Levels and clinical significance of serum IL-2, IL-10, TNF-α and IFN-γ in patients with early idiopathic membranous nephropathy
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摘要: 目的 探究早期特发性膜性肾病(IMN)患者血清白细胞介素-2(IL-2)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)和干扰素-γ(IFN-γ)水平及临床意义。方法 选择2019年1月至2020年12月诊治的125例IMN患者作为观察组, 另选取同时期100例健康体检者作为对照组。观察组治疗后33例未缓解, 92例缓解。检测2组血清IL-2、IL-10、TNF-α和IFN-γ水平及观察组治疗前、后其水平, 分析观察组治疗前血清IL-2、IL-10、TNF-α和IFN-γ水平与各项临床指标的相关性, 比较不同疗效患者血清IL-2、IL-10、TNF-α和IFN-γ水平的变化。结果 观察组血清IL-2、TNF-α水平较对照组高, 血清IL-10、IFN-γ水平较对照组低(P< 0.05)；观察组血压、24 h尿蛋白、血清C反应蛋白(CRP)均较对照组高(P< 0.05)；Pearson相关性分析显示, 观察组IL-10水平与血压呈负相关(P< 0.05), TNF-α水平与24 h尿蛋白、CRP均呈正相关, IFN-γ水平与血压、CRP均呈负相关(P< 0.05)；缓解组治疗后血清IL-2、TNF-α水平较未缓解组低, 血清IL-10、IFN-γ水平较未缓解组高(P< 0.05)。结论 IMN患者血清IL-2、IL-10、TNF-α和IFN-γ水平存在显著异常, 对病情及疗效评估的参考价值较高。Abstract: Objective To explore the levels and clinical significance of serum interleukin-2(IL-2), interleukin-10(IL-10), tumor necrosis factor α(TNF-α) and interferonγ(IFN-γ) in patients with early idiopathic membranous nephropathy(IMN).Methods A total of 125 patients with IMN were enrolled as observation group between January 2019 and December 2020, while other 100 healthy controls during the same period were enrolled as control group. In the observation group, 33 patients were not relieved and 92 patients were relieved after treatment. The levels of serum IL-2, IL-10, TNF-α and IFN-γin both groups, and before and after treatment in observation group were detected. Correlation between serum IL-2, IL-10, TNF-α, IFN-γand various clinical indexes was analyzed. The levels change of serum IL-2, IL-10, TNF-α and IFN-γin patients with different curative effect were compared.Results The levels of serum IL-2 and TNF-α in observation group were higher than those in control group, while levels of serum IL-10 and IFN-γwere lower than those in control group(P< 0.05). The levels of blood pressure, 24 h urine protein and CRP in observation group were all higher than those in control group(P< 0.05). Pearson correlation analysis showed that IL-10 level was negatively correlated with blood pressure(P< 0.05), TNF-α level was positively correlated with 24 h urine protein and CRP, and IFN-γlevel was negatively correlated with blood pressure and CRP(P< 0.05). After treatment, the levels of serum IL-2 and TNF-α in remission group were lower than those in non-remission group, while the levels of serum IL-10 and IFN-γwere higher than those in non-remission group(P< 0.05).Conclusion The levels of serum IL-2, IL-10, TNF-α and IFN-γare significantly abnormal in patients with early IMN, which might be of great reference value for evaluating conditions and curative effect.
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表 1 2组血清IL-2、IL-10、TNF-α和IFN-γ水平比较
X±S 组别 例数 IL-2/(pg·mL-1) IL-10/(pg·mL-1) TNF-α/(ng·L-1) IFN-γ/(pg·mL-1) 观察组 125 144.38±28.54 98.69±9.14 101.26±21.53 66.07±12.81 对照组 100 89.61±4.82 153.25±31.37 42.85±10.24 86.29±15.31 t 18.967 18.498 24.957 10.784 P < 0.001 < 0.001 < 0.001 < 0.001 
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表 2 2组血压、24 h尿蛋白、CRP比较
X±S 组别 例数 收缩压/mmHg 舒张压/mmHg 24 h尿蛋白/g CRP/(mg·L-1) 观察组 125 128.69±17.31 82.53±10.38 4.15±1.38 8.39±2.15 对照组 100 115.97±3.56 77.71±2.55 0.06±0.01 5.71±1.87 t 7.224 4.534 29.624 9.838 P < 0.001 < 0.001 < 0.001 < 0.001
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表 3 观察组血清IL-2、IL-10、TNF-α和IFN-γ水平与血压、24h尿蛋白、CRP的相关性分析
项目 血压 24 h尿蛋白 CRP r P r P r P IL-2 0.015 0.906 0.118 0.342 0.183 0.122 IL-10 -0.311 < 0.050 0.152 0.283 0.107 0.421 TNF-α 0.195 0.117 0.486 < 0.001 0.539 < 0.001 IFN-γ -0.542 < 0.001 0.157 0.364 -0.458 < 0.001
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表 4 观察组治疗前、后血清IL-2、IL-10、TNF-α和IFN-γ水平比较
X±S 组别 例数 IL-2/(pg·mL-1) IL-10/(pg·mL-1) TNF-α/(ng·L-1) IFN-γ/(pg·mL-1) 治疗前 125 144.38±28.54 98.69±9.14 101.26±21.53 66.07±12.81 治疗后 125 117.27±10.32 121.28±21.42 75.87±20.39 78.24±14.83 t 9.987 10.845 9.573 6.943 P < 0.001 < 0.001 < 0.001 < 0.001
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表 5 不同疗效患者血清IL-2、IL-10、TNF-α和IFN-γ水平比较
X±S 组别 例数 IL-2/(pg·mL-1) IL-10/(pg·mL-1) TNF-α/(ng·L-1) IFN-γ/(pg·mL-1) 未缓解组 33 139.57±18.49 100.16±12.17 96.71±21.06 68.93±13.65 缓解组 92 109.27±9.85 128.86±21.54 68.39±17.32 81.58±15.27 t 11.779 7.239 7.599 4.194 P < 0.001 < 0.001 < 0.001 < 0.001
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