肿瘤坏死因子及其可溶性受体对狼疮活动的价值

目的 探讨肿瘤坏死因子(TNFα)和可溶性肿瘤坏死因子受体(sTNFR)对系统性红斑狼疮(SLE)疾病活动的价值。方法 分别采用狼疮活动标准记分(LACC)和SLE疾病活动指数(SLEDAI)判断狼疮活动和活动程度，采用双抗夹心ELISA法分别检测35例活动、25例稳定SLE和20例对照血浆TNFα、sTNFRl和sTNFR2水平。结果 SLE患者血浆sTNFR水平显著高于正常对照组。狼疮活动、稳定及对照sTNFR水平差异显著；SLE活动期sTNFRl、sTNFR2升高者显著多于稳定期。sTNF2水平与SLEDAI显著正相关(r＝0．40，P＜0．01)；sTNFR1与sTNFR2显著正相关(r＝0．62，P＜0．001)。结论 SLE患者血浆sTNFRl、sTNFR2均升高，狼疮活动时sTNFRl、sTNFR2升高的患者明显增多，可作为判断狼疮活动的指标。

The significance of plasma tumor necrosis factor(TNF)-alpha and its soluble receptors in disease activity of systemic lupus erythematosus

Objective To study the relationship between plasma TNF-alpha and its soluble receptors and disease activity in systemic lupus erythematosus (SLE). Methods Lupus activity criteria count (LACC) and SLE disease activity index (SLEDAI) were implied to judge disease activity and its degree. Plasma level of TNF-alpha and soluble receptor 1 and receptor 2 of TNF (sTNFR) were deter mined with double antibodies sandwich ELISA in 60 SLE patients including 35 disease active patients and 25 stable patients and 20 healthy controls. Results Plasma level of sTNFR was significantly higher in SLE group than in control group. The difference of plasma level of sTNFR1 and sTNFR2 were significant between disease active, stable patients and healthy controls( P <0.05 and P <0.001); The patients with increased sTNFR1 or sTNFR2 in active stage were significantly higher than in stable stage. The positive correlations between sTNFR2 and SLEDAI, sTNFR1 and sTNFR2, SLEDAI and LACC were significant ( r =0.40, P <0.01; r =0.62, P <0.001; r =0.90, P <0.001 respectively). Conclusion Plasm level of sTNFR1 and sTNFR2 increase significantly in SLE, especialy in active patients and may be implied as an index to judge disease activity.