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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例初治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＝０２３～１１３，ＦＩ＝５０～１６０，诊断为药敏；另一例为ＬＳＭＰ，ＲＩ＝３６０，ＦＩ＝３６７，诊断为原发耐药。１５例临床耐药的ＡＭＬ中，１２例为ＬＳＭＰ，ＤＲＩ＝２５９～１７７２，ＦＩ＝２６５～１０４１，诊断为经典耐药；其余３例为ＲＳＭＰ，ＤＲＩ＝０３９～０６７，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?
OBJECTIVE: To establish a fluorescent histogram for the detection of intracellular daunorubicin (DNR) in the diagnosis of drug resistance in leukemia cells. Materials and Methods: Fifteen cases of clinically resistant acute myeloid leukemia (AML) and 5 cases of newly diagnosed AML were selected for study. Flow cytometry (FCM) was used to detect the intracellular DNR fluorescence intensity, and the intensity was divided into In the drug-resistant and drug-susceptible regions, the histogram shift to the left (LSMP) was diagnosed as drug resistance; the right shift of the histogram (RSMP) was diagnosed as drug susceptibility. The drug resistance index (DRI), R/S (R is the number of resistant cells, S is the number of drug sensitive cells) ≥2 is drug resistance, and <2 is drug susceptibility. Fluorescence index (FI) = average fluorescence intensity × DRI, FI ≥ 200 for drug resistance, FI <200 for susceptibility. RESULTS: Of the 5 cases of newly diagnosed AML, 4 were RSMP, DRI was 023～113, FI=50～160, and the diagnosis was drug sensitivity; the other case was LSMP, RI=360, FI=367, The diagnosis is primary drug resistance. Of the 15 clinically resistant AML patients, 12 were LSMP, DRI=259-17.72, FI=265-1041, diagnosed as classic drug resistance; the remaining 3 patients were RSMP, DRI=039-0. 67, FI = 57-83, diagnosis of regenerative drug resistance. Conclusion: Using FCM to detect the fluorescence histogram of DNR in leukemia cells, combined with DRI, FI, clinical drug resistance, and the diagnostic cut-off point of fluorescence intensity of drug-resistant cells, we can quickly, easily, and intuitively detect clinically Assess AML resistance?