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目的：探讨T 辅助细胞（Th）相关细胞因子在狼疮性肾炎发病中的免疫机制作用。方法：64 例系统性红斑狼疮患者和28 例健康体检者作为对照，采用酶联免疫吸附测定法（ELISA 法）检测所有受试者血清IL-17、IFN-γ、IL-4 水平，并对其与SLEDAI、 SDI、24 小时尿蛋白量相关性进行研究。结果：狼疮性肾炎组血清IL-17 水平显著高于狼疮无肾炎组和健康对照组（P<0.001），狼疮性肾炎组血清IFN-γ 水平显著高于狼疮无肾炎组（P<0.05）和健康对照组（P<0.01），血清IL-4 水平在狼疮性肾炎组、狼疮无肾炎组均显著高于健康对照组（P<0.01）。狼疮性肾炎组IFN-γ/IL-4 比值显著高于狼疮无肾炎组（P<0.01）和健康对照组（P<0.05）；狼疮无肾炎组IFN-γ/IL-4 比值显著低于健康对照组（P<0.01）。SLE 患者血清IFN-γ 表达水平与SLEDAI 积分呈正相关（r =0.402, P <0.05），血清IL-17、IL-4 表达水平与SLEDAI、SDI、抗ds-DNA 抗体、C3、24 小时尿蛋白量均无相关性。结论：狼疮性肾炎患者外周血中IL-17、IFN-γ、IL-4 等促炎细胞因子均有不同程度升高促起炎症发生及组织损伤，参与了狼疮性肾炎的免疫发病过程。

英文摘要:

Objective: To investigate the effect and the clinical significance of Th cells in the pathogenesis of patients with lupus nephritis (LN). Methods：64 systemic lupus erythematosus patients and 28 healthy controls were enrolled. The concentrations of serum IL-17, IFN-γ, IL-4 were measured by enzyme-linked immunosorbent assay (ELISA). Results: 1. The expression of IL-17 in LN Group exhibited a significant increase compared with that in SLE Group and healthy controls (P<0.001). 2. The levels of IFN-γ in LN Group were higher than those in SLE Group and in healthy controls (P<0.05, P<0.01, respectively). 3. The levels of IL-4 in SLE Group, LN Group were higher than those in healthy controls (P<0.01). 4. Th1/Th2 (IFN-γ/IL-4) ratio in LN Group increased significantly than that in SLE Group (P<0.01) and HC group (P<0.05); Th1/Th2 (IFN-γ/IL-4) ratio decreased in SLE Group compared with that in HC group (P<0. 01). 5. The levels of IFN-γ were positively correlated with SLEDAI scores in SLE patients (P<0.05). Conclusions: The significantly elevated serum IL-17, IFN-γ, IL-4 levels in lupus nephritis, suggesting that Th17/ Th1/ Th2 functional imbalance may be involved in the pathogenesis of renal damage in SLE patients.

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