原发性肾病综合征患者淋巴细胞糖皮质激素受体及基因测定的意义

Determination of glucocorticoid receptor level and the gene structure of lymphocytes and significance in patients with primary nephrotic syndrome

目的 :研究原发性肾病综合征 (PNS)患者外周血淋巴细胞糖皮质激素受体α(GRα)水平及其部分基因结构与糖皮质激素 (GC)治疗反应的相关性。方法 :用放射配体结合法及聚合酶链反应 单链构像多态性 (PCR SSCP)、DNA测序法 ,分析 3 0例PNS患者及 2 0例正常对照外周血淋巴细胞GRα水平及其部分基因结构。根据对GC的治疗反应 (强地松 1mg/kg/d,8周 )分完全缓解、部分缓解、无效组。结果 :PNS患者GRα水平低于正常对照组。轻微病变及轻 中度系膜增殖性肾炎的患者 ,其病理类型与治疗反应之间无明显的相关性 ,但GRα水平在各治疗组有统计学差异 ,GRα水平高者对GC的治疗反应好。未发现GRα基因外显子 9有结构异常。结论 :外周血淋巴细胞GRα水平可预测PNS患者对GC的治疗反应。在PNS患者中未发现GRα基因外显子

Objective:To study the correlation between the level of glucocorticiod receptor α(GR α), the structure of some of its genes in peripheral lymphocytes and the responses to glucocorticiod(GC)therapy in patients with primary nephritic syndrome(PNS). Methods: The GR α level of peripheral lymphocytes,the structure of some of its genes and the DNA sequence were measured in 30 PNS patients and 20 controls.The patients were treated with prednisone(lmg/kg/d)for 8 weeks and divided into three groups depending on their responses to GC therapy complete remission,partial remission and infectiveness. Results: The GR α number of lymphocytes from PNS patients was smaller than that of the controls,especially in the groups of partial remission and infectiveness.In glomerulopathy with mild change and mild middle degree mesangial glomerulonephritis,though the effect of GC showed no difference among the groups,the level of GR α was distinctly different.Abnormality in GR α gene exon 9 was not detected. Conclusion: The GR α level of lymphocyte in PNS patients can predict the therapeutic effect of GC and no abnormal structure of GR α gene exon 9 was found with PNS patients.