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目的 探讨环孢素亲合素（ＣｙＰ）在儿童难治性肾病中基因表达及临床意义。方法采用逆转录聚合酶链反应（ＲＴ－ＰＣＲ）测定３３例难治性肾病患儿血白细胞中ＣｙＰｍＲＮＡ的表达，并以正常儿童作对照。结果ＣｙＰ碱基对为４０８ｂｐ与β－ａｃｔｉｎ条带（２３４ ｂｐ）可清晰区分。系膜增殖性肾小球肾炎（０．２８９±０．０１７）、局处节段性肾小球硬化（０．２８７±0．006）患儿的血白细胞中 ＣｙＰ ｍＲＮＡ的水平高于微小病变型肾病（０．２７１± ０．００７）和膜增殖性肾小球肾炎（０．２６７ ± ０．００８）；激素依赖、激素耐药、频繁复发患儿之间 ＣｙＰ ｍＲＮＡ表达无差异。肾病组急性期（０．２８１ ±０．０１６）ＣｙＰ ｍＲＮＡ水平高于恢复期（０．２６７±０．１００）与对照组（０．２５８±０．０１１）。结论 监测难治性肾病 ＣｙＰｍＲＮＡ的表达可能对环孢素的治疗有指导意义。
Objective To investigate the gene expression and clinical significance of cyclosporin A (CyP) in children with refractory nephropathy. Methods The expression of CyP mRNA in 33 children with refractory nephropathy was measured by reverse transcription-polymerase chain reaction (RT-PCR) and compared with normal children. Results Cyb base pair was 408 bp and β-actin band (234 bp) was clearly distinguishable. The level of CyP mRNA in blood leucocytes in patients with mesangioproliferative glomerulonephritis (0.289 ± 0.017) and local segmental glomerulosclerosis (0.287 ± 0.006) was higher than that in patients with minimal disease Nephropathy (0.271 ± 0.007) and proliferative glomerulonephritis (0.267 ± 0.008). There was no difference in the expression of CyP mRNA in children with hormone-dependent and hormone-refractory diseases. The level of CyP mRNA in acute stage of nephropathy group (0.281 ± 0.016) was higher than that in convalescence stage (0.267 ± 0.100) and control group (0.258 ± 0.011). Conclusion Monitoring CyPmRNA expression in refractory nephropathy may be instructive for the treatment of cyclosporine.