【摘要】 目的　探讨原发性肾病综合征患者血糖和胰岛素水平的变化及肾组织胰岛素受体β (ISNR - β)、C -肽受体 (CPR)和内皮型一氧化氮合成酶 (eNOS)的表达。方法　采用葡萄糖氧化酶法和化学发光法 ,分别检测 4 6例原发性肾病综合征患者和 2 0例对照者的空腹血糖 (FBG)、空腹血清胰岛素 (FISN)、空腹血清C -肽 (FCP) ,并计算胰岛素敏感指数 (ISI)。通过免疫组织化学染色法检测原发性肾病综合征患者和对照者的肾组织ISNR - β、CPR和eNOS的表达。结果　原发性肾病综合征患者与对照者的FBG、FISN、FCP、ISI的均值间的差别均有显著性意义 (P <0 0 5 ) ;其肾小管上皮细胞和小管间质血管内皮细胞均有ISNR - β、CPR、eNOS的表达 ,且两组间差异无显著性意义(P >0 0 5 ) ;但三者在肾小球的表达两组间差异无显著性意义 (P >0 0 5 )。结论　原发性肾病综合征患者血糖、胰岛素和C -肽水平显著升高 ,并出现胰岛素抵抗 (IR)。其肾小管上皮细胞和小管间质血管内皮细胞ISNR - β、CPR、eNOS的表达减弱更多还原

【Abstract】 Objective To investigate change of glucose and insulin,the expression of insulin receptor beta (INSR-β),C-peptide receptor (CPR) and endothelial nitric oxide syntheses (eNOS) in renal tissue in patients with primary nephritic syndrome.Methods With glucose oxidase method and chemical luminous method,fasting serum glucose (FBG),insulin (FISN) and C-peptide (FCP) were tested respectively in 46 cases in control group and 20 cases in normal group,insulin sensitive index(ISI) was calculated.The expression of ISNR-β,CPR and eNOS in renal tissue were examined by immunohistochemical staining techniques in patients with primary nephritic syndrome and those in the normal group.Results Compared with the normal group,there was significant difference in the concentration of FBC,FISN,FCP and ISI of patients with primary nephritic syndrome (P<0.05),and there was in the expression of INSR-β,CPR and eNOS in both renal tubular epithelial cells and interstitial vascular endothelial cells,but there was no significant difference(P>0.01).But the expression of INSR-β,CPR and eNOS weakened in renal glomerulus,and there was no statistical difference in the two groups (P>0.05).Conclusion The levels of blood glucose,insulin and C-peptide increased obviously in patients with primary nephritic syndrome,insulin resistance (IR) appeared at the same time,and the expression of ISNR-β,CPR and eNOS in renal tubular epithelial cells and interstitial vascular endothelial cells weakened.更多还原