血、尿白介素-6在重症狼疮肾炎诊治中的临床价值  

Clinical value of serum and urine IL-6 levels on diagnosing and curing patients with severe lupus nephritis

作　　者：陈慧[1] 谭超[2] 莫琳[3] 夏成云[3] 

机构地区：[1]宜宾学院医院,四川宜宾644007 [2]宜宾学院化学与化工学院,四川宜宾644007 [3]川北医学院临床医学院,四川南充637000

出　　处：《中国现代医学杂志》2011年第27期3396-3399,共4页China Journal of Modern Medicine

基　　金：宜宾学院青年基金项目(No:2010Q11);四川省青年科技基金(No:09ZQ026-066);宜宾学院科研与教学创新团队建设计划(No:Cx201104)

摘　　要：目的探讨血、尿白细胞介素-6(IL-6)的检测在重症狼疮肾炎(SLN)患者中的临床价值。方法采用双抗体夹心ELISA法检测38名健康人(正常对照组)和43例SLN患者经甲泼尼龙(MP)与环磷酰胺(CTX)双冲击治疗前后血、尿IL-6的水平;抗双链DNA抗体、抗核小体抗体采用ELISA法测定;抗核抗体采用间接免疫荧光法检测;补体C3、C4含量采用速率散射比浊法测定。结果 SLN患者治疗前血、尿IL-6的水平均显著高于正常对照组(P<0.01)并与SLEDAI评分、抗核抗体、抗双链DNA抗体、抗核小体抗体、血沉、24 h小时尿蛋白定量、血尿素氮(BUN)、血肌酐(Scr)、尿胱抑素C呈显著正相关(P<0.05或<0.01),与补体C3、C4、内生肌酐清除率(Ccr)呈显著负相关(P<0.05或<0.01);但血清IL-6与尿IL-6无相关关系(P>0.05)。MP与CTX双冲击治疗能显著降低SLN患者血、尿IL-6的水平(P<0.01)。结论 IL-6参与了SLN的发病过程,血、尿IL-6水平的检测在一定程度上可反映SLN患者肾脏损害程度、病情轻重。动态观察SLN患者血、尿IL-6的水平有助于了解SLN的狼疮活动、治疗效果及判断预后。[ Objective ] To investigate the clinical value of detecting serum and urine IL-6 on patients with severe lupus nephritis （SLN）. [Methods] Serum and urine IL-6 levels were determined in 38 health controls and 43 cases of SLN patients by double antibody sandwich enzyme-linked immunosorbent assay （ELISA） before and after the double pulse therapy with MP and CTX. Anti-dsDNA antibody and Anti-nucleosome antibodies antibody were detected by ELISA. Antinuelear antibody （ANA） was detected by indirect immunofluorescence. Complement C3 and complement C4 were detected by rate nephelometry. [Results] The levels of serum and urine IL-6 were significantly higher in SLN than those in normal control group （P 〈0.01） and they were positively correlated with the systemic lupus erythematosus disease activity index （SLEDA1） score, ANA, anti-dsDNA antibody, Anti-nucleosome antibody（AnuA）, erythroeyte sedimentation rate （ESR）, 24-hour urinary protein, blood urea nitrogen （BUN）, serum creatinine （Ser） and cystatin C （Cyst C）（P 〈0.05 or 19 〈0.01）, and negatively correlated with complement C3, complement C4 and endogenous creatinine clearance rate （Ccr）（P 〈0.05 or P 〈0.01）. But there was no correlation between serum IL-6 level and urine IL-6 level（P 〉0.05）. In patients with SLN treated with the double pulse therapy with MP and CTX, the levels of serum and urine IL-6 were obviously lower than those of pre-treatment （P 〈0.01）. [ Conclusions ] IL-6 takes part in the progress of SLN. The level of serum and urine IL-6, in some degree, indicates the level of renal damage and the extent of the disease with SLN. The dynamic observation of the level of serum and urine IL-6 contributes to judge SLN＇S activity, treatment effectiveness and prognosis.

关 键 词：狼疮肾炎 白介素-6 双冲击治疗 

分 类 号：R593.24[医药卫生—内科学]