Effects of methylprednisolone and cyclophosphamide pulse therapy on renal infiltrating cells in patients with crescentic glomerulonephritis  

作　　者：唐政 周虹 姚小丹 胡伟新 黎磊石 

出　　处：《Chinese Medical Journal》1997年第3期46-49,共4页中华医学杂志（英文版）

摘　　要：Objective To investigate the effects of pulse methylprednisolone (MP) and monthly intravenous cyclophosphamide (CTX) therapy (MP+CTX) on renal infiltrating cells in patients with rapid progressive glomerular nephritis (RPGN). Methods Twelve patients with RPGN (>50% crescents) were given MP+CTX therapy and received repeated renal biopsies within 4 to 12 weeks after MP+CTX treatment. Seven were diagnosed as type II RPGN,including one case of IgA nephropathy, 2 cases of idiopathic RPGN and 4 cases of lupus nephritis and five were diagnosed as type III RPGN,including 2 cases of idiopathic RPGN and 3 cases of vasculitis. The changes of infiltrating CD4 +, CD8 +, CD68 + and proliferating cell neuclear antigen PCNA + cell levels were determined by four PAP method in glomeruli and interstitium. Results In the patients before MP+CTX therapy, there were higher levels of infiltrating CD4 + and CD8 + cells (306±118 and 223±98.4Num/mm 2) in renal interstitium, CD68 + cells (17.2±9.95 Num/G) in glomeruli and (1120±229 Num/mm 2) in interstitium, and PCNA + cells (7.56±3.57 Num/G) in glomeruli and (17.6±6.85 Num/mm 2) in interstitium as compared with those in the patients after MP+CTX therapy (CD4 +/CD8 + cells were 171±87.5/121±38.4 Num/mm 2, CD68 + cells were 9.04±4.33 Num/G and 600±107 Num/mm 2,and PCNA + cells were 2.04±1.43 Num/G and 9.40± 4.45 Num/mm 2). These changes were associated with improving renal dysfunctions (the levles of serum creatinine and proteinuria decreased gradually from 766±356 to 284±192 μmol/L and 2.60±1.46 to 1.29±0.85 g/day ). Conclusions Our data indicate that the renal infiltrating cells may play an important role in renal injury in patients with RPGN.The effects of MP+CTX therapy on improving renal dysfunctions may partially contribute to its amelioration of infiltrating cells in renal tissues. The degrees of CD4 +, CD68 +, and PCNA + cells in the kidney may be useful indicators of MP+CTX therapy for RPGN.Objective To investigate the effects of pulse methylprednisolone (MP) and monthly intravenous cyclophosphamide (CTX) therapy (MP+CTX) on renal infiltrating cells in patients with rapid progressive glomerular nephritis (RPGN). Methods Twelve patients with RPGN (>50% crescents) were given MP+CTX therapy and received repeated renal biopsies within 4 to 12 weeks after MP+CTX treatment. Seven were diagnosed as type II RPGN,including one case of IgA nephropathy, 2 cases of idiopathic RPGN and 4 cases of lupus nephritis and five were diagnosed as type III RPGN,including 2 cases of idiopathic RPGN and 3 cases of vasculitis. The changes of infiltrating CD4 +, CD8 +, CD68 + and proliferating cell neuclear antigen PCNA + cell levels were determined by four PAP method in glomeruli and interstitium. Results In the patients before MP+CTX therapy, there were higher levels of infiltrating CD4 + and CD8 + cells (306±118 and 223±98.4Num/mm 2) in renal interstitium, CD68 + cells (17.2±9.95 Num/G) in glomeruli and (1120±229 Num/mm 2) in interstitium, and PCNA + cells (7.56±3.57 Num/G) in glomeruli and (17.6±6.85 Num/mm 2) in interstitium as compared with those in the patients after MP+CTX therapy (CD4 +/CD8 + cells were 171±87.5/121±38.4 Num/mm 2, CD68 + cells were 9.04±4.33 Num/G and 600±107 Num/mm 2,and PCNA + cells were 2.04±1.43 Num/G and 9.40± 4.45 Num/mm 2). These changes were associated with improving renal dysfunctions (the levles of serum creatinine and proteinuria decreased gradually from 766±356 to 284±192 μmol/L and 2.60±1.46 to 1.29±0.85 g/day ). Conclusions Our data indicate that the renal infiltrating cells may play an important role in renal injury in patients with RPGN.The effects of MP+CTX therapy on improving renal dysfunctions may partially contribute to its amelioration of infiltrating cells in renal tissues. The degrees of CD4 +, CD68 +, and PCNA + cells in the kidney may be useful indicators of MP+CTX therapy for RPGN.

关 键 词：infiltrating 黎磊石 周虹 胡伟 

分 类 号：R[医药卫生]