柔红霉素（DNR）荧光直方图诊断白血病细胞耐药的意义 _药学论文.docVIP

柔红霉素（DNR）荧光直方图诊断白血病细胞耐药的意义 _药学论文 柔红霉素（DNR）荧光直方图诊断白血病细胞耐药的意义 _药学论文 【摘要】目的：建立检测细胞内柔红霉素（DNR）的荧光直方图诊断白血病细胞耐药的方法。材料与方法：选取15例临床耐药的急性髓性白血病（AML），5初治AML进行研究，用流式细胞仪（FCM）检测细胞内DNR的荧光强度，根据其强弱程度划分成耐药区和药敏区，其直方图主峰左移（LSMP）诊断为耐药；直方图右移（RSMP）诊断为药敏。耐药指数（DRI），即R/S（R为耐药细胞数，S为药敏细胞数）≥2为耐药，＜2为药敏。荧光指数（FI）=平均荧光强度×DRI，FI≥200为耐药，FI＜200为药敏。结果：初治5例AML中，4例为RSMP，DRI=0.23～1.13，FI=50～160，诊断为药敏；另一例为LSMP，RI=3.60，FI=367，诊断为原发耐药。15例临床耐药的AML中，12例为LSMP，DRI=2.59～17.72，FI=265～1041，诊断为经典耐药；其余3例为RSMP，DRI=0.39～0.67，FI=57～83，诊断为再生耐药。结论：用FCM检测白血病细胞内DNR的荧光直方图，结合DRI、FI以及临床耐药表现和耐药细胞荧光强度的诊断界点的方法，我们可以快速、简便、直观地在临床上及时发现和评价AML耐药的类型和程度，可为制定个体化疗的方案提供依据，也为观察逆转耐药的疗效提供了一个方法。 　　 Significance of fluorescent histogram of daunorubicin(DNR) in 　　diagnosis of drug resistance to leukemic cells 　　【Abstract】Objective：To develop a fluorescent histogram of intracellular daunorubicin(DNR) as a diagnostic method for drug resistance in acute myeloid leukemia(AML).Methods：15 patients with clinically diagnosed drugy of fluorescence of intracellular DNR and the fluorescent histogram were determined by flow cytometer(FCM).According to a degree of the intensity, both drug－resistan t and－sensitive zones were marked off. Left shift of main peak(LSMP) with the fluoresent histogram may be diagnosed as drug resistance, and right shift of main peak(RSMP) as drug sensitivity. R/S stood for drug resistant index(DRI);R for the number of drug resistant cells, and S for drug－sensitive cells. DRI≥ 2 was drug－resistant or DRI ＜2 was drug-sensitive. Fluorescent index(FI) was the product of mean fluorescent intensity (MFI) multiplied by DRI. FI≥ 200 meant drug-resistant, while FI＜ 200 meant drug-sensitive.Results：Among 5 patients with previously untreated AML, 4 patients were diagnosed as drug-sensitive for RSMP, DRI=0.23～ 1.13,FI=50～ 160,and one patient was diagnosed as primary drug-resistant for LSMP,DRI=3.60, FI=367. In 15 patients with clinically drugP,DRI=2.59～ 17.72,and FI=265～ 1041,and 3 patients as regrowth drug resistance for RSMP,DRI=0.39～ 0.67,and