摘要
目的:探讨不同类型糖皮质激素(GC)对儿童原发性肾病综合征(PNS)患者糖皮质激素受体(GR)的影响。方法:正常儿童为对照组(N组)20例;55例初治PNS患儿随机分为泼尼松组(A组)17例,曲安西龙组(B组)20例,甲基泼尼松龙组(C组)18例,均给予相应GC治疗并在0、4及8周时取静脉血,通过半定量逆转录-聚合酶链反应(RT-PCR)检测外周血单个核细胞(PBMCs)中GRα和GRβ的mRNA表达水平。结果:未经GC治疗时PNS组GRα低于N组,GRβ高于N组,差异有统计学意义(P<0.05)。各组患儿经GC治疗后,GRα、GRβ指标组间、时间效应差异均有统计学意义(P<0.05或P<0.01);GRα指标时间与组间无交互作用(P>0.05),GRβ指标时间与组间存在交互作用(P<0.05)。55例PNS患儿中GC耐药组6例,敏感组49例,2组患儿经GC治疗后,GRα、GRβ指标组间、时间效应差异均有统计学意义(P<0.05或P<0.01);各组GRα指标时间与组间效应无交互作用(P>0.05),但GRβ指标时间与组间存在交互作用(P<0.05)。结论:在调节GR的表达水平上甲基泼尼松龙治疗PNS效果较好。
Objective：To observe the effects of glucocorticoid （GC） on the mRNA expression of glucocorticoid receptor （GR） in children with primary nephritic syndrome （PNS）.Methods：Twenty healthy children were selected randomly as control group（N group）,55 PNS kid patients were randomly divided into prednisone group（A group,n=17）,triamcinolone group（B group,n=20） and methylprednisolone group（C group,n=18）.After corresponding GC application,blood samples were collected at 0,4 and 8 weeks after the treatment with GC.The mRNA expression levels of the GR subtypes （GRα and GRβ） in peripheral blood mononuclear cells （PBMCs） were detected by semi-quantitative RT-PCR.Results：At the 0th week of treatment with GC,the level of GRα was lower in PNS group than that of N group （P 0.05）.But the level of GRβ was higher in PNS group than that of N group （P 0.05）.After treatment with GC,there were significant differences in time effects of GRα and GRβ between groups （P 0.05 or P 0.01）.Differences in interaction between groups and time effect were only significant in the level of GRβ （P 0.05）.There were 6 cases of steroid-resistance in PNS children.After treatment with GC,there were significant differences in time effects and GRα and GRβ between the two groups （P 0.05 or P 0.01）.Differences in interaction between groups and time effect were only significant in the level of GRβ （P 0.05）.Conclusion：There is a better treatment effect of methylpredrisolone on PNS GR regulation.
出处
《天津医药》
CAS
北大核心
2011年第11期1037-1040,1088,共5页
Tianjin Medical Journal
