肺心病患者外周血白细胞糖皮质激素受体检测的临床价值

THEVALUEOFTHECLINICALTESTOFGLUCOCORTICOIDRECEPTORSOFPERIPHERALBLOODLEUKOCYTESINPATIENTSWITHCHRONICPULMONARYHEARTDISEASE

为探讨肺心病患者肾上腺皮质的功能状态，用放射配基结合分析法测定了该病患者外周血白细胞糖皮质激素受体（ＧＣＲ）水平，同时测定了其血浆皮质醇（Ｆ）浓度。结果发现肺心病患者ＧＣＲ水平较正常对照组明显降低（Ｐ＜０．０１），在急性期下降极明显，缓解期则有所回升，但与正常对照组比仍有明显区别（Ｐ＜０．０１）。经吸氧，缓解期患者ＧＣＲ可以明显提高，但仍不能恢复到正常水平（Ｐ＜０．０１）。而血浆皮质醇水平与正常对照组相比，差异无显著性（Ｐ＞０．０５）。提示本组肺心病患者肾上腺皮质功能尚可以代偿，但其ＧＣＲ功能存在异常，其原因在于体内有严重的缺氧，吸氧则可使ＧＣＲ水平提高。表明氧疗可使体内的ＧＣＲ水平提高。故应提倡氧疗，以延缓肺心病的进展。

Inordertoinquireintothefunctionalstateofadrenalcortexinpatientswithpulmonaryheartdisease,thenumberofglucocorticoidreceptors(GCR)ofperipheralbloodleukocytesinpatientswithchronicpulmonaryheartdiseasewasdeterminedwithradioligand-bindingasayandthecore-spondingplasmacortisollevelswereasesedwithradioimmuneasays.TheresultsshowedthatthenumberofGCRinthepatientswassignificantlyreduced(P<0.01)anditwasincreasedwhentheirhealthstatewasimproved.However,itwasstillowerthanthatinhealthysubjects(P<0.01).ThenumberofGCRinthepatientswasgreatlyincreasedwhenthesepatientsweretreatedwithoxygen(P<0.01).Nodiferenceinplasmacortisolwasfoundbetweenthepatientsandthehealthysubjects(P>0.05).Theseresultsindicatethatthefunctionofadrenalcortexmaybeimprovedbythecompensationmechanismofthepatients,butthelowerGCRnumberwastheresultoflackingofoxygeninthepa-tients.ThenumberofGCRmaybeimprovedbyinhalationofoxygen.Thereforeoxygentherapyishelpfulinraisingtheactivityofglucocorticoidreceptorsandcontrolingthedevelopmentofthedisease.