[關(guān)鍵詞]
[摘要]
糖皮質(zhì)激素因其強(qiáng)效的抗炎作用在臨床上廣泛使用,但是使用中發(fā)現(xiàn)在嚴(yán)重哮喘、慢性阻塞性肺病、急性淋巴細(xì)胞白血病、間質(zhì)性肺病等炎癥性疾病中有部分患者存在激素抵抗,限制了糖皮質(zhì)激素的使用及預(yù)后。激素治療患者存在糖皮質(zhì)激素激素抵抗主要是由于糖皮質(zhì)激素受體蛋白表達(dá)差異、基因多態(tài)性和基因突變、細(xì)胞轉(zhuǎn)錄因子的異常等引起的。不同疾病存在的糖皮質(zhì)激素抵抗的機(jī)制也存在差異,對(duì)于哮喘和間質(zhì)性肺病患者糖皮質(zhì)激素抵抗主要是由于糖皮質(zhì)受體基因多態(tài)性,急性淋巴細(xì)胞白血病患者主要是受體蛋白的表達(dá)差異,而糖皮質(zhì)激素對(duì)于慢性阻塞性肺病患者可能無(wú)效。
[Key word]
[Abstract]
Glucocorticoid is used widely for its potent anti-inflammatory effects in clinic, however, it is found that some patients emerged resistant of hormone in some diseases such as severe asthma, chronic obstructive pulmonary, acute lymphoblastic leukemia, and interstitial lung disease, et al. This phenomenon restrict the use and prognosis of glucocorticoid. The existance of hormone resistance in patients with these diseases primarily because of glucocorticoid receptors diverse expression, gene polymorphisms, gene mutations, and abnormity of transcription factors. The mechanisms of glucocorticoid resistance are different in those diseases. In patients with asthma and interstitial lung disease, glucocorticoid resistance is mainly due to the polymorphism of the glucocorticoid receptor gene. Glucocorticoid resistance in the patients with acute lymphoblastic leukemia is primarily due to the expression difference of receptor protein, while glucocorticoid may have no effect in patients with chronic obstructive pulmonary disease.
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