Inaba S, Takahashi T, Ishihara S, Kurose K, Arai M, Sakai Y, Yamamoto S, Matsukura H, Okada T
Department of Pediatrics, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.
Nephron. 1996;72(4):518-22. doi: 10.1159/000188932.
Tumor necrosis factor (TNF)-alpha and interferon (INF)-gamma levels were measured in the sera obtained from 29 patients with IgA glomerulonephritis (IgA GN), 8 patients with minimal change nephrotic syndrome (MCNS) and 12 patients with upper respiratory tract infection (URI) without renal diseases in children. The serum TNF-alpha level of IgA GN was 123.0 +/- 175.4 pg/ml, MCNS was 4.9 +/- 4.0 pg/ml and URI was 10.5 +/- 4.5 pg/ml respectively. The serum TNF-alpha level of IgA GN was significantly higher than those of MCNS and URI. The serum TNF-alpha level of URI was on the high trend compared with that of MCNS, but was not statistically significant. Although the TNF-alpha level was related to mesangial cell proliferation in patients with IgA GN, it was unrelated to the grade of mesangial matrix expansion and magnitude of proteinuria. In 17 patients with IgA GN having macroscopic hematuria, the serum TNF-alpha level was 190.5 +/- 201.6 pg/ml, and in other IgA GN patients with microscopic hematuria it was 37.4 +/- 75.7 pg/ml. The serum TNF-alpha level of IgA GN with macroscopic hematuria was significantly higher than that with microscopic hematuria. In 6 patients with IgA GN with macroscopic hematuria, the serum TNF-alpha level was significantly decreased after macroscopic hematuria disappeared. The mean serum IFN-gamma level of IgA GN was 0.3 +/- 0.6 IU/ml, and MCNS was not detectable. Although the serum IFN-gamma level was related to mesangial cell proliferation in patients with IgA GN, it was unrelated to magnitude of proteinuria, the grade of mesangial matrix expansion and also the presence or absence of macroscopic hematuria. We suggest that macroscopic hematuria of IgA GN was closely related to the serum TNF-alpha level.
对29例儿童IgA肾小球肾炎（IgA GN）患者、8例微小病变肾病综合征（MCNS）患者和12例无肾脏疾病的上呼吸道感染（URI）患儿的血清进行肿瘤坏死因子（TNF）-α和干扰素（INF）-γ水平检测。IgA GN患者血清TNF-α水平为123.0±175.4 pg/ml，MCNS患者为4.9±4.0 pg/ml，URI患儿为10.5±4.5 pg/ml。IgA GN患者血清TNF-α水平显著高于MCNS患者和URI患儿。URI患儿血清TNF-α水平与MCNS患者相比呈升高趋势，但差异无统计学意义。虽然IgA GN患者的TNF-α水平与系膜细胞增殖有关，但与系膜基质扩张程度和蛋白尿程度无关。17例有肉眼血尿的IgA GN患者血清TNF-α水平为190.5±201.6 pg/ml，其他镜下血尿的IgA GN患者血清TNF-α水平为37.4±75.7 pg/ml。有肉眼血尿的IgA GN患者血清TNF-α水平显著高于镜下血尿患者。6例有肉眼血尿的IgA GN患者肉眼血尿消失后血清TNF-α水平显著下降。IgA GN患者血清IFN-γ平均水平为0.3±0.6 IU/ml，MCNS患者未检测到。虽然IgA GN患者的血清IFN-γ水平与系膜细胞增殖有关，但与蛋白尿程度、系膜基质扩张程度以及有无肉眼血尿无关。我们认为IgA GN的肉眼血尿与血清TNF-α水平密切相关。
