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目的:探讨不同病理类型的狼疮肾炎(LN)患者血中巨噬细胞衍生趋化因子(MDC)和白介素18(IL-18)的变化及意义。方法:应用ELISA法对不同病理类型LN患者血中MDC和IL-18进行测定。结果:(1)Ⅱ、Ⅲ型LN患者血中MDC的水平明显增高。MDC的水平与LN患者血中补体的变化呈负相关,与抗ds-DNA抗体的变化呈正相关,与系统性红斑狼疮的疾病活动评分(SLEDAI)呈正相关。(2)IL-18的水平在Ⅱ、Ⅲ、Ⅳ型LN患者血中均明显增高,且与补体下降呈负相关,与抗ds-DNA抗体水平、SLEDAI评分及LN患者的肾功异常呈正相关。③MDC的水平在Ⅱ、Ⅲ型LN组与IL-18水平的变化呈正相关,在Ⅳ型LN组无明显相关变化。结论:MDC和IL-18在LN的发生发展中均有重要作用,MDC对病变过程中的病理损伤的程度及Th1/Th2细胞失衡的变化的探讨具有重要意义。IL-18在LN的发生发展、治疗及预后的监控上具有重要作用。
Objective: To investigate the changes and significance of macrophage-derived chemotactic factor (MDC) and interleukin-18 (IL-18) in blood of patients with different pathological types of lupus nephritis (LN). Methods: The serum levels of MDC and IL-18 in patients with different pathological types of LN were measured by ELISA. Results: (1) The blood levels of MDC in type Ⅱ and type Ⅲ LN patients were significantly higher. The level of MDC was negatively correlated with the change of complement in blood of LN patients, positively correlated with the change of anti-dsDNA antibody and positively correlated with the disease activity score (SLEDAI) of systemic lupus erythematosus. (2) The level of IL-18 in patients with type II, III and IV LN was significantly higher than that in patients with LN, and negatively correlated with the decline of complement, which was positively correlated with the levels of anti-dsDNA antibody, SLEDAI score and renal dysfunction . ③ The level of MDC was positively correlated with the level of IL-18 in type Ⅱ and type Ⅲ LN group, but no significant change in type Ⅳ LN group. CONCLUSION: Both MDC and IL-18 play an important role in the development and progression of LN. The study on the degree of pathological damage and the imbalance of Th1 / Th2 cells in MDC plays an important role. IL-18 plays an important role in the development, treatment and prognosis of LN.