摘要
目的探讨神经元特异性烯醇化酶(NSE)对中枢神经系统白血病早期诊断的临床意义和和三联药物鞘注(甲氨喋呤、阿糖胞苷、地塞米松)对中枢神经系统的损伤作用。方法2004～2006年在我院收治的急性非淋巴细胞白血病10例、急性淋巴细胞白血病23例和中枢神经系统白血病5例,用电化学发光法测定脑脊液中神经元特异性烯醇化酶浓度,同时用放射免疫法测定脑脊液中β2微球蛋白浓度。结果中枢神经系统白血病患者脑脊液神经元特异性烯醇化酶浓度(11.56±4.52ng/ml)与急性白血病组(9.59±3.42ng/ml)比较无统计学差异,三联药物鞘注后10d(11.15±3.49ng/ml)、20d(12.32±3.55ng/ml)、56d(10.76±2.76ng/ml)与鞘注前(9.96±3.37ng/ml)比较无统计学差异。中枢神经系统白血病患者脑脊液β2微球蛋白(5.42±1.1mg/l)明显高于急性白血病组(1.67±0.21mg/l)。结论脑脊液神经元特异性烯醇化酶作为中枢神经系统白血病诊断指标有待于探讨;三联药物鞘注近期内对中枢神经系统无损伤作用,是安全有效的;脑脊液中β2微球蛋白对中枢神经系统白血病的诊断有重要意义。
Objective To study the trauma for central nervous system （CNS） from CNS leukemia （CNSL） and intrathecal injection （IT） with methotrexate, arabinosylcytosin and dexamethasone through detecting neuron-specific enolase （NSE） content in eerebrospinal fluid （CSF） .Methods 10 cases of acute non-lymphoblastie leukemia （ANLL） ,23 cases acute lymphoblastie leukemia （ALL） and 5 cases of CNSL patients were studied from 2004 to 2006. The NSE in CSF was detected with electrochemistry luminescence; and theβ2-mieroglobulin （β2-MG） was detected with radioimmunoassay. Result NSE was （11.56±4.52ng/ml） in CNSL and there was not significantly higher than acute leukemia （AL） group （9.59±3.42ng/ml）. There was no significantly change of NSE （9.96±3.37ng/ml） before IT, and （11.15±3.49ng/ml） at day 10, and （12.32±3.55 ng/ml）at day 20, and （10.76±2.76 ng/ml） at day 56 after IT. β2-MG was （5.42 ±1.1mg/l） in CNSL and significantly higher than AL group （1.67 ±0.21mg/l）. Conclusion IT with methotrexate, arabinosylcytosin and dexamethasone was safe and effective because of non-harm to CNS in the near future. β2-MG in CSFwas a useful marker in diagnosis of CNSL,but NSE was not.
出处
《医学信息》
2008年第11期2057-2059,共3页
Journal of Medical Information
