【摘要】 本文观察环孢霉素（ＣｓＡ）治疗１６例重症ＬＮ患者，对血尿可溶性白介素２受体（ＳＩＬ－２Ｒ）及外周血Ｔ淋巴细胞亚群（ＣＤ４＋／ＣＤ８＋细胞）的影响。结果ＣｓＡ治疗后，ＬＮ患者血尿ＳＩＬ－２Ｒ均有明显下降（Ｐ＜０．０１），外周血ＣＤ４＋细胞亦有下降趋势；同时伴有血清免疫学异常及临床肾损害的明显改善。本文提示ＳＩＬ－２Ｒ可作为ＬＮ活动度的一项敏感指标；ＣｓＡ可能通过抑制Ｔ淋巴细胞活性，减少被激活的淋巴细胞释放ＳＩＬ－２Ｒ，从而取得治疗ＬＮ的良好疗效。更多还原

【Abstract】 bjective To evaluate the association ofthe level of urinary and serum soluble inter-leukin-2 receptor (SIL-2R) with disease ac-tivity and response to cyclosporine A (CsA)therapy in patients with lupus nephritis(LN ) .Patients and Methods Sixteen addmittedpatients with LN were studied ,including 15cases of type NLN and one case of type Ⅴ-LN. All patients received CsA 6 mg/(kg ·d) for 6～8 weeks ,then tapered off gradual-ly to 2 mg/(kg ·d). The levels of urinaryand serum SIL-2R were determined by en-zyme-linked immunosorbent assay (ELISA)as well as serum anti-ds-DNA ,complementC3, C4, total IgG, creatinine and urinaryblood red cells and protein excretion, andlymphocyte subpopulations in peripheralblood were examined before and after CsAtreatment.Results In LN patients,both urine (534±101 U/ml) and serum (326± 148 U/ml)SIL-2R levels were higher than those innormal controls (<100 U/ml ) , associatedwith higher levels of peripheral blood CD4+and CD8+ lymphocytes (29. 3± 4. 24% and28. 6 ±9. 12% ) , higher titer of serum anti-ds-DNA , lower levels of serum complementC3 and C4 ( 0. 98 ± 0. 23 g/L and 0. 24±0. 12 g/L) , as well as larger amount pro-teinuria (Upro 2. 99 ± 0.76 g/24 h) andhematuria [URBC (83. 9 ± 95. 23 ×104/ml] . These abnormalities were graduallyameliorated by CsA therapy. The changes inlevels of both serum (116± 58. 6 U/ml) andurinary (136± 43. 2 U/ml) SIL-2R inducedby CsA (at 8th week) correlated with thechanges in levels of CD4+ and CD8+ cells(23. 2±3. 30% and 26. 7±3. 54%),and de-gree of immune abnormalities (serum C31. 28±0. 14g/L and C4 0. 42±0. 06 g/L) ,and renal injuries [Upro 1. 07± 0. 46 g/24h ,URBC (5. 82 ± 3. 15)× 104/ml] .Conclusions The results suggest that theserum and urine SIL-2R are sensitive mark-ers for disease activity in LN. CsA ,a power-ful immunosuppressive agent, significantlyimproves both immunologic disorders andrenal functional imparinients, which mightbe through affection on lymphocyte activa-tion in peripheral blood and renal tissue asevidenced by the changes in SIL-2R levelsafter treatment.更多还原