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目的:探讨不同病理类型的狼疮肾炎患者的肾脏损伤与血清中肿瘤坏死因子和可溶性肿瘤坏死因子受体的相关性。方法:B超引导下对23例狼疮肾炎行肾组织活检并做病理分型;同时应用ELISA方法测定患者及30例正常对照组血清中肿瘤坏死因子和可溶性肿瘤坏死因子受体的水平。结果:本组患者的肾脏活检病理分型为Ⅱ、Ⅲ、Ⅳ和Ⅴ型;患者血清中肿瘤坏死因子和可溶性肿瘤坏死因子受体的水平明显高于正常对照组（P<0.01）,且随病理损伤程度的加重其表达水平亦增高,4组间有显著差别（P<0.05）。结论:狼疮肾炎患者的肿瘤坏死因子和可溶性肿瘤坏死因子受体参与了疾病的免疫损伤机制,它们可作为一种间接判断肾脏损伤程度的依据。
OBJECTIVE: To investigate the correlation between renal damage and serum tumor necrosis factor and soluble tumor necrosis factor receptor in patients with different pathological types of lupus nephritis. Methods: Twenty-three cases of lupus nephritis underwent renal biopsy under pathological examination. The serum levels of tumor necrosis factor and soluble tumor necrosis factor receptor were measured by ELISA in patients and 30 normal controls. Results: The pathological classification of renal biopsy in this group was type Ⅱ, Ⅲ, Ⅳ and Ⅴ. The levels of serum tumor necrosis factor and soluble tumor necrosis factor receptor in patients were significantly higher than those in normal control group (P <0.01) The degree of pathological injury increased its expression level also increased, there was a significant difference between the 4 groups (P <0.05). CONCLUSIONS: Tumor necrosis factor and soluble tumor necrosis factor receptor are involved in the mechanism of immune injury in lupus nephritis, and they may serve as an indirect basis to judge the degree of renal damage.