尿毒症患者多形核白细胞糖皮质激素受体与趋化移动的改变及意义  

Changes of Glucocorticoid Receptor and Chemotactic Migration of Polymorphonuclear Leukocytes in Patients with Uremia

作　　者：林萍[1] 刘志民[1] 刘景山[1] 

机构地区：[1]杭州市第二医院内二科,杭州第二军医大学长征医院肾内科

出　　处：《标记免疫分析与临床》1995年第3期125-128,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：应用放射配体结合分析，检测尿毒症患者外周血多形核白细胞（ＰＭＬ）的糖皮质激素受体（ＧＲ），尿毒症患者ＰＭＬＧＲ的最大结合容量（Ｂｍａｘ）明显低于对照组，而其解离常数（Ｋｄ）比对照组的显著升高。同时检测ＧＲ的效应指标：皮质醇（Ｆ）对ＰＭＬ的趋化移动（ＣｈｔＭ）的抑制率（ＦＩ），Ｆ对ＣｈｔＭ的ＦＩ明显低于对照组，与降低的ＧＲ呈正相关（ｒ＝０．７８５，Ｐ＜０．０１）．尿毒症患者ＰＭＬ的ＧＲ降低的同时，伴效应指标的改变，表明ＧＲ的降低具有临床意义。尿毒症患者ＰＭＬ的随机移动（ＲＭ）和ＣｈｔＭ均明显降低，提示白细胞功能降低。Glucocorticoid receptor (GR) of human peripheral polymorphonuclear leukocytes (PML)from thirty patients with uremia were investigated with[3H]dexamethasone as radioligand to determine the maximal binding capacity (Bmax) and dissociation constant (Kd) of GR, which were 3508±598 site/cell and 11. 7±2.6nmol/L, respectively and were significantly different from those of the controls (7250±1006site/cell, P<0.01 and 5.3±1.9nmol/L, P<0.05, respectively). Random migration (RM) and chemotactic migration (ChtM) of PML in uremic patients were significantly decreased as compared with those of the healthy subjects. The fraction inhibition (FI) of ChtM by hydrocortisone was lower in patients than in the normal persons and was positively correlated with the lowered Bmax of GR on PML(r=0. 785,P<0.01), indicating that the reduced GR binding sites on PML of uremic patients were accompanied by the lowered migratory function of PML,i. e. the effector parameter and may have implication in the development of the disease.

关 键 词：尿毒症 受体 糖皮质激素 趋化性 多形核白细胞 

分 类 号：R692.5[医药卫生—泌尿科学] R695[医药卫生—外科学]