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目的动态观察狼疮性肾炎患者血清IL-6、IL-18的变化水平,探讨Th1/Th2平衡失调在狼疮性肾炎病程中的作用。方法采用双抗体夹心Elisa的方法检测34例狼疮性肾炎患者治疗前及经甲泼尼龙与环磷酰胺双冲击治疗1、3、6、12个月后血清IL-6、IL-18水平,并同期进行系统性红斑狼疮活动性评分(SLEDAI),另选取30例健康者为对照组。结果治疗前、后SLEDAI评分具有统计学差异(P<0.05);治疗前、治疗1个月后血清IL-18水平均显著高于对照组(P<0.01),但治疗3～12个月后其水平显著下降,与治疗前及治疗1个月时比较具有统计学差异(P<0.05),与健康对照组比无统计学差异(P>0.05);血清IL-6水平在治疗前明显高于对照组,但治疗1个月后即显著下降,显著低于治疗前(P<0.01),治疗12个月后几乎降至正常。结论 Th1/Th2平衡失调在狼疮性肾炎发病中起重要作用,但经有效治疗后可恢复正常。
Objective To observe the changes of serum IL-6 and IL-18 levels in patients with lupus nephritis and to explore the role of Th1 / Th2 balance disorders in the course of lupus nephritis. Methods Serum levels of IL-6 and IL-18 in 34 patients with lupus nephritis before and after double impact with methylprednisolone and cyclophosphamide were measured by Elisa method The same period, systemic lupus erythematosus activity score (SLEDAI), another 30 healthy people as the control group. Results Before and after treatment, the SLEDAI score was statistically significant (P <0.05). Before treatment, the level of IL-18 in serum was significantly higher than that in the control group after 1 month of treatment (P <0.01), but after 3 to 12 months of treatment The level of IL-6 was significantly lower than that before treatment and one month after treatment (P <0.05), but not significantly different from that of healthy controls (P> 0.05). The level of IL-6 in serum before treatment was significantly higher In the control group, but decreased significantly after 1 month of treatment, which was significantly lower than that before treatment (P <0.01), and almost reduced to normal after 12 months of treatment. Conclusion The imbalance of Th1 / Th2 play an important role in the pathogenesis of lupus nephritis, but it can return to normal after effective treatment.