雄黄治疗维甲酸耐药急性早幼粒细胞白血病-M_3及诱导凋亡的作用  

A clinical study of Realgar on ATRA-resistant acute promyelocytic leukemia and its effects on apoptosis induction

作　　者：王梦昌[1] 李信民[1] 刘陕西[1] 尚菊战[1] 

机构地区：[1]西安交通大学血液学研究中心,西安710061

出　　处：《西安医科大学学报》2002年第2期175-177,共3页Journal of Xi'an Medical University(Chinese)

摘　　要：目的　研究雄黄体外诱导人急性早幼粒细胞白血病 M3细胞凋亡的作用 ,并观察其对维甲酸耐药的急性早幼粒细胞白血病 M3的治疗效果。方法　用雄黄处理在体外培养耐维甲酸的人白血病细胞 ,电子显微镜观测白血病细胞凋亡过程 ,并前后对照观察应用雄黄治疗维甲酸耐药的急性早幼粒细胞白血病 M3的疗效。结果　在 1 .0～ 2 .0 μmol·L- 1 的浓度下 ,雄黄作用于白血病细胞 2 4h后 ,可见到较为典型的细胞凋亡形态学变化 :细胞核固缩 ,染色体凝集 ,呈新月型紧贴于核膜周边 ,核碎裂 ,染色质片断化 ,凋亡小体形成等。用雄黄治疗的 2 0例患者 ,完全缓解(CR) 1 7例 ,部分缓解 (PR) 1例 ,总有效率 (CR +PR) 90 %。结论　雄黄能够诱导耐维甲酸的白血病细胞凋亡 ,可用于维甲酸耐药的急性早幼粒细胞白血病 M3治疗 ,且缓解率及长期生存率高。Objective To investigate the cell apoptosis of Realgar on human acute leukemia in vitro and observe the clinical effects of Realgar on ATRA resistant acute promyelocytic leukemia. Methods Electron microscope was used to observe the course of apoptosis of Realgar treated ATRA resistant human leukemia cells. Twenty patients with ATRA resistant acute promyelocytic leukemia were given Realgar and the clinical effects were compared.Results After 24 hours' incubation with 1.0～2.0μmol·L -1 Realgar, typical apoptosis morphologic changes occurred: nucleus was concentrated, chromosomes were condensed like a new moon adhering to nuclear membrane; nucleus collapsed, chromatin split, apoptosis body appeared. In the 20 patients treated with Realgar, 17 got complete remession (CR), 1 got partial remession (PR), total efficiency rate (CR plus PR) being 90%.Conclusion Realgar could induce cell apoptosis of ATRA resistant acute promyelocytic leukemia. It can be used to treat ATRA resistant acute promyelocytic leukemia and it has great rates of remession and long survival.

关 键 词：雄黄 维甲酸 急性早幼粒细胞白血病-M3 诱导凋亡 中药 ATRA 耐药性 

分 类 号：R273.371[医药卫生—中西医结合]