TNF检测在环磷酰胺治疗狼疮性肾炎中的价值

目的 探讨肿瘤坏死因子（ＴＮＦ）检测在大剂量环磷酰胺静脉冲击治疗狼疮性肾炎（ＬＮ）中的价值。方法 用ＥＬＩＳＡ双抗体夹心法检测５１例ＬＮ患者环磷酰胺静脉冲击治疗（ＩＶ－ＣＴＸ）前后血清和尿ＴＮＦ水平。结果 活动期ＬＮ患者血清和尿ＴＮＦ水平显著高于稳定性（Ｐ〈０．００１）。血甭ＴＮＦ水平与血沉呈显著正相关（ｎ＝５１，ｒ＝０．３８６，Ｐ〈０．０５）。轻度肾功不全患者血清ＴＮＦ显著高于肾功正常（Ｐ，０．

Changes and significance of tumor necrosis factor in lupus nephritis treated with cyclophosphamide pulse

ObjectiveTo investigate changes of tumor necrosis factor(TNF) and effects of cyclophosphamide (CTX) pulse therapy on levels of TNF in lupus nephritis(LN).Methods Serum and urinary levels of TNF were determined by using sandwich ELISA in 51 LN patients.Results Serum and urinary TNF levels in the active LN were significantly higher than those in the inactive LN(P<0.001).There was a positive correlation between serum TNF levels and erythrocyte sedimentation rate in LN(n=51,r=0.386,P<0.05).Serum TNF levels in LN patients with mild azotemia were significantly higher than those in LN patients with normal levels of serum creatinine(P<0.05).A significant correlation was found between the urinary TNF level and proteinuria in LN(n=51,r=0.421,P<0.01).In LN patients treated with IVCTX and prednisone,urinary TNF levels of posttreatment were significantly lower than those of pretreatment.Compared with Group B,urinary TNF levels in LN patients from Group A were obviously lower at 4 weeks after treated with IVCTX(P<0.01).ConclusionTNF may take part in immune pathogenesis of LN.Serum and urinary levels of TNF may be an useful indicator for monitoring disease activity and degree of renal damage in LN.IVCTX may have a significant effect on inhibiting the production of TNF in the monocytes/macrophages and T cells.A reasonable IVCTX should be modulated according to the disease activity(inclu ding TNF levels). [