环磷酰胺冲击疗法对狼疮性肾炎血清IL-6的影响  

Effect of cyclophosphamide pulse therapy on levels of serum interleukin-6 in patients with lupus nephritis

作　　者：范兴忠[1] 李新东[1] 潘宝安[1] 李世荣[1] 徐新伟[1] 

机构地区：[1]山东省潍坊市人民医院肾内科,潍坊261041

出　　处：《中国免疫学杂志》2001年第11期622-623,共2页Chinese Journal of Immunology

摘　　要：目的 :探讨白介素 6(IL 6)在狼疮性肾炎 (LN)发病中的作用及大剂量环磷酰胺静脉给药 (IV CTX)对IL 6产生的影响。方法 :应用ELISA双抗体夹心法对IV CTX治疗前后LN患者血清IL 6水平进行检测。结果 :活动期LN血清IL 6水平显著高于非活动期及健康人 (P <0 0 0 1) ,血清IL 6水平与血沉呈显著正相关 (n =2 2 ,r=0 5 70 ,P <0 0 1) ;抗ds DNA抗体阳性且血清IgG >16g/L的LN患者有更高的血清IL 6水平 (P <0 0 5 ) ;活动期LN治疗 4w后血清IL 6水平显著下降 (P <0 0 0 1)。结论 :LN的B细胞过度活化和自身抗体产生可能与IL 6分泌过量有关。IV CTX可能通过抑制IL 6的产生而减轻免疫损伤 ,血清ILObjective:To investigate role of interleukin 6(IL 6) in the pathogenesis of lupus nephritis(LN) and effect of cyclophosphamide pulse therapy on production of IL 6.Methods:Serum IL 6 levels of pre and post therapy were determined by using sandwich ELISA in LN patients.Results:In the active LN patients,serum levels of IL 6 were significantly higher than those in inactive LN patients and healthy controls(268.26±79 64 ng/L vs 62.40±45 23 ng/L,268 26±79 64 ng/L vs 50.36±42 75 ng/L,P<0 001).Serum IL 6 level was highly correlated with level of erythrocyte sedimentation rate(n=22,r=0.570,P<0.01).Serum IL 6 levels in the patients with anti dsDNA antibody positive and serum IgG level>16 g/L were significantly higher than those in other active LN patients (329.58±94.21 ng/L vs 233.22±43.56 ng/L,P<0.05).In active LN patients treated with cyclophosphamide,serum IL 6 levels of post therapy were significantly lower than those of pre therapy(268.26±79.64 ng/L vs 89.26±67.93 ng/L,P<0.01).Conclusion:Continuous overproduction of IL 6 may contribute to the B cell hyperactivity and autoantibody production.Cyclophosphamide pulse therapy may reduce immune damage by inhibiting the production of IL 6 in the immunocytes and renal intrinsic cells.Detection of serum IL 6 may be an useful indicator for monitoring disease activity and effects of immunosuppressive drugs.

关 键 词：狼疮性肾炎 IL-6 环磷酰胺 冲击治疗 

分 类 号：R593.242[医药卫生—内科学] R392.11[医药卫生—临床医学]