激素抵抗肾病综合征患者激素受体和细胞因子的表达及意义  

Expression and significance of GRα,IL-1β and TNF-α in patients with steroid resistant nephrotic syndrome

作　　者：乔丽[1] 李荣发[2] 曹礼应[1] 曹娟[1] 余月明[1] 蔡纯青[1] 张勇[1] 孟熙[1] 和卫梅[1] 

机构地区：[1]成都军区昆明总医院肾脏科,昆明650032 [2]郑州市消防支队卫生队

出　　处：《西南国防医药》2010年第11期1188-1190,F0004,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨肾病综合征激素抵抗患者肾脏组织中激素受体α(GRα)和血清中细胞因子(IL-1β和TNF-α)的表达及意义。方法根据糖皮质激素治疗效果,将45例原发性肾病综合征患者分为以下3组:激素敏感组、激素抵抗组、复发后激素抵抗组,每组各15例。用免疫组织化学方法检测各组患者肾组织中GRα的表达,并用计算机图像分析系统对结果进行分析。用ELISA方法检测各组患者血清IL-1β和TNF-α浓度,并进行方差检验。结果复发后激素抵抗组和激素抵抗组肾组织中GRα含量明显低于激素敏感组(P<0.05);复发后激素抵抗组肾组织中GRα与激素抵抗组之间无显著性差异(P>0.05)。复发后激素抵抗组和激素抵抗组血清IL-1β、TNF-α水平明显高于激素敏感组(P<0.01);复发后激素抵抗组血清IL-1β和TNF-α与激素抵抗组之间无显著性差异(P>0.05)。结论肾组织中GRα降低和血清IL-1β和TNF-α升高可能与原发性肾病综合征激素抵抗有关,检测肾组织中GRα和血清IL-1β和TNF-α水平变化有助于预后判断和调整治疗。Objective To investigate the expression and significance of glucocorticoid receptor α（GRα）,IL-1β and TNF-α in the renal tissues of patients with steroid resistant nephrotic syndrome（NS）.Methods According to the response to corticosteroids treatment,45 patients were divided into three groups（n=15）：steroid sensitive group,steroid resistant group and recurrent steroid resistant group.All patients received renal biopsy before steroid treatment.The expression of GRα in renal tissues of each group was measured by immunohistochemistry technique and the findings were analyzed by a computerized image analysis system.The IL-1β and TNF-α concentration in sera collected also before steroid treatment were measured by ELISA,and the results was analyzed by variance test.Results GRα contents in renal tissues decreased markedly in recurrent steroid resistant group and steroid resistant group compared with steroid sensitive group（P〈0.05）,but there was no significant difference in GRα expression between the two resistant group（P〉0.05）.The serum levels of TNF-α and IL-1β increased markedly in steroid resistant group and recurrent steroid resistant group compared with those in the steroid sensitive group,although no significant differences were found between the two resistant groups（P〉0.05）.Conclusion The decrease of GRα expression and the increase of TNF-α and IL-1β levels might be related to the steroid resistance in NS patients.Therefore,the detection of GRα expression in renal tissues as well as serum level changes of TNF-α and IL-1β might be beneficial to predict the prognosis and adjust the therapeutic regimen in NS patients.

关 键 词：肾病综合征 糖皮质激素受体Α IL-1Β TNF-Α 激素抵抗 

分 类 号：R692.5[医药卫生—泌尿科学]