系统性红斑狼疮患者外周血白细胞糖皮质激素受体结合量测定的临床意义  

Determination and clinical significance of the binding capacity of glucocorticoid receptor on peripheral leukocytes from patients with systemic lupus erythematosus

作　　者：李志军[1] 余裕民[2] 李兴福[3] 陈琳洁[1] 孙俊杰[2] 范晓云[1] 李秀义[2] 杨珂珂[1] 

机构地区：[1]蚌埠医学院附属医院风湿病科,安徽233004 [2]蚌埠医学院核医学教研室 [3]山东大学齐鲁医院风湿病科

出　　处：《中华风湿病学杂志》2005年第10期597-600,共4页Chinese Journal of Rheumatology

基　　金：安徽省教委基金资助项目(96JL0092)

摘　　要：目的探讨系统性红斑狼疮(SLE)患者外周血白细胞糖皮质激素受体(GCR)结合量的变化及其临床意义。方法应用放射配体结合法测定白细胞GCR结合量。结果61例SLE患者应用糖皮质激素(GC)治疗前白细胞GCR结合量为(4156±1408)位点/细胞,显著低于正常对照组(5072±1312)位点/细胞(t=3.506,P=0.01)。3个以上重要器官或系统受损者白细胞GCR结合量显著减低(t=3.262,P=0.002)。SLE患者治疗前白细胞GCR水平与SLE病情活动指数呈负相关(r=-0.487,F=18.372,P=0.001)。白细胞GCR结合量较低的患者应用GC的疗效较差,副反应较多见。结论SLE患者白细胞GCR结合量显著减低,这种变化与SLE患者病情活动性、重要系统器官受损情况以及GC的疗效和副反应等有一定相关性。Objective To investigate the change and clinical significance of the binding capacity of glucocorticoid receptor （GCR） on peripheral leukocytes from patients with systemic lupus erythematosus （SLE）. Methods The binding capacity of GCR on peripheral leukocytes was measured by radio-ligand binding assay using ^3H-dexamethasone as the ligand before glucocorticoid （GC） treatment. At the same time, the concentration of plasma cortisol in the patients was determined by radioimmunoassay. The clinical characteristics of the patients were investigated. The data were inputted into a computer and were analyzed by statistical package for the social science （SPSS） 10.0. Results The binding capacity of GCR on peripheral leukocytes in 61 SLE patients was （4156±1408） sites/cell before receiving GC and the level of GCR on peripheral leukocytes in 50 normal controls was （5072±1312） sites/cell. The level of GCR on peripheral leukocytes from the SLE patients was significantly lower than normal controls （t=3.506, P=0.01）. The concentration of plasma cortisol in the SLE patients was （305±87） nmol/L before receiving GC and the concentra- tion of plasma cortisol in the controls was （332±39） nmol/L. The level of plasma cortisol in the SLE patients was also significantly lower than normal controls （t=2.055, P=0.042）. In the patients who had more than three major organs of system involvement, such as heart, lungs, liver, kidneys and the central nervous system, the level of GCR was （3501±1223） sites/cell and the level of GCR in the other SLE patients whose major organs or systems involved less three was （4611±1361） sites/cell. The binding capacity of GCR in the former group was significantly less than the latter （t=3.262, P=0.002）. The level of GCR and the SLE disease activity index （SLEDAI） were correlated negatively before treatment （r=-0.487, F=18.372, P=0.000）. After four weeks GC treatment, the SLE patients with lower binding capacity of GCR on peripheral leukocytes had

关 键 词：红斑狼疮 系统性 白细胞 受体 糖皮质激素 外周血白细胞糖皮质激素受体 系统性红斑狼疮患者 临床意义 合量测定 SLE患者 放射配体结合法 病情活动指数 器官受损 GCR 

分 类 号：R593.241[医药卫生—内科学]