白血病、肾病综合征的外周血淋巴细胞糖皮质激素受体与糖皮质激素依赖性关系的临床意义

Relationship Between Glucocorticoid Receptors on Lymphocytes and Glucocorticoid Dependence in Patients with Leukemia or Nephrotic Syndrome

用放射配体结合分析检测了急性白血病和肾病综合征（肾综）外周淋巴细胞的糖皮质激素受体（ＧＲ）的含量。结果提示：白血病和肾综多为糖皮质激素依赖性。急性淋巴细胞性白血病ＧＲ含量明显增高，对激素治疗的反应性较高；成人和小儿肾综的ＧＲ含量均高于正常人（Ｐ＜０．０５）。小儿肾综的ＧＲ含量大于正常值者，对激素治疗的反应敏感比率为７０．５９％；小于正常值者则为５０％，且易复发，这表明ＧＲ含量高的患者激素疗效好，反之疗效低。本方法简便，用于观察激素疗效较灵敏，可多次取材重复检测，具有一定临床价值。

Glucocorticoid receptors (GR) on lymphocytes of patients with acute leukemia or nephrotic syndrome were measured with radioligand binding assay. Our result showed that most of them were glucocorticoid dependent. The binding capacity of GR was markedly increased in patients with acute lymphocytic leukemia highly responsive to glucocorticoid. The contents of GR in both adults and infants with nephrotic syndrome were higher than those of normal subjects (P < 0. 05). The responsiveness rate to glucocorticoid was 70. 59% in nephrotic infants whose GR content was higher than the normal value, while that of the nephrotic infants with GR content less than the normal value was merely 50% and recurrence was frequently observed. Peripheral lymphocytes can be repeatedly separated from patients and the radioligand assay is easy to perform and sensitive to monitor the hormone effect, so that it may be of clinical value in the treatment of these diseases.