狼疮性肾炎病人尿足细胞和IL-18的变化及意义  

THE CHANGES AND CLINICAL SIGNIFICANCE OF INTERLEUKIN-18 AND URINE PODOCYTES IN PATIENTS WITH LUPUS NEPHRITIS

作　　者：刘楠楠[1] 李作林[1] 马瑞霞[1] 武国华[1] 

机构地区：[1]青岛大学附属医院肾内科,山东青岛266003

出　　处：《青岛大学医学院学报》2016年第2期197-200,共4页Acta Academiae Medicinae Qingdao Universitatis

基　　金：青岛市科技局资助项目(2012-1-3-2-(2)-nsh)

摘　　要：目的探讨狼疮性肾炎(LN)病人尿足细胞和白细胞介素-18(IL-18)的变化及临床意义。方法选择我院经肾穿刺病理检查确诊为LN的病人60例,根据2000年系统性红斑狼疮疾病活动性指数(SLEDAI)分为活动组38例和非活动组22例,以30例健康体检者作为对照组。收集各组尿标本,采用间接免疫荧光技术测定尿Podocalyxin(PCX)阳性染色细胞,采用酶联免疫吸附试验(ELISA)法检测尿IL-18水平,分析尿足细胞和IL-18水平与临床病理指标的相关性。结果 LN病人尿足细胞和IL-18水平均明显高于对照组,且活动组高于非活动组(F=236.93、203.09,P<0.01)。Pearson相关性分析显示,LN病人尿足细胞和IL-18水平均与24h尿蛋白定量、血肌酐、血尿素氮、SLEDAI、肾小球活动指数、肾小管间质活动指数、肾脏病理活动指数呈正相关(r=0.459~0.672,P<0.05),与补体C3和肾小球滤过率估算值呈负相关(r=-0.644^-0.551,P<0.05),而与补体C4、慢性化指数无相关性(P>0.05);LN病人尿足细胞与IL-18水平呈正相关(r=0.692,P<0.01)。结论尿足细胞和IL-18水平与LN活动性及肾脏病理活动具有相关性,二者联合检测可作为评估LN严重程度及监测病情活动的一种无创性指标。Objective To investigate the changes of urine podocytes and urine interleukin-18 （IL-18） in patients with lu- pus nephritis （LN） and assess its clinical significance. Methods Sixty cases of LN patients confirmed by renal biopsy pathology were enrolled in this study. According to SLE disease activity index （SLEDAI） 2000, the patients were divided into activity group （38 cases） and inactive group （22 cases）, and 30 healthy individuals served as controls, Urine samples were collected from each group, positive urine podocaiyxin （PCX） ceils were detected using indirect immunofiuoreseene method, and urine IL-18 was mea sured using enzyme linked immunosorbent assay （ELISA）, the correlation between urine IL-18 levels and elinicopathological indi eators in LN were analyzed. Results The levels of urine PCX and urine IL-18 in LN patients were higher than the healthy controls, and that in activity group was higher than that in inactive group （F = 236.93,203.09;P〈0.01）. The Pearson correlation analysis showed the levels of urine PCX and IL-18 in LN patients were positively correlated with 24-hour urinary protein quantitation, serum creatinine, blood urea nitrogen （BUN）, SLEDAI, giomerular activity index, renal tubular interstitial activity index and renal pathological activity index （r=0.459-0.672,P〈0.05）, and negatively correlated with serum complement C3 and glomerular filtration rate （eGFR） （r =-0.644--0.551,P〈0.05）, and not associated with compliment C4 and chronicity index （P〉0.05）. The cell count of urine PCX in LN patients was positively correlated with urine IL-18 （r =0.692 ,P〈0.01）. Conclusion The levels of urine podoeytes and IL-18 are closely related with reactiveness and renal pathology of lupus nephritis, combined detection of urine podoeytes and IL-18 may be used as a nowinvasive indicator for assessing the severity and monitoring patient＇s condition.

关 键 词：狼疮肾炎 足细胞 白细胞介素18 

分 类 号：R593.242[医药卫生—内科学]