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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。
Objective To observe the effect of calcium channel blocker nifedipine and active vitamin D preparation Luo Pong Quan on PTH receptor gene expression in peripheral blood mononuclear cells (PBMCs) of uremic patients. Methods Thirty patients with nondiabetic conventional hemodialysis were randomly divided into nifedipine group, Luo Ca group and placebo group for 8 weeks. The mRNA expression of PTH receptor on PBMC was detected by reverse transcription polymerase chain reaction (RT-PCR). Results Nifedipine treatment could significantly up-regulate the expression of PTH receptor mRNA in PBMC of patients with uremia (0.1436 ± 0.0500 vs 0 3584 ± 0.0400, P <0.001), but still not up to normal Group level (0.6837 ± 0.0300, P <0.001). Luo calcium treatment can be significantly corrected low calcium, high phosphorus and high PTH hyperlipidemia, PTH receptor mRNA expression also have some upregulation (0.1472 ± 0.0100 vs 0.2192 ± 0.0200, P <0.001 ). Conclusion Nifedipine and Luo calcium all can partially correct the abnormal expression of PTH receptor gene in patients with uremia.