普乐可复对难治性肾病综合征患者血清IL-2、sIL-2R的影响及其临床意义

目的:研究普乐可复(FK506)对难治性肾病综合征患者血清IL-2、sIL-2R的影响及其临床意义。方法:应用酶联免疫吸附法检测难治性肾病综合征患者经普乐可复治疗前后血清IL-2、sIL-2R水平变化,并监测患者24小时尿蛋白、血浆白蛋白、血脂的变化。结果:难治性肾病综合征患者经普乐可复治疗前血清IL-2、sIL-2R水平均显著高于正常对照组(P<0.05)。治疗后血清IL-2、sIL-2R水平较治疗前明显下降(P<0.05)。治疗前24小时尿蛋白水平显著高于正常对照组(P<0.01),血浆白蛋白显著低于正常对照组(P<0.01),血脂水平显著高于正常对照组(P<0.01);与治疗前比较,治疗后24小时尿蛋白水平显著下降(P<0.05),血浆白蛋白水平显著升高(P<0.01),血脂水平显著下降(P<0.05)。治疗后组与正常组比较,除IL-2外,余各项指标均无显著性差异(P>0.05)。结论:在难治性肾病综合征患者体内存在IL-2、sIL-2R的异常,普乐可复对其有明确的抑制作用,从而调节T细胞活性,有效降低24小时尿蛋白,提高血浆白蛋白含量,降血脂,缓解难治性肾病综合征的病情。

Effect and clinical significance of Tacrolimus on serum interleukin-2 (IL-2)、 soluble interleukin-2 receptor(sIL-2R) expression in refractory nephrotic syndrome

Objective:To investigate the effect of Tacroliums(FK506) on the significance of IL-2 and sIL-2R expression in refractory nephrotic syndrome. Methods: The expression of IL-2 and sIL-2R were evaluated by enzyme-linked immunosorbent assay (ELISA) on both pretreatment and post-treatment groups, and supervise the changes of 24hours urinary protein,serum albumin and lipid. Results:Serum IL-2 and sIL-2R level were higher in pre-treatment group than in normal control group(P<0.05), and 24 h urinary protein, serum lipid level were higher and serum albumin level was lower in pre-treatment group than in normal control group(P<0.01).After the treatment of FK506, IL-2 and sIL-2R levels decreased(P<0.05), 24 h urinary protein,serum lipid significantly decreased, and albumin level significantly increased (P<0.01).Except IL-2, there were no significant differences in sIL-2R expression,24 h urinary protein,serum albumin and lipid in both post-treatment and normal control groups. Conclusion:This study demonstrated that there were unnormal IL-2 and sIL-2R expression on the refractory nephrotic syndrome,tecroliums could significantly inhibit the expression of activated IL-2 and sIL-2R, and express the activation of T lymphocytes, reduce 24 h urinary protein,serum lipid level and increase serum albumin level, Tacrolimus could alleviate refractory nephritic syndrome.