摘要：目的观察钙通道阻滞剂硝苯地平和活性维生素D制剂罗钙全对尿毒症患者外周血单个核细胞(PBMC)上甲状旁腺素(PTH)受体基因表达的影响。方法30例非糖尿病常规血液透析患者随机分成硝苯地平组、罗钙全组和安慰剂组，治疗8周。应用逆转录，聚合酶链反应(RT-PCR)方法检测用药前后PBMC上PTH受体Mrna表达。结果硝苯地平治疗能使尿毒症患者PBMc上PTH受体Mrna的低表达显著上调(0．1436±0．0500比0．3584±0．0400，P＜0．001)，但仍未达到正常组水平(0．6837±0．0300，P＜0．001)。罗钙全治疗可明显纠正低钙、高磷和高PTH血症，对PTH受体Mrna表达也有一定上调作用(0．1472±0．0100比0．2192±0．0200，P＜0．001)。结论硝苯地平和罗钙全均能部分纠正尿毒症患者PTH受体基因表达的异常。

Effects of nifedipine and calcitriol on the PTH/PTHrP receptor mRNA expression in uremic patients

CHEN Jing ,GU Yong ,ZHANG Jian,et al.

(Division of Nephrology,Huashan Hospital,Shanghai Medical University,Shanghai 200040,China)

Abstract：Objective To investigate the effects of calcium channel blocker (nifedipine)and 1,25 (OH)₂VitD₃ (calcitriol)on the mRNA expression of PTH receptor in PBMC of uremic patients.Methods Thirty non-diabetic uremic patients undergoing maintenance hemodialysis were divided into the following groups:(1)nifedipine group;(2)calcitriol group;(3)placebo group.The level of PTH receptor mRNA was measured by semi-quantitative RT-PCR method at the end of 8th week.Results The clown-regulation of PTH receptor in PBMC was observed in all patients before treatment,and there was no difference among three groups.After 8-week treatment,the levels of PTH receptor mRNA expression(PTH receptor I.O.D/beta-actin I.O.D) were significantly increased in nifedipine group(from 0.1436±0.0500 to 0. 3584±0. 0400,P＜0.001 )and in calcitriol group(from 0.1472±0.0100 to 0.2192±0.0200,P＜0.001),but still lower than that in normal group(0.6837±0.0300,P＜0.001).Placebo therapy produced no change.Conclusion Both calcium channel blocker and 1,25(OH)₂VitD₃ could up-regulate PTH receptor mRNA expression in PBMC of uremic patients.

Keywords：Uremia;Receptor,parathyroid hormone;Calcium channel blocker;1,25 (OH) ₂VitD₃基金项目：卫生部基金资助项目(96-2-127)

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收稿日期：2000-04-17