糖皮质激素对原发性肾病综合征患者TNFα的影响  

Effect of corticosteroids on TNFα level in patients with primary nephrotic syndrome

作　　者：刘晓渭[1] 李冬梅[2] 李元勋[1] 赵正辉[1] 徐月清[1] 

机构地区：[1]第四军医大学西京医院肾脏内科,陕西西安710033 [2]第四军医大学西京医院图书馆,陕西西安710033

出　　处：《第四军医大学学报》2001年第8期721-724,共4页Journal of the Fourth Military Medical University

摘　　要：目的　观察原发性肾病综合征 (PNS)患者应用糖皮质激素 (以下简称激素 )前后血、尿 TNFα变化 .方法　检测了 40例 PNS患者激素治疗前及用激素后 1,2 ,4,8wk血、尿TNFα变化 ,并与 2 0例正常人血、尿 TNFα进行比较 .结果　PNS患者 40例治疗前血、尿 TNFα明显增高 (血正常 (6 8±19) (k U·L- 1 ) ,PNS(4 6 1± 36 2 ) (k U·L- 1 ) ,尿正常 0 / k U·L- 1 PNS (2 0 2± 147) (k U· L- 1 ) (P<0 .0 1) ,激素治疗后 31例患者显效 ,9例无效 ,显效率为 77.5 % .显效者血、尿 TNFα早期即开始下降 (血治疗前 (4 6 1± 36 2 ) (k U· L- 1 ) ,治疗后(2 80± 183) (k U· L- 1 ) ,尿治疗前 (2 0 2± 147) (k U· L- 1 ) ,治疗后 (12 9± 91) (k U· L- 1 ) ,P<0 .0 1) ,而激素治疗无效者血、尿 TNFα无明显变化 .结论　 TNFα参与原发性肾病综合征发病及疾病进展 ;激素治疗 PNS有效 ,其作用机制可能与其抑制 TNFα产生有关 ;血、尿 TNFα可作为判断激素疗效与预后的参考指标 .AIM To investigate the effect of corticosteroids on the plasma and urine level of tumor necrosis factor alpha(TNFα) in patients with primary nephrotic syndrome. METHODS Before and after the treatment with corticos teroids, the plasma and urine level of TNFα in 40 patients were tested and 20 healthy donors served as control group. RESULTS Before the treatment with corticosteroids, the plasma and urine level of TNFα in 40 cases were significantly higher than healthy donors ( plasma normal 68±19(kU·L -1 ) PNS (461±362)(kU·L -1 ) urine nonml O kU·L -1 PNS (202±147)(kU·L -1 )( P <0.01). Treatment with corticosteroids was effective in 31 cases whose plasma and urine level of TNFα decreased rapidly but ineffectively in 9 cases whose plasma and urine level of TNFα didn't change ( P >0 05). CONCLUSION TNFα is involved in invasion and disease progression of primary nephrotic syndrome. The effect and mechanisms of corticosteroids are correlated with the inhibition in the production of TNFα. Plasma and urine levels of TNFα can serve as an index of the effect of corticosteroids on patients with primary nephrotic syndrome.

关 键 词：原发性肾病综合征 肿瘤坏死因子 糖皮质激素 

分 类 号：R692[医药卫生—泌尿科学]