【摘要】 目的探讨肾病综合征(NS)患儿外周血单个核细胞(PBMC)中多药耐药基因(MDR1)的表达与不同激素(GC)效应患儿的关系。方法收集2007年5月-2008年2月收治的原发特发性肾病(PNS)患儿47例,按照GC对患儿的效应分为GC敏感组(SSNS)、GC耐药组(SRNS)两组,根据GC敏感患儿临床疗效又分为非频反复组(NFR)和频反复(FR)及GC依赖(SD)组(简称FR&SD)两组,采用荧光定量PCR方法检测NS患儿的外周血中PBMC中MDR1 mRNA表达水平,以12例健康正常儿童为对照。结果GC治疗后NS患儿PBMC中MDR1 mRNA的表达均高于正常对照组,而SRNS组PBMC中MDR1mRNA的表达高于SSNS组;且FR&SD组患儿MDR1 mRNA的表达量要比NFR更高;SSNS患儿MDR1 mRNA的表达与缓解时间、复发次数、病程呈正相关,尤其是FR&SD组患儿MDR1 mRNA的表达与其缓解时间呈正相关(r=0.796,P<0.01)。结论GC治疗后NS患儿MDR1的高表达与GC耐药、GC依赖和复发有关。更多还原

【Abstract】 Objective To explore relationship between the expression of multiple drug-resistant gene(MDR1) in peripheral blood mononuclear cells(PBMC) of children with nephrotic syndrome(NS) and their different clinical response to glucocorticoid(GC) treatment.Methods Forty-seven pediatric inpatients and outpatients with NS were recruited from May 2007 to February 2008.The children with NS were divided into two groups according to their response to glucocorticoid,steroid-sensitive nephritic syndrome(SSNS) and steroid-resistant nephritic syndrome(SRNS).According to the clinical effect,the steroid-sensitive patients were further divided into non-frequent relapse NS(NFR),frequent relapse NS(FR) and SD-steroid-dependent NS(FN&SD).The expression of MDR1 mRNA was detected by realtime fluorescent quantitative PCR.Twelve healthy children were served as control group.Results After GC treatment,the expression of MDR1 mRNA in children with NS was higher than in control group,higher in SRNS group than in SSNS group,and higher in FR&SD group than in NFR group.The expression of MDR1 mRNA was positively correlated with the time to remission,number of NS episodes,and course of disease in SSNS group,especially in FR&SD group(r=0.796,P<0.01).Conclusions Higher expression of MDR1 mRNA in NS children after the treatment of GC may be associated with GC resistance,GC dependence and relapse.更多还原