多发伤患者外周血白细胞糖皮质激素受体α、β的表达及其意义  

Expression of glucocorticoid receptor (GR) α mRNA and GRβ mRNA in the peripheral blood leucocytes of multiple trauma patients and its clinical significance

作　　者：李思齐[1] 白祥军[1] 王海平[1] 李占飞[1] 任骏[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院创伤外科,武汉430030

出　　处：《中华创伤杂志》2005年第10期729-732,共4页Chinese Journal of Trauma

基　　金：国家自然科学基金资助项目(30371465)

摘　　要：目的探讨多发伤患者外周血白细胞糖皮质激素受体α、β(GRα、GRβ)在转录水平的表达规律及其意义。方法收集30例我科多发伤患者及5例健康志愿者(对照组)外周血,提取白细胞RNA,半定量逆转录-聚合酶链反应(RT-PCR)法检测外周血白细胞GRα、GRβm RNA水平表达,同时检测患者皮质醇水平。结果多发伤患者伤后第1,4,7天外周血GRαmRNA半定量比值分别为0.56±0.03、0.82±0.06、0.85±0.06,伤后第1天比对照组(0.86±0.08)明显降低(P<0.05);多发伤患者伤后第1,4,7d外周血GRβmRNA半定量比值分别为1.12±0.06、0.79±0.08、0.76±0.08,伤后第1天比对照组(0.74±0.06)明显升高(P<0.05)。伤后第1天,损伤严重度评分(ISS)≥16分组GRα表达低于ISS<16分组,而GRβ表达高于ISS<16分组(P<0.05)。多发伤患者外周血皮质醇在伤后第1天比对照组明显升高(P<0.05),其升高与GRα的降低呈负相关。结论多发伤患者创伤早期外周血白细胞GRα、GRβ在转录水平的表达与损伤严重程度有关,GRβ高表达在创伤患者发生糖皮质激素抵抗的过程中起重要作用。Objective To investigate the expression status of human glucocorticoid receptor （GR） α mRNA and GRβ mRNA at the transcription level and determine its clinical significance. Methods Peripheral blood RNA from 30 multiple trauma patients （ trauma group） and five healthy volunteers （control group） was collected to determine expression level of GRα mRNA and GRβ mRNA by semiquantitative reverse transcriptional polymerase chain reaction （RT-PCR） and simultaneously detect the cortisol level. Results The values of GRot mRNA of trauma group at days 1.4 and 7 were 0.56 ± 0.03, 0.82 ± 0.06 and 0.85 ± 0.06, respectively, which were lower than that of control group （0.86 ± 0.08 ） one day after trauma （ P 〈 0.05 ）. The values of GRβ mRNA of trauma group at days 1,4 and 7 were 1.12 ± 0.06, 0. 79 ± 0.08 and 0.76 ± 0.08, respectively, which were higher than that of control group （0.74 ± 0.06 ） one day after trauma （ P 〈 0.05 =. One day after trauma, expression of GRot of trauma group with injury severity score （ISS）≥ 16 was lower than those with ISS 〈 16, but expression of GRβ was on the contrary （ P 〈 0.05 =. The cortisol level of trauma group one day after trauma was higher than that of control group （ P 〈 0.05 = , which was negatively correlated with expression level of GRα. Conclusions Expressions of GRot and GR[3 at the transcription level in multiple trauma patients are related to injury severity. The high expression level of GRβ may play an important role in the process of glucocorticoid resistance in trauma patients.

关 键 词：糖皮质激素受体 多处创伤 损伤严重度评分 表达 外周血白细胞糖皮质激素受体 创伤患者 糖皮质激素受体Α 其意义 多发 逆转录一聚合酶链反应 

分 类 号：R641[医药卫生—外科学]