医药学论文：柔红霉素（dnr）荧光直方图诊断白血病细胞耐药的意义[1]

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关键字：白血病 检测 直方图 荧光 细胞 临床 诊断 耐药 方法 强度
　　【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 drug resistant AML and 5 patients with previously untreated AML were studied. The intensity 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 wi医药学论文