糖皮质激素受体在肾病综合征治疗中的意义

THE SIGNIFICANCE OF GLUCOCORTICOID RECEPTORS IN THE THERAPY OF NEPHROTIC SYNDROME

检测了肾病综合征（ＮＳ）３２例和正常人３０例的外周血单个核细胞糖皮质激素受体（ＧＣＲ）、血浆ＡＣＴＨ和皮质醇水平。结果表明，对糖皮质激素（ＧＣ）敏感或低度敏感的ＮＳ患者ＧＣＲ，儿童为６２２８±２１６６位点／细胞，成人为７５８９±２５５２位点／细胞；对ＧＣ无反应的ＮＳ患者ＧＣＲ，儿童为２２９２±１００６位点／细胞，成人为３２４２±５９８位点／细胞，ＧＣＲ的水平与ＧＣ的疗效密切相关。１２例成人ＮＳ患者ＧＣＲ为６１４０±２９７０位点／细胞，ＡＣＴＨ为１６．８８±２．６０ｎｇ／Ｌ皮质醇为６９．２３±３５．４６μｇ／Ｌ；１２例正常成人ＧＣＲ为３２７９±１１１６位点／细胞，ＡＣＴＨ为３１．７８±１０．４７ｎｇ／Ｌ，皮质醇为１４２．３５±３８．０７μｇ／Ｌ。２２例儿童ＮＳ患者ＧＣＲ为４４３９±１６３０位点／细胞，ＡＣＴＨ为２２．３５±４．５ｎｇ／Ｌ，皮质醇为６４．５９±３２．７９μｇ／Ｌ；１８例正常儿童ＧＣＲ为２０１７±１０９０位点／细胞，ＡＣＴＨ为２８．９６±６．６ｎｇ／Ｌ，皮质醇为８９．４５±２６．００μｇ／Ｌ。ＮＳ患者ＧＣＲ水平高于正常人，而血浆ＡＣＴＨ、皮质醇水平低于正常人。动物实验初步证明，小柴胡汤对用ＧＣ后引?

In this article,the authors measure the GCR levels and the plasma levels of ACTH and cortisone of 34 patients with nephrotic syndrome and 30 healthy persons.It was found that the GCR levels of NS patients who are sensitive or hyposensitive to GC therapy are higher (7589 ± 2552 sites/cell for adults, 6228 ± 2166 sites/cell for children)than that of those who are unresponsible to GC therapy(2292± 1006 sites/cell for children, 3242±598 sites/cell for adults), there is a close correlation between the GCRlevel and the effect of GC therapy. The GCR levels of 12 adults with NS are 6140±2970sites/cell, and their ACTH levels are 16. 88 ± 2. 60ng/L,cortisol levels are 69. 23 ± 35.46μg/L. The GCR levels of 12 healthy adults are 3279± 11 16 sites/cell,their ACTH 31.78± 10. 47ng/L,cortisol 142. 35 ± 38. 07μg/L. The GCR levels of 22 children with NS are 4439 ± 1630 sites/cell, ACTH 22. 35 ± 4. 5ng/L, cortisol 64. 59 ± 32. 79μg/L. The GCR levels of 18 healthy children are 2017 ± 1090 sites/cell, ACTH 28. 96 ± 6. 6ng/L,cortisol 89. 45 ±26. 00μg/L. The GCR levels of patients with NS are higher than that of the healthy person, while their ACTH and cortisol levels are lower. The authors also measured the GCR levels of 12 rats with different treatment and found that Xiaochaihutang can reduce the down-regulation of GCR induced by GC therapy.