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目的观察非ＩｇＡ系膜增殖性肾炎患者应用激素前后血清肿瘤坏死因子－α（ＴＮＦ－α）的变化及其与尿蛋白的相关关系。方法３０例非ＩｇＡ系膜增殖性肾炎表现为肾病综合征的患者按病理增生程度不同分为轻度增生组和中重度增生组，两组均在用激素前及用激素后４周及８周测定血清ＴＮＦ－α及２４小时尿蛋白定量。结果两组患者治疗前血清ＴＮＦ－α明显升高，且ＴＮＦ－α水平与系膜增生程度有关，激素治疗后ＴＮＦ－α下降，疗效与系膜增生程度及ＴＮＦ－α水平有关。ＴＮＦ－α与２４小时尿蛋白存在显著正相关。结论对非ＩｇＡ系膜增殖性肾炎患者测定血清ＴＮＦ－α可作为判断组织学损伤的非创伤性参考指标及判断激素疗效与预后的参考指标。
Objective To investigate the changes of serum tumor necrosis factor-α (TNF-α) and its relationship with urinary protein in non-IgA mesangial proliferative glomerulonephritis patients before and after application of hormones. Methods Thirty non-IgA mesangial proliferative glomerulonephritis patients with nephrotic syndrome were divided into mild hyperplasia group and moderate-severe hyperplasia group according to the degree of pathological hyperplasia. Both groups were treated with hormones before and 4 and 8 weeks after hormone therapy Serum TNF-α and 24-hour urinary protein were measured. Results The levels of serum TNF-α in the two groups before treatment were significantly increased, and the level of TNF-α was related to the degree of mesangial proliferation. The level of TNF-α decreased after hormone therapy. The therapeutic effect was related to the mesangial proliferation and the level of TNF-α. There was a significant positive correlation between TNF-α and 24-hour urinary protein. Conclusion The determination of serum TNF-α in patients with non-IgA mesangial proliferative glomerulonephritis can be used as a non-invasive reference index for judging histological injury and a reference index for judging hormone therapy efficacy and prognosis.