　金：福建省教育厅基金资助项目(JA04223)

摘　　要：目的探讨活动期狼疮性肾炎(LN)患者中西结合治疗前后外周血单个核细胞(PBMC)凋亡率、CD+3 CD+4细胞、sFas表达的意义。方法采用双抗体夹心酶联免疫吸附(ELISA)法测定38例LN患者和20例健康人血清中sFas的水平,应用AnnexinV凋亡检测试剂盒及流式细胞仪检测外周血单个核细胞的凋亡率及CD+3 CD+4。结果①LN治疗前PBMC凋亡率、sFas较正常人组明显升高(P<0.01),CD+3 CD+4细胞较正常人组明显减少(P<0 05);②治疗后sFas较正常人组增高(P<0.05);观察组和对照组治疗后临床观察指标差异显著(P<0.05);③观察组副作用较对照组差异显著(P<0.05);④LN患者sFas与PBMC凋亡率呈显著正相关(P<0.01)。结论①细胞凋亡增加与血清sFas水平相关,并且可能是LN进展中的一个因素;②中西结合治疗可以提高单纯西药治疗活动期狼疮性肾炎的临床指标疗效,且明显抑制了西药的副作用。Objective To investigate the significance of the peripheral blood monouclear cells （PBMC） apoptosis rate and the expressions of CD3^＋CD4^＋ cell and sFas in patients with active stage lupus nephritis （LN） before and after the integrated treatment. Methods The serum level of sFas was detected with the double-antibody sandwich ELISA, the apoptosis rate of PBMC and CD3^＋CD4^＋ with annexin V apoptosis detection kit and flow cytometry. Results ① The PBMC apoptosis rate and sFas of LN were significantly higher than that of the normal group before treatment （P〈0.01）, but CD3^＋CD4^＋ cells were significantly less （P〈0.05） ; ② The sFas was higher than that of normal group after treatment （P〈0.05）, the differences of clinical indicators between two groups were significant （P〈0.05） ; ③ The differences of side effects between two groups were significant （P〈0.05） ; ④ The sFas and apoptosis rate of PBMC of LN patients were positive correlated （P〈0.01）. Conclusion ① The increase of cell apoptosis is related to the level of blood serum sFas, which is possibly a factor of LN progresses; ②Compared with pure western medicine therapy, the integrated therapy could improve the curative effect of clinical target of active stage LN and suppress the side effects of western medicine obviously.

关 键 词：狼疮性肾炎 中西医结合治疗 细胞凋亡 CD3^+CD4^+ SFAS 流式细胞仪 

分 类 号：R593.242[医药卫生—内科学]