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目的：研究难治性肾病患儿ＣｓＡ治疗前后环孢霉素亲和素（ＣｙＰ）ｍＲＮＡ的表达及ＣｓＡ的浓度与ＣｙＰｍＲＮＡ基因表达之间的关系，探讨ＣｙＰ在儿童难治性肾病中的临床意义。方法：用ＣｓＡ５ｍｇ／（ｋｇ．ｄ）治疗２６例，其中１６例用逆转录聚合酶链反应（ＲＴ－ＰＣＲ）法测定了治疗前后血白细胞中ＣｙＰｍＲＮＡ的基因表达，并以正常儿童作对照及测定ＣｓＡ血浓度。结果：难治性肾病患儿用ＣｓＡ治疗前血白细胞中ＣｙＰｍＲＮＡ基因表达明显高于治疗后和对照组，而ＣｓＡ血浓度与ＣｙＰｍＲＮＡ基因表达之间成负相关关系。结论：低浓度的ＣｓＡ与高水平表达的ＣｙＰ对肾病不能起到治疗作用，而ＣｓＡ血浓度在１００～２００μｇ／Ｌ之间与低水平表达的ＣｙＰ有助于肾病的缓解。
Objective: To investigate the expression of cyclosporin avidin (CyP) mRNA before and after CsA treatment in children with refractory nephropathy and the relationship between the concentration of CsA and the expression of CyP mRNA gene, and to explore the clinical significance of CyP in children with refractory nephropathy . Methods: Twenty-six patients were treated with CsA5mg / (kg.d), and 16 of them were detected by reverse transcriptase-polymerase chain reaction (RT-PCR) before and after treatment. The expression of CyPmRNA in blood leukocytes was measured and compared with normal children CsA blood concentration. Results: The expression of CyPmRNA in pre-treatment white blood cells of children with refractory nephropathy was significantly higher than that of the control and the control group, while the concentration of CsA was negatively correlated with the expression of CyP mRNA. CONCLUSION: Low concentration of CsA and high level of CyP can not play a therapeutic role in nephropathy. However, CyP with low concentration of CsA in the concentration range of 100 ~ 200μg / L may be helpful to the nephropathy.