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目的：研究ｂｃｌ－ＸＬ基因高表达在白血病细胞耐药形成中的作用，观察急性髓细胞白血病病人的ｂｃｌ－ＸＬ表达与临床疗效间的相关性。方法：采用脂质体法将 ｂｃｌ－ＸＬ ｃＤＮＡ转导入ＨＬ－６０细胞；流式细胞仪定量检测凋亡细胞；ＭＴＴ法测定足叶乙甙、柔红霉素、阿霉素对转染细胞的细胞毒性； ＲＴ－ＰＣＲ法检测２０例急性髓细胞白血病病人的 ｂｃｌ－Ｘ_Ｌ表达。结果：ｂｃｌ－Ｘ_Ｌ高表达可抑制足叶乙甙诱发的凋亡，抑制率为４０．５％；降低上述化疗药物的细胞毒作用，耐药指数分别为３．２、３．２、１．６。１６／２０例急性髓细胞白血病病人ｂｃｌ－ＸＬ阳性，其中７例ｂｃｌ－ＸＬ强阳性表达，仅２例（２８．６％）获得完全缓解；９例ｂｃｌ－Ｘ_Ｌ弱阳性表达，６例（６６．７％）获得完全缓解。结论：ｂｃｌ－Ｘ_Ｌ可能作为一种新的耐药途径，通过抑制化疗药物诱发的细胞凋亡参与多药耐药的形成，可以作为预测耐药及判定预后的一种参考指标。
Objective: To study the role of high expression of bcl-XL gene in the development of drug resistance in leukemia cells and to observe the correlation between bcl-XL expression and clinical efficacy in patients with acute myeloid leukemia. METHODS: bcl-XL cDNA was transduced into HL-60 cells by liposome method; apoptotic cells were quantified by flow cytometry; MTT assay was used to determine the transfected cells of Etoposide, daunorubicin, and doxorubicin. Cytotoxicity; The expression of bcl-X_L in 20 patients with acute myeloid leukemia was detected by RT-PCR. Results: The high expression of bcl-X_L could inhibit the apoptosis induced by acetotory of A. elegans, and the inhibition rate was 40.5%. The cytotoxicity of the above-mentioned chemotherapeutic drugs was reduced, and the resistance index was 3.2, 3.2, and 1. 6. 16/20 cases of acute myeloid leukemia patients were positive for bcl-XL, of which 7 cases had strong bcl-XL expression, only 2 cases (28.6%) achieved complete remission; 9 cases had weakly positive expression of bcl-XL, 6 cases (66.7%) achieved complete remission. Conclusion: bcl-X_L may be used as a new drug resistance pathway. It may participate in the formation of multidrug resistance by inhibiting apoptosis induced by chemotherapeutic drugs. It can be used as a reference index for predicting drug resistance and determining prognosis.