【作者】 邱明山；

【导师】 阮诗玮；

【作者基本信息】 福建中医学院 ， 中西医结合内科学， 2003， 硕士

【摘要】 目的 探讨外周血淋巴细胞(PBL)凋亡调控因子Fas、FasL、bcl-2和血、尿白细胞介素-8(IL-8)表达在活动性狼疮性肾炎(LN)患者中的作用及其与中医证型的关系。 资料与方法 根据美国风湿病学会(ARA)1982年修订的SLE诊断标准和Unowitz狼疮活动性标准，选择活动性LN患者36例(男3例，女33例)平均年龄31.08±11.74岁，进行观察，并按照中医辨证分型标准将其分为热毒炽盛证、阴虚内热证、气阴两虚证、脾肾阳虚证四型；正常健康志愿者15例(男性2例，女性13例)平均年龄33.27±10.58岁，为对照。运用免疫组化法检测Fas、FasL、bCl-2在外周血淋巴细胞的表达水平；用放射免疫法检测血清、尿IL-8含量。 结果 活动性LN患者Fas、FasL、bcl-2表达均显著高于正常对照组(P＜0.001)，Fas、FasL表达与临床活动指数积分呈正相关(r=0.517、P＜0.005；r=0.543，P＜0.005)，bcl-2表达与临床活动指数积分无显著相关性(r=0.09，P＞0.05)；血清、尿IL—8水平明显低于正常组(P＜0.01)，但与临床活动指数积分无关，与Fas、FasL、bcl-2无明显相关。各中医证型之间的临床活动指数积分、Fas、FasL、bcl-2、血清、尿IL—8表达水平皆无显著差异。福建中医学院2003届硕l:f讲究生学位论文中西医结合内科专业邱明山结论(1) Fas、FasL、bcl一的表达升高可能导致外周血淋巴细胞凋亡异常，为SLE、LN发病机制之一:(2)外周血淋巴细胞中Fas、FasL表达水平可作为病情活动的指标:(3)血、尿IL一8水平低下，可能与免疫功能紊乱有关，有待进一步研究。(4)传统的以中医证型来辨识狼疮活动程度的观点值得商榷。更多还原

【Abstract】 Objective To explore the clinical significance of the expression of Fas, Fas ligand (FasL), bcl-2 of peripheral blood lymphocytes (PBL) and interlinkin-8(IL-8) of serum and urine in patients with active lupus nephrity(LN) and to study the relationship of them to TCM syndromes in LN.Materials and Methods According to American Rheumatology Academy standard(ARA) and Unowitz’s lupus active standard ,36 patients(3 male and 33 female) with active LN, with an average age of 31.08 \11.74 years, were divided into four groups based on Zheng differentiation-classification, such as Excess of Noxious Heat (ENH),Interior Heat due to Yin Deficiency(IHYD),both Qi and Yin Deficiency(QYD),and Spleen Yang and Kidney Yang Deficiency(SYKYD). 15 healthy volunteers(2 male and 13 female) were taken as the normal control group ,with an average age of 33.27\10.58 years. The expression of Fas, FasL and bcl-2 were examined by immunohistochemical stain. And IL-8 of serum and urine were determined by radiate immunity assay.Result The expression of Fas, FasL and bcl-2 of PBL in active LN patients was significantly higher than those normal control group (P<0.001). The expression of Fas, FasL was positively related to SLE disease active index (r=0.517> P<0.005;r=0.543, P<0.005)in those LN patients but not-to bcl-2(r=0.09,P>0.05). The levels of IL-8 of serum and urine were lower than those in normal control group (P<0.01). There were not significantly related among the expression of FasN FasL and bcl-2 and IL-8. There were not significantly difference among various TCM syndromes in the expression of Fas, FasL and bcl-2 and IL-8 and disease active index.Conclusion The abnormity expression of Fas, FasL, bcl-2 may lead to abnormalapoptosis and play important role in the pathogenesis of LN. The expression of Fas, FasL may serves as active indexes for SLE and LN. The descent of IL-8 of serum and urine may relate to the dysfunction immunization, and it needs further research. It is inappropriate to assess the disease activity by TCM syndromes.更多还原