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目的：判断环孢素A（CsA）加地尔硫对难治性急性白血病、恶性淋巴瘤（NHL）多药耐药基因（mdr1）逆转的疗效。方法：采用逆转录PCR扩增检测201例恶性血液病mdrl表达情况，用高效液相层色法测定CsA血药浓度。对12例对照组及12例逆转组的难治性急性白血病、NHL采用联合化疗方案、CsA加地尔硫进行逆转，并分析。结果：201例恶性血液病mdr1表达情况为mdr1表达阳性94例，阳性率为46．7％，其中急性淋巴细胞白血病（ALL）为47．4％，急性非淋巴细胞白血病（ANLL）为50．5％，NHL为32．1％，其它肿瘤为477％；逆转组有效率为58.3％，对照组为25％。结论：采用联合化疗方案、CsA加地尔硫在逆转组病人中治疗的有效率较对照组高。
Objective: To evaluate the efficacy of cyclosporine A (CsA) plus diltiazem for the reversal of multidrug resistance gene (mdr1) in refractory acute leukemia and malignant lymphoma (NHL). Methods: The expression of mdrl in 201 cases of hematological malignancy was detected by reverse transcription PCR amplification. The plasma concentration of CsA was determined by high performance liquid chromatography. The 12 patients with refractory acute leukemia and NHL in the control group and 12 reversal groups were treated with a combination chemotherapy regimen, CsA and diltiazem reversed, and analyzed. Results: The expression of mdr1 in 201 cases of hematological malignancies was 94 cases with mdr1 positive expression, the positive rate was 46.7%, of which acute lymphoblastic leukemia (ALL) was 47.4%, and acute nonlymphocytic leukemia (ANLL) was 50. 5%, NHL was 32.1%, other tumors were 477%; the effective rate in the reversal group was 58.3%, and the control group was 25%. CONCLUSIONS: The use of combination chemotherapy regimens with CsA and G were more effective in the reversal group than in the control group.