脑脊液检查对中枢神经系统白血病早期诊断的价值

Value of Cerebrospinal Fluid Examination in Early Diagnosis of Central Nervous System Leukemia

作者采用侯氏玻片离心沉淀法和放免法对４６例急性白血病患者的脑脊液进行细胞学、铁蛋白及β２－微球蛋白联合检测。结果显示：脑脊液细胞学检查确诊中枢神经系统白血病１７例，阳性率为３６．９％，其中亚临床病人９例。急性白血病合并中枢神经系统白血病组脑脊液铁蛋白、β２－微球蛋白分别为３８．２４±９．１２ｕｇ／Ｌ、４．２３±０．３４ｍｇ／Ｌ，明显高于正常对照组（Ｐ＜０．０１）；急性白血病不合并中枢神经系统白血病组分别为７．９５±３．０１ｕｇ／Ｌ、１．３２±０．３０ｍｇ／Ｌ，与正常对照组相比无显著性差异（Ｐ＞０．０５）。提示：脑脊液细胞学检查结合铁蛋白和β２－微球蛋白检测对中枢神经系统白血病的早期诊断有一定价值。

Cerebrospinal fluid was examined cytology and levels of ferritin and beta 2 microglobulin in cerebrospinal fluid were determined by method of Hou′s slide centrifuge and radioimmunity analysis in 46 patinets were diagnosed central nervous system leukemia by cerebrospinal fluid cytology, the postive rate was 36.9%, 9 of these patients were sub clinical. In patients who had central nervous system leukemia, the levels of ferritin and beta 2 microglobulin in cerebrospinal fluid were 38.24±9.12 ug/L and 4.12±0.34 mg/L, respectively, either of them was statistically different from that in the health controls( P <0.01); In patients who had not central nervous system leukemia, the levels of ferritin and beta 2 microglobulin were 7.95±3.01 ug/L and 1.32±0.30 mg/L, respectively, neither of them was significantly different from that in the normal controls ( P >0.05). The results suggest that cerebrospinal cytology combined with the determination of ferritin and beta 2 microglobulin are significantly valuable in the early diagnosis of central nervous system leukemia.