【作者】 汪国生；

【导师】 杨明功； 李向培；

【作者基本信息】 安徽医科大学 ， 内分泌与代谢病， 2001， 硕士

【摘要】 目的 探讨系统性红斑狼疮（SLE）患者血浆中肿瘤坏死因子（TNFα）和可溶性肿瘤坏死因子受体（sTNFR）水平及其临床意义。方法 采用双抗夹心ELISA法分别检测60例SLE和20例对照血浆TNFα、sTNFR1和sTNFR2水平。记录患者SLE疾病活动指标（SLEDAI）和狼疮活动标准计分（LACC）。比较SLE和对照、疾病活动与稳定、有无狼疮肾炎上述检测指标的差异。结果1、SLE患者血浆sTNFR1、sTNFR2水平显著高于正常对照组（P＜0.001），而TNFα血浆水平与正常对照无差异（P＞0.05）。2、有狼疮肾炎患者sTNFR1和sTNFR2均显著高于无肾炎患者（P＜0.001和P＜0.05）；无肾炎患者sTNFR1与对照差异无显著性，而sTNFR2显著高于对照（P＜0.001）；TNFα三组差异无显著性。3、狼疮活动患者sTNFR1显著高于对照（P＜0.01），活动与稳定、稳定与对照差异无显著性；而sTNFR2活动显著高于稳定和对照（P＜0.05和P＜0.001），稳定患者也显著高于对照（P=0.002）；SLE活动患者sTNFR1、sTNFR2升高者显著多于稳定患者。4、血浆TNFα和sTNFR1水平与SLEDAI及LACC无相关性；sTNFR2水平与SLEDAI显著正相关（r=0.395，P＜0.01）；sTNFR1与sTNFR2显著正相关（r=0.623，P＜0.001）；SLEDAI与LACC显著正相关（r=0.904，P＜0.001）。结论SLE患者血浆sTNFR1、sTNFR2均异常增高，狼疮肾炎肾脏TNFR1表达增加，狼疮活动时sTNFR1、sTNFR2升高的患者明显增多，sTNFR2与SLEDAI正相关。更多还原

【Abstract】 Objective To study the level of TNF-alpha and soluble receptors of TNF in systemic lupus erythematosus (SLE) patients and it抯 clinical significance. Methods Plasma level of TNF-alpha and soluble receptor I and receptor 2 of TNF (sTNFR) were determined with double antibodies sandwich ELISA in 60 SLE patients and 20 healthy controls. Other immunological index including anti ds-DNA antibody and C3 were test at same tline. SLE disease activity index (SLEDAI) and lupus activity criteria count (LACC) were recorded Plasma level of TNF-alpha and its soluble receptors between SLE patients and healthy controls, patients with and without lupus nephritis, disease active and stable were compared. Results I. Plasma level of sTNFRI and sTNFR2 were significant higher in SLE group than in control group (P<O.OOl). No difference of plasma level of TNF-alpha between two groups was found. 2. Plasma level of sTNFRI and sTNFR2 in patients with lupus nephritis were significant higher than without lupus nephritis (P<O.O0l and NO.05); Plasma level of sTNFR2 in patients without lupus nephritis was significant higher than healthy controls (P<0.O0l), the same result wasn抰 found for sTNFRI between patients without lupus nephritis and healthy controls; No significant differences of TNF-alpha are found between and within groups. 3. Plasma level of sTNFR1 was significant higher in disease active patients than in stable patients (NO.01); But the differences between active and stable patients, between stable patients and healthy controls weren抰 significant. Plasma level of sTNFR2 in active patients was significant higher than stable patients and healthy controls (P<0.05 and P<0.0O 1), even in stable 2 patients sTNFR2 was higher than healthy controls (P=~0.002). No significant differences of TNF-alpha were found between and within groups. The patients with hyper-sTNFRI in active patients was significant more than in stable patients and so did hyper-sTNFR2. 4. The positive correlations between sTNFR2 and SLEDAI, sTNFRI and sTNFr2, SLEDAI and LACC were significant (r = 0.395, P<0.0l; r = 0.623, P<0.00l; r = 0.904, P<0.001). No correlations were found between TNF-alpha and SLEDAI and between sTNFRI and SLEDAI. Conclusion There is an abnormal increasing of sTNFR in SLE patients. Kidney may express more sTNFR1 in lupus nephritis. sTNFR2 shows positive correlation with SLEDAI.更多还原