急性白血病患者血浆锌含量变化与多药耐药关系的探讨

【目的】探讨急性白血病（AL）患者血浆锌含量变化与病情及临床疗效的关系。【方法】采用原子吸收分光光度法，检测52例AL患者血浆锌含量及免疫组化法检测化疗后33例AL患者骨髓单个核细胞p-糖蛋白的表达。【结果】①52例AL患者，其中初治未化疗19例血浆锌含量（2．62±1.12μg／mL）较正常对照组（4．28±1．68μg／mL）明显减低（P〈0．01），化疗后病情缓解16例锌含量（4．66±2．18μg／mL）较难治／复发17例（3．34±0．93μg／mL）明显增高（P〈0．05），缓解组血浆锌含量较初治未化疗组明显增高（P〈0．01）；②17例难治／复发AI。患者其中15例骨髓单个核细胞P-gP表达阳性细胞率与血浆锌含量呈明显的负相关（r=0．69，P〈0．01）。【结论】①AL患者血浆锌含量变化与病情及临床疗效有关。②AL患者血浆锌含量测定可作为判断病情、疗效及预后指标之一。锌可能参与AL多药耐药的发生。

Relationship Between Plasma Zinc and Multidrug-resisitance in Acute Leukemia Patients

[Objective] To investigate the relationship between acute leukemia（AL） patients＇ plasma zinc concentration change and clinical curative effect. [Methods] The plasma zinc concentration of 52 AL patients was examined by absorption speetrophotometry. The expression of P glycoprotein（P-gp） in mononuclear cells of bone marrow was observed by immunohistochemistry with the refractory/relapsed AL. [Results]The zinc concentration change of the untreated group was significantly lower than that of normal control（ P〈0.01）. The zinc concentration change of the complete remission group was significantly higher than that of the refractory/relapsed group（ P〈0.05）. Zinc concentration of the complete remission group was significantly higher than that of the untreated group（ P〈0.01）. There were 15 patients whose P-gp expression was positive in 17 refractory/relapsed AL patients. There was negative correlation between plasma zinc concentration and positive cell rate of P-gp expression （r=-0.69, P〈0.01）. [Conclusion] ① AL patients＇ plasma zinc concentration is related to pathogenetic condition and clinical curative effect. ②AL patients＇ plasma zinc concentration change may be one of the indicators for learning clinical condition and curative effect and predicting prognosis. ③ Zinc may take a part in occurrence of multidrug-resistance （MDR） in acute leukemia.