【摘要】 为研究多药耐药（ＭＤＲ）在白血病中临床意义，以及环孢霉素Ａ（ＣｓＡ）对ＭＤＲ体外逆转效果，对２６例白血病患者采用流式细胞仪测定治疗前白血病细胞内柔红霉素（ＤＮＲ）浓度及应用原位杂交技术检测ＭＤＲ１表达水平，并与加入ＣｓＡ后细胞内ＤＮＲ浓度变化比较。结果显示，初治完全缓解组，ＭＤＲ１阳性细胞内ＤＮＲ平均浓度（８０．０１％±２．１０％）明显高于难治、复发组（４４．８０％±７．７４％）（Ｐ＜０．０１），ＣｓＡ对难治组、复发组中ＭＤＲ１阳性者逆转效果好（Ｐ＜０．０１）。提示两种方法联合检测ＭＤＲ可指导临床化疗方案设计，ＣｓＡ对体外白血病耐药细胞有明显逆转效果更多还原

【Abstract】 Multidrugresistance(MDR)inleukemiaandthereversalofMDRbycyclosporinA(CsA)invitrohavebeenstudiedthroughintracelularaccumulationofdaunorubicin(DNR)inleukemicmyeloblasts.Thestudywascarriedoutwithreal-timeflowcytometryandrelativeexpressionlevelsofMDR1whichisestimatedbyRNAinsituhybridizationin26patientssuferingfromleukemia.ThechangeofintracelularDNRaccumulationinvitroafteraddingCsAwasalsoanalyzed.TheresultsshowedthatintracelularDNRaccumulationinnewlydiagnosedandtreatedpatients(MDR1negative)withremissionincreasedsignificantlythanthatinrefractoryandrelapsingpatients(P<0.01).GoodreversalefectwasobtainedinrefractorypatientsandMDR1positiverelapsingpatientsbyaddingCsA(P<0.01).ItissuggestedthatMDRdetectionbythetwoabave-mentionedmethodscouldhelptopro-jectthechemotherapyschedulechinicaly,CsAhadobviousreversalefectonthedrug-resistantleukemiccelsinvitro.更多还原