IgA肾病患者扁桃体切除前后血、尿IL-2、IL-6的变化

目的检测IgA肾病患者扁桃体切除前后患者的血、尿IL-2、IL-6的水平,以探讨其变化规律和临床意义。方法选取经肾活检诊断为IgA肾病的患者76例,并排除肝硬化等继发性IgA肾病,并根据系膜增生程度分为轻度系膜增生组(A组)62例,中度系膜增生组(B组)5例,中度系膜增生伴新月体形成(C组)5例、局灶节段硬化组(D组)4例,同时选取健康查体10人作正常对照组(E组),观察患者扁桃体切除术前、术后6个月时患者的血尿IL-2、IL-6的水平。结果轻、中度系膜增生组扁桃体切除半年后尿IL-2、血IL-6、尿IL-6含量明显低于扁桃体切除前,结果有显著性差异(T=1.9624-9.6436、P0.05),而中度系膜增生伴新月体形成组和局灶节段硬化组两组患者扁桃体切除前和切除半年后血清及尿IL-2、IL-6较前下降,但无统计学意义(t=0.3221-1.0914)。无论扁桃体切除前后C、D两组患者的尿IL-2、IL-6水平均明显高于A、B组患者,二者有统计学差异(T2.235 5,P0.01)。结论轻、中度系膜增生性IgA肾病患者行扁桃体切除能改善患者的炎症因子的产生,降低患者尿IL-2、IL-6水平,而对于中度系膜增生伴新月体形成和局灶节段硬化的患者来说,扁桃体切除意义不大;对于尿液中IL-2、IL-6水平持续处于高水平的患者,提示病理损伤较重,扁桃体切除的意义不大。

The Changing Research About IL-2,IL-6 levels of IgA Nephropathy Patients 's Blood and Urine Before and After Tonsillectomy

Objective To detect IL-2,IL-6 levels in patients ＇s blood and urine with hematuria IgA nephropathy before and after tonsillectomy,in order to research the variation and clinical significance.Methods To select 76 patients with IgA nephropathy diagnosed by renal biopsy,and remove cirrhosis and another secondary IgA nephropathy;According to the degree of mesangial proliferative mild mesangial proliferative 62 cases（group A）,mo-derate mesangial hyperplasia 5 cases（group B）,moderate mesangial prolifer-ation with crescent formation 5 cases（group C）,focal segmental sclerosis group 4 cases（group D）;while 10 healthy were selected as normal control group（group E）;detecting IL-2,IL-6 levels in patients ＇s blood and urine before and after tonsillectomy after 6 monthsResults Six months later after tonsillectomy IL-2 and IL-6 levels in urine,IL-6 level in serum of group Aand B were significantly lower than before tonsillectomy,results is significantly different（T=1.962 4,P〈0.05 T=2.395 6,T=9.643 6,P〈0.01）,but IL-2,IL-6 level in blood and urine of group C and D is lower after tonsillectomy six months later but not significant difference than before tonsillectomy（t=0.322 1-1.091 4）.Both before and after tonsillectomy in C and D groups,patients＇s IL-2,IL-6 in urine were significantly higher than group A,and B,both are significantly different（T〉 2.2355,P〈0.01）.Conclusion For patients with mild to moderate mesangial proliferative IgA nephropathy,tonsillectomy can reduce inflammation fators,and lower urinary IL-2,IL-6 levels,but to moderate mesangial proliferation with crescent formation and focal section Section sclerosis patients,tonsillectomy is not necessary,urine IL-2,IL-6 levels in these patients were sustained in high levels,suggesting these patients＇s pathological changing were heavier,tonsillectomy is not need.