The Clinical Research On The Relationship Between Blood TNF-α And Blood No In Frequent Relapses Nephrotic Syndrome

ObjectiveiTo investigate the relationship between tumor necrosis factor (TNF-a) and nitric oxide (NO) and FRNS, to evaluate the value of TNF- a and NO in predicting relapse, to observe the levels of plasma TNF and serum NO effected by Qing Jie Shen Kang Ling and further explain the anti-relapse mechanism of Qing Jie Shen Kang Ling.Methods: 60 patients with FRNS were randomly divided into group A (Qing Jie Shen Kang Ling+Westen medicine) and B ( Westen medicine ) , 30 healthy subjects served as group C, Group B severd as the control group. Prednisone was adopted inducing remission, transplanting and tapering methods; Tn was adopted 24 weeks methods; or CTX was took orally 8 weeks or vein pulsion; Qing Jie Shen Kang Ling was given at 15 g/time,tid for a year.Vein blood samples of the patients were collected at 8 o'clock in the morning for testing before and after the treatment. TNF- a was tested by ELISA. NO was tested by enzyme assay. Serum CHO, ALB, were tested by Auto Biochemistry Analysis. Statisticalanalysis was performed on SPSS 8.0. system software.Results: The levels of plasma TNF-a and serum NO of the cases with FRNS at relapse were markedly higher than those at remission and group C( P<0.01). After completion of therapy , there were not remarkable difference between group A and group C (p>0.05); the levels of plasma TNF- a were not remarkable difference between group B and group C(p>0.05); the levels of serum NO were remarkable difference between group B and group C(p < 0.01); Effect of group A was better than that of group B after treatment (p<0.01). Side effects in group A were obviously less than those in group B. Group A was much better than group B in correcting abnormality of CHO ( p<0.01 ). study data showed the level of plasma TNF- a was positively correlated with the relapses (Chi-Square X2=69.6, TNF-a Variable B=1.2976) ,and showed the same relationship to NO.Conclusions: 1. Plasma TNF- a and serum NO may be regarded as index of FRNS in active period. The level of plasma TNF- a may predict the trend toward relapse in children with FRNS. The higher level of plasma TNF- a , the more frequently the relapses occur. 2. Qing Jei Shen Kang Ling has significantly better effects on treatment and prophylaxis of FRNS. It can decrease the levels of TNF-a, control the injury associated with TNF- a and NO, and be dominant in decreasing the complication and steroid side effects.3. Qing Jie Shen Kang Ling is a kide of safe and effective Chinese herbal medicine against FRNS.