目的 探讨来氟米特对系膜增生性肾小球肾炎的治疗作用及对炎性因子的改善情况。方法 36只SD雄性大鼠随机分为3 组:正常对照组(n=12);模型组(n=12);治疗组(n=12)。各组大鼠均于实验4、8、12周末检测24 h尿蛋白定量、血清胱抑素C、血肌酐水平， HE染色光镜下观察肾组织系膜增生程度;免疫组化二步法检测TLR4、NF-κB、细胞因子IL-6、TNF-α的表达情况。结果 对照组大鼠24 h尿蛋白定量、血清胱抑素C、血肌酐水平、肾组织系膜增生程度、TLR4、NF-κB及细胞因子IL-6、TNF-α的水平均低于模型组、治疗组(P<0.05);与模型组相比，治疗组上述指标明显减低(P<0.05)。结论 来氟米特可通过抑制TLR4、NF-κB及细胞因子IL-6、TNF-a的水平对系膜增生性肾小球肾炎发挥治疗作用。

Objective To investigate the therapeutic effect of leflunomide on mesangial proliferative glomerulonephritis and the role of TLR4 signaling pathway in rat mesangial proliferative glomerulonephritis. Methods A total of 36 normal male Sprague-Dawley rats were randomly divided into 3 groups: normal control group (n=12), model group (n=12) and treatment group (n=12). Rats in each group were tested 24-hour urinary protein excretion, serum cystatin C and serum creatinine levels in the end of 4,8 and 12 weeks to observe the mesangial proliferative extent of renal tissue under light microscope after HE staining . Two-step immunohistochemical methods were used to detect the changes in the expression of TLR4, NF-κB, cytokines IL-6 and TNF-α. Results Levels of 24-hour urinary protein excretion, serum cystatin C, serum creatinine, mesangial proliferation of renal tissue, TLR4, NF-κB cytokine IL-6 and TNF-α in model group and treatment group were higher than those in normal control group (P<0.05),levels in treatment group were significantly lower than those in model group (P<0.05). Conclusions Leflunomide has a therapeutic effect on mesangial proliferative glomerulonephritis by inhibiting TLR4 signaling pathway and NF-κB cytokine IL-6 and TNF-α.