激素敏感型单纯性肾病外周血白细胞乙酰肝素酶基因表达的研究  

Heparanase expression of peripheral blood cells in steroid responsive nephrotic syndrome patients

作　　者：阎妍[1] 王峥[1] 陶于洪[1] 

机构地区：[1]四川大学华西第二医院儿科,成都610041

出　　处：《中华儿科杂志》2004年第3期199-201,共3页Chinese Journal of Pediatrics

基　　金：国家自然科学基金资助项目 (3 9870 747)

摘　　要：目的　研究激素敏感型单纯性肾病 (SRSNS)外周血白细胞中乙酰肝素酶 (Hpa)基因表达水平及其与尿蛋白定量之间的关系 ,探讨肾小球基底膜电荷屏障破坏的机制。方法　采用逆转录 聚合酶链反应的方法 ,分别对 4 3例SRSNS患儿 (活动期 2 3例、恢复期 10例、缓解期 10例 )、2 3例肾炎性肾病、15例紫癜性肾炎 (肾病型 )和 15例正常对照儿童外周血白细胞中Hpa基因表达水平进行半定量研究。结果　 (1)SRSNS活动期Hpa表达量 (1 2 7± 0 36 )高于肾炎性肾病、紫癜性肾炎 (肾病型 )和正常对照组 (0 36± 0 13) ,差异有显著意义 (P <0 0 0 1)。 (2 )不同阶段的SRSNS患者之间Hpa表达量活动期 >恢复期 >缓解期 ,差异有显著意义 (P <0 0 5 ) ;缓解期 (0 34± 0 18)与正常对照组之间差异无显著意义。 (3)SRSNS组活动期、恢复期和缓解期Hpa表达水平与尿蛋白定量之间呈正相关 (rs=0 75 1,P <0 0 0 1)。结论　外周血白细胞Hpa表达的增高可能与SRSNS大量蛋白尿的产生有关。Objective The β D endoglycosidase heparanase (Hpa) is HS specific which leads to the degradation of heparan sulfate (HS). An increased permeability of the glomerular basement membrane (GBM) for proteinuria was suggested to relate to a decrease of HS side chains in the GBM. However, whether an up regulated expression of Hpa exists in steroid responsive nephrotic syndrome (SRSNS) remains unknown. The purpose of this study was to evaluate the role of Hpa in the development of SRSNS and the correlation with the proteinuria. Methods Forty three children with SRSNS were selected and included the active stage group ( n =23), the restoration stage group ( n =10) and the remission stage group ( n =10). There were 23 nephritic nephrosis children, 15 purpura nephritis children and 15 healthy children as controls. By using the method of reverse transcriptase PCR (RT PCR), Hpa gene expression in the peripheral blood leukocytes (PBLs) was assayed. Results (1)All patients with nephrotic syndrome exhibited higher levels of Hpa mRNA than those of the healthy group ( P <0.05).The highest expression was in the active stage group of SRSNS (1.27±0.36, P <0.001), while there was no difference between the patients of nephritic nephrosis group(0.62±0.15) and purpura nephritis group(0.55±0.17)( P > 0.05). (2)In contrast with the healthy group, there was a significant difference in the active stage group of SRSNS ( P <0.001). So was the restoration stage group ( P <0.05), but there was no difference to the remission stage group ( P >0.05). (3)There was a positive correlation between the expression level of Hpa mRNA and the quantity of urinary protein ( r s =0.751, P <0.001). Conclusion Up regulated expression of Hpa mRNA may be important to the loss of glomerular negative charge in GBM and lead to proteinuria in SRSNS.

关 键 词：激素敏感型单纯性肾病 外周血 白细胞 乙酰肝素酶 基因表达 小儿 

分 类 号：R726.9[医药卫生—儿科]