原发性肾病综合征患者激素敏感性与糖皮质激素受体亚型的关系研究  

Study on the Relationship Between Sensitivity to Glucocorticoid and Glucocorticoid Receptor Isoform in Patients with Primary Nephrotic Syndrome

作　　者：彭家清[1] 周松林[1] 张克凯[1] 徐立[1] 邢天柱[1] 熊燕[1] 彭君[1] 秦鹏[1] 

机构地区：[1]华中科技大学同济医学院附属荆州医院肾内科,434020

出　　处：《医学研究杂志》2009年第6期61-63,共3页Journal of Medical Research

摘　　要：目的探讨原发性肾病综合征(PNS)患者对糖皮质激素(以下简称激素)敏感性与其外周血单个核细胞(PBMC)内激素受体(GR)亚型表达的关系。方法应用流式细胞术(FCM)检测正常对照组(10例)和PNS组(28例,其中激素敏感组10例、激素依赖组10例、激素抵抗组8例)外周血PBMC内α与β亚型表达水平的变化。结果与正常对照组相比,PNS患者3组中GRα的表达水平均降低,差异有显著性(P<0.05);GRβ在激素抵抗组中表达明显增高,差异有显著性(P<0.01),而在激素敏感组、激素依赖组中表达无明显差异(P>0.05)。结论PNS患者糖皮质激素受体GRα、GRβ表达水平的变化,导致GRα与GRβ比例失调,使组织细胞对激素的敏感性降低,因此,导致PNS患者对糖皮质激素治疗反应不同,PNS出现激素抵抗可能与GRβ表达水平增高有关。Objective To investigate the relationship between sensitivity to glucocorticoid and glucocorticoid receptor（GR）isoforms in peripheral blood mononuclear cells（PBMC）isolated from patients with primary nephrotic syndrome（PNS）. Methods The expression of glucocorticoid receptoralpha and beta（ GR- αand GR- pin PBMC） in control group and PWS group were detected by flow cytometry. The PNS group in clude ten steroid - sensitive, ten steroid - dependent and eight steroid - resistant patients. Results Compared to normal, the expression of GR- αin the three groups of PNS were significantly decreased（ P 〈 0.05）. The expression of GR- αwas highly increased in steroid - resistant PNS （P 〈 0.01 ） , whereas no significant difference was detected in steroid - sensitive and steroid - dependent PNS. Conclusion The changed expression of glucocorticoid receptors - alpha and beta in PNS leads to decreased ratio of GR - α to GR - β and reduced sensitivity to glucocorticoid in ceils. Therefore, the phenomenon of steroid - resistance in some patients of PNS might be related to the increased expression of GR - βin PBMC.

关 键 词：原发性肾病综合征 糖皮质激素 糖皮质激素受体亚型 激素敏感性 

分 类 号：R644[医药卫生—外科学] R692[医药卫生—临床医学]