中文摘要：

目的：探索尿液炎症因子白细胞介素-6（interleukin-6,IL-6）、肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）和单核细胞趋化蛋白-1（monocyte chemotactic protein-1,MCP-1）表达与肾性血尿中医分型的相关性。方法：收集原发性单纯性血尿（肉眼或镜下血尿且24 h尿蛋白定量〈1.0 g）或血尿伴蛋白尿（24 h尿蛋白定量〈3.5 g）的行肾穿刺的患者,排除继发性、遗传性及其他非肾小球来源的血尿患者共237例,通过中医症候辨证分型,将其分为气阴两虚型80例,风湿内扰型59例,脉络瘀阻型98例,并设40例正常对照;采用酶联免疫吸附剂测定法（enzyme linked immunosorbent assay,ELISA）检测患者尿液炎症因子IL-6、TNF-α和MCP-1表达,通过免疫荧光检测肾脏组织病理改变。结果：气阴两虚型、风湿内扰型和脉络瘀阻型之间,尿液的IL-6、TNF-α和MCP-1浓度差异存在统计学意义,以风湿内扰型尿液的IL-6、TNF-α和MCP-1浓度最高（P〈0.05-0.01）;气阴两虚型、风湿内扰型和脉络瘀阻型不同中医证型与肾脏免疫病理存在相关性,气阴两虚型肾脏Ig A、Ig G和Ig M表达最低,Ig A和Ig M表达差异有统计学意义（P〈0.05-0.01）,IgG表达差异无统计学意义（P〉0.05）;肾脏补体C_3、C1q和Fib亦以气阴两虚型表达最低,其中C3和C1q表达差异有统计学意义（P〈0.05-0.01）,Fib表达差异无统计学意义（P〉0.05）。结论：肾性血尿中医辨证分型之气阴两虚型、风湿内扰型和脉络瘀阻型,各型尿液中IL-6、TNF-α和MCP-1浓度差异存在统计学意义,肾脏免疫病理的IgA、IgG、IgM和补体C3、C1q表达亦不尽相同,该类生物标志物是中医辨证论治的物质基础的补充。

英文摘要：

Objective：To explore the correlation between the expression of IL -6 ,TNF - α ,MCP - 1 in urinary inflammatory, renal immune pathology and TCM syndrome type of renal hematuria. Methods： Screening patients who undergoing renal biopsying with primary isolated hematuria （ gross or microscopic hematuria, 24 h urinary protein excretion 〈 1.0 g） or proteinuria combined with hematuria （ 24 h urinary protein excretion 〈 3.5 g） from July 2008 - June 2012 in Hangzhou Hospital of TCM. And then excluding the secondary, hereditary and other non -glomerular bematuria, the final number is 237 cases. These cases are classified to Qi -yin dual Deficiency Syndrome 80 cases, wind-dampness Syndrome 59 cases, Blood Stasis Syndrome 98cases. At the same time, set up 40 normal controls as well as comparable with analysis. Determining the IL -6,TNF - ct and MCP - 1 in urine by Elisa method, simultaneous determining the corresponding concentration of urine creatinine used as calibration. The pathological changes of renal tissues were detected by immunofluorescence. Results ：There are significant differences between these syndromes. The uIL- 6 ,TNF -ctand MCP - 1 concentration in wind - dampness group were highest （P 〈0.05 -0.01 ）. What＇ s more, the above three different TCM syndromes have correlation with renal immune pathology. The expression of immunoglobulin IgA,IgG and IgM was lowest in Qi - yin dual Deficiency, which the deposition of IgA and IgM had significant difference （ P 〈 0.05 - 0.01 ）, while the difference of IgG has no sta- tistically significance （ P 〉 0.05）. The Qi - yin dual Deficiency group had the lowest deposition of C3 、 1q and fibrinogen （Fib）. Compared with the other two groups, the expression of C3 and Clq had statistical difference （P 〈0.05 -0.01 ）, while the difference of Fib has no statistically significance（P 〉 0.05）. Conclusion：The uIL -6 ,TNF- ctand MCP- 1 concentration in the above three TCM syndrome have significant difference. Also the deposition o