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目的 :研究急性白血病 (AL)多药耐药 (MDR1 )基因表达与临床耐药的关系。方法 :应用反转录聚合酶链反应 (RT- PCR) ,检测 6 8例 AL 患者骨髓和 10名正常人外周血单个核细胞中 MDR1 基因的表达。结果 :复发难治组 MDR1 阳性率最高 ,与正常对照组、初治组、完全缓解组相比均有显著差异 (P<0 .0 5 )。初治组 MDR1 阳性病例与 MDR1 阴性病例的首次完全缓解率 (分别为 45 .45 %和 88.89% )之间有显著差异。MDR1 的表达在 FAB各亚型间略有差异。MDR1 阳性的复发难治 AL 患者 ,经环孢酶素 A(Cs A)逆转多药耐药后 ,完全缓解显著增高。结论 :MDR1基因过度表达可导致临床耐药 ,是预后的重要不利因素 ,是判断疗效及早期复发的一个重要标志。Cs A有较好逆转复发难治 AL 多药耐药的作用
Objective: To study the relationship between multidrug resistance (MDR1) gene expression and clinical drug resistance in acute leukemia (AL). Methods: The expression of MDR1 gene in 68 bone marrow and 10 normal human peripheral blood mononuclear cells was detected by RT-PCR. Results: The positive rate of MDR1 in refractory relapsed patients was the highest, which was significantly different from that in normal control group, initial treatment group and complete remission group (P <0.05). There was a significant difference between the initial complete remission rate of MDR1-positive cases and MDR1-negative cases (45.45% and 88.89% respectively). MDR1 expression is slightly different among FAB subtypes. MDR1-positive relapsed patients with AL refractory, cyclosporin A (Cs A) reversal of multidrug resistance, complete remission was significantly higher. Conclusion: MDR1 gene overexpression leads to clinical drug resistance and is an important adverse prognostic factor. It is an important marker to judge the efficacy and early recurrence. Cs A has a good effect of reversing the relapse-refractory AL multi-drug resistance