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目的:探讨转化生长因子(TGF-β)和白介素-18(IL-18)在狼疮肾炎(LN)患者血清中的表达及临床意义。方法:使用ELISA法对46LN患者血清进行检测,并与31例正常人作对照。结果:LN患者血清中IL-18的水平显著高于正常对照组(P<0.01)。LN患者血清中的TGF-β水平显著低于正常对照组(P<0.01)。血清IL-18的表达和LN患者SLEDAI评分之间有相关性(P<0.01)。抗dsDNA、抗Sm、抗nRNP、aCL IgG抗体在LN组有较高的阳性率,与对照组比较差异有显著性(P<0.05)。将IL-18、TGF-β、抗dsDNA抗体、抗Sm抗体、抗nRNP抗体和aCLIgG抗体分别引入LOGISTIC回归进行统计分析。结果:入选的自变量包括血清IL-18、抗dsDNA抗体、血清TGF-β、抗Sm抗体(P<0.05)。结论:在LN患者中,可能存在着血清IL-18的高表达和血清TGF-的低表达。血清IL-18可能是反映了系统性红斑狼疮患者并发肾脏损害的一个重要的指标。抗dsDNA抗体、抗Sm抗体、血清IL-18、血清TGF-β可能参与了LN的发病进程。
Objective: To investigate the expression of transforming growth factor (TGF-β) and interleukin-18 (IL-18) in serum of patients with lupus nephritis (LN) and its clinical significance. Methods: The serum of patients with 46LN was detected by ELISA and compared with 31 healthy controls. Results: The serum levels of IL-18 in LN patients were significantly higher than those in normal controls (P <0.01). The level of TGF-β in serum of LN patients was significantly lower than that of the normal control group (P <0.01). There was a correlation between serum IL-18 expression and SLEDAI score in patients with LN (P <0.01). Anti-dsDNA, anti-Sm, anti-nRNP, aCL IgG antibodies in LN group had a higher positive rate, compared with the control group, the difference was significant (P <0.05). The IL-18, TGF-β, anti-dsDNA antibody, anti-Sm antibody, anti-nRNP antibody and aCLIgG antibody were introduced into LOGISTIC regression for statistical analysis. Results: The independent variables included serum IL-18, anti-dsDNA antibody, serum TGF-β, anti-Sm antibody (P <0.05). CONCLUSIONS: In patients with LN, high serum IL-18 expression and low serum TGF-β expression may exist. Serum IL-18 may be an important indicator of renal damage in patients with systemic lupus erythematosus. Anti-dsDNA antibody, anti-Sm antibody, serum IL-18, serum TGF-β may be involved in the pathogenesis of LN.