急性白血病多药耐药基因表达的临床研究  

A CLINICAL STUDY ON MULTIDRUG RESISTANCE GENE(MDR1)EXPRESSION IN ACUTE LEUKEMIA

作　　者：浦津[1] 刘海川[1] 楼方定[1] 周绮[1] 冯凯[1] 韩晓萍[1] 阎影[1] 汪月增[1] 

机构地区：[1]北京解放军总医院血液科

出　　处：《中华内科杂志》1995年第10期655-658,共4页Chinese Journal of Internal Medicine

摘　　要：为降低白血病细胞对化疗药物的敏感性，用逆转录聚合酶链式反应（ＲＴ－ＰＣＲ）技术，定量检测了各病期９１例急性白血病患者的多药耐药基因（ＭＤＲ１）表达水平，发现初治组、缓解组、难治复发组ＭＤＲ１阳性率分别为４０．０％、２８．１％、８２．８％，且难治复发组ＭＤＲ１基因表达水平０．４３８８±０．０６７９（±ｓ）明显高于初治组０．２２０８±０．０８９６和缓解组０．２４５６±０．０７６８。在３０例初治患者中，ＭＤＲ１阳性组化疗缓解率为４１．７％，明显低于阴性组的８８．９％（Ｐ＜０．０５）。在缓解病人中，ＭＤＲ１表达阳性组与阴性组复发率有显著的差异（６６．７％；１３．０％Ｐ＜０．０１）。认为ＭＤＲ１基因表达增加是急性白血病患者的一个不良预后因素，是判断早期高危因素及耐药复发的一个重要指征。he authors established a highly sensitive,specific and quantitative method-RT-PCR for measuring the levels of MDR1 mRNA in 91 acute leukemic samples(including 30 untreated cases,32 remission cases 29 refractory and relapse cases).The results showed that MDR1 mRNA positive rate for refractory and re lapse cases,untreated cases and remission cases were 82.8%,40.0%,28.1% respectively,In untreated patients, it was found that the first complete remission rate differed significantly between MDR1 positive(41.7%)and MDR1 negative groups (88.9%)(P<0.05).In remission group,MDR1 positive cases had a higher relapse rate than MDR1 negative cases(66.7%;13.0% p<0.01)and all these cases relapsed of MDR1 gene overexpression(6 cases)were resistant to further treatment .It is concluded that the expres- sion of MDR1 mRNA might be an unfavorable prognostic factor for patients with acute leukaemia and could predict the efficacy of intensive chemotherapy and serve as a high risk factor for early and resistant relapse.

关 键 词：白血病 聚合酶链反应 基因表达 药物疗法 抗药性 

分 类 号：R733.710.5[医药卫生—肿瘤] R730.53[医药卫生—临床医学]