中枢神经系统白血病38例临床分析

Clinical analysis of 38 cases of central nervous system leukemia(CNSL)

目的回顾性调查我院中枢神经系统白血病的发病率及死亡率,总结临床经验、吸取教训。方法对90例白血病患者中38例中枢神经系统白血病患者的资料进行分析。结果90例白血病患者总死亡率为14.4%,中枢神经系统白血病总发生率为42.2%,ALL80.0%,ANLL39.2%,CL10.5%。结论①急性白血病的病死率高(15.4%),并发中枢神经系统白血病的发生率高(50.8%),且ALL>ANLL>CL,相互之间差异有统计学意义(P<0.01);②中枢神经系统白血病是白血病的主要并发症之一,是白血病缓解后复发及死亡的主要原因,且与FAB分型有关;③我院白血病患者主要为外来打工者,占86.7%;死亡率及中枢神经系统白血病的发病率皆高于国内外相关报道,其原因为患者经济条件差,文化水平低,健康意识缺乏。

Objective To Survey the incidence and mortality rate of CNSL for aggregating clinical experience and learn a lesson from them. Methods There were 90 hospitalized patients, in which 38 complicated with CNSL , all of their clinical data had been analyzed. Results The mortality rate of 90 leukemia patients was 14.4%, the total rate of CNSL was 42. 2%, ALL80. 0%, ANLL39.2%, CL10. 5%. Conclusion The analysis indicated ,firstly, the high mortality rate of AL was 15.4%, the incidence of CNSL was 50. 8%, and also ALL 〉 ANLL 〉 CL. There was a significant difference between them （ P 〈 0. 01 ） . Secondly, CNSL was a major complication of leukemia. It was the leading cause of death and leukemia relapse. It was related with the FAB classification. At last, these patients were mainly foreign workers in these data, accounting for 86.7%, the mortality and morbidity rates of CNSL were higher than the domestic and foreign＇ s reports. The reasons lay in poor economic conditions, low literacy level and lack of health awareness.