| Objective Through the detection of the urine Interleukin-6(uIL-6) and Tumor Necrosis Factor,(uTNF-a) concentration from patients with primary renal hematuria, analyzing TCM syndromes in patients with primary renal hematuria and the correlation with renal pathology, providing an objective basis for Chinese Medicine syndrome differentiation, guiding the diagnosis and treatment, and providing the basis for estimating the serious degree of the clinical condition and the prognosis of renal hematuria.Methods Screening patients with primary isolated hematuria (gross or microscopic hematuria) or hematuria with proteinuria (24h urinary protein excretion<3.5g) and with undergoing renal biopsying,excluding the secondary, hereditary and other non-glomerular hematuria from January2011-June2012in Hangzhou Hospital of TCM. There are82cases. Sampling the stored urine specimens from Hangzhou Hospital of TCM Nephropathy Laboratory, and analyzing the clinical features in82cases of patients with primary renal hematuria, dividing them into three groups, qi-yin deficiency group, rheumatism within the scrambling group and context stasis group according to "three-types-syndromes analysis" from the article called Study on the Therapy Based on Tonijying Deficiency, Resolving Blood Stasis, and Dispelling Wind-dampness of IgA Nephropathy in123cases which was written by WangYongjun professer who is the pace-setter in department of nephropathy in our hospital, comparing differences between the three groups; While analyzing their different renal biopsy datas, total glomerular sclerosis ratio(global sclerosis ratio+segmental sclerosis ratio), crescents, renal interstitium, interstitial inflammatory cell infiltration, interstitial atrophy, dividing them into corresponding groups, then comparing the differences. Determining the urine IL-6and TNF-a level by Elisa method, Simultaneous determining of the corresponding urine creatinine concentration be used as calibration, the results were statistically analyzed by SPSS17.0software.Results In TCM Syndrome, uIL-6and uTNF-a concentration in rheumatism within the scrambling group was higher than qi-yin deficiency group, the difference was statistically significant(P<0.05), uTNF-a concentrations when after being creatinine corrected had statistically significance(P<0.01). The difference between context stasis group and qi-yin deficiency group the uIL-6/uTNF-a concentration had no statistically significance (P>0.05); Compared with the rheumatism within the scrambling group, uTNF-a concentration in context stasis group and its creatinine concentration were reduced, the differences were statistically significant(P<0.05), while uIL-6and its creatinine corrected concentration had no statistically significance (P>0.05). In the pathological manifestations of glomerular,the group which total glomerular sclerosis ratio>25%(total glomerular sclerosis ratio=global sclerosis ratio+segmental sclerosis ratio) had higher concentration values of uIL-6/uTNF-a than the groups of almost no sclerosis and total sclerosis ratio<25%,and the differences were statistically significant(P<0.05). In different crescents (including cells, cell fibrous, fiber cell, fibrous crescents), comparing the ratios of each groups’concentration values of uIL-6/uTNF-a and concentration by creatinine corrected, the differences were not statistically significant(P>0.05). In the pathological manifestations of renal interstitium, the group of renal interstitial fibrosis>25%had higher concentration values of uIL-6than the group of almost no fibrosis, the difference was statistically significant (P<0.05);Comparing the group of interstitial fibrosis≤25%, the interstitial fibrosis>25%group’s concentration values of uIL-6/uTNF-a were much higher,the difference was statistically significant (P<0.01), as well as corrected by urinary creatinine (P<0.05).The group of interstitial inflammatory cell infiltration≥25%had higher uTNF-a than almost no inflammatory cell infiltration group, the difference was statistically significant (P<0.01),and it’s also higher than the group of inflammatory cell infiltration<25%(P<0.05); UIL-6concentration in renal interstitial atrophy≥25%group than that shrinkage<25%group, the difference was statistically significant (P<0.05).Conclusion The detection of uIL-6/uTNF-a density via the ELISA method can quantify different TCM classification of primary renal hematuria, provide the basis of the laboratory tests directly, and it also lays a non-invasive foundation of prompting pathological manifestation of renal hematuria to some extent. ELISA method can supply the basis for estimating the serious degree of the clinical condition and the prognosis of renal hematuria. |
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