慢性肾炎及尿毒症患者性激素及性激素受体改变的研究

Changes of sexual hormones and sexual hormone receptors in the patients with chronic glomerulonephritis and uremia

目的 探讨性激素及其受体改变与慢性肾炎及尿毒症病因及发病机理的联系。方法 应用放射配体结合法检测慢性肾炎63例及尿毒症101例患者外周血白细胞雄激素受体(AR)及雌激素受体(ER)。结果 (1)慢性肾炎患者白细胞AR测定结果显示男性、育龄女性及绝经女性3组与对照组比无显著性差异。(2)慢性肾炎患者白细胞ER测定结果显示上述3组明显高于对照组(P<0.01)。(3)尿毒症患者白细胞AR测定结果显示3组均明显低于对照组(均P<0.05)。(4)尿毒症患者白细胞ER测定结果显示3组明显高于对照组(P<0.05或P<0.01)。结论 慢性肾炎及尿毒症患者白细胞ER的结合容量明显升高;尿毒症患者白细胞AR降低。提示ER及AR的改变导致性激素功能的改变,与慢性肾炎及尿毒症的病理变化有一定关联。

Objective Whether changes of sexual hormones and sexual hormone receptors were involved in the pathogeny of chronic glomerulonephritis and uremia. Methods The maximal binding capacity (Bmax)' and dissociation constant (Kd) of androgen receptor (AR) and estrogen receptor (ER) in the peripheral leukocytes were estimated by radioligand binding assays in 63 patients with chronic glomerulonephritis and 101 with uremia. Results (1)The Bmax of AR was 638± 176, 508 ± 112 and 437± 126 sites/cell in men, child-bearing age womeru menopause women with chronic nephritis re-spectivily. The binding capacity was not different with controls. (2)The Bmax of ER was 1041±358, 1492 ± 387 and 1107 ± 274 sites/cell in three groups of chronic nephritis .respectively. They were all higher than those of controls ( P < 0.01). (3)Bmax of AR was 583± 123, 413 ± 106, 154 ± 98 sites/cell in three groups of uremia respectively. They were all lower than those of controls ( F<0.01). (4)Bmax of ER was 923 + 315> 1298± 413 and 10381284 sites/cell in three groups of uremia respectively. The binding capacity of ER was all higher than that of controls ( P <0.01). Conclusion The Bmax of ER increased in chronic nephritis and uremia and the Bmax of AR decreased in uremia. These results indicated that the changes of ER and AR were involved in the pathogeny and development of chronic glomerulonephritis and uremia.