脑膜白血病有关诊断方法的初步探讨

PRELIMINARY INVESTIGATION OF EARLY DIAGNOSTIC METHODS FOR CENTRAL NERVOUS SYSTEM LEUKEMIA

近年来由于诱导缓解联合化疗的不断改进和缓解期的合理治疗,急性白血病的缓解期和生存期也大大延长。但与此同时,白血病患者中枢神经系统并发症的发生率却逐年增加,成为缓解期中引起白血病复发的一个重要原因。 脑膜白血病(简称脑白)可出现于急性白血病病程中的任何阶段,而以缓解期多见。

In order to investigate the methods for early diagnosis of central nervous systemleukemia (CNL), tanned sheep erythrocyte electrophoretic mobility test (TEEM test),activity of lactic dehydrogenase in cerebral spinal fluid (CSF LDH) were used in a studyof 9 patients with CNL. All patients with CNL were tested with TEEM test, totally for 40times in different episodes. It was positive in 18 out of 19 times (94. 7% )during meningealrelapse, but none was positive in the meningeal remission. The differences were statiscallysignificant between these 2 groups (P<0. 001). LDH and its isoenzymes were measured inCSF of 4 patients for 12 times, the CSF LDH activity was all within normal ranges, butdetermination of LDH isoenzymes indicated that LDH_2(1 case) and LDH_3(3 cases) weresignificantly elevated prior to clinical manifestations and positive CSF findings in CNLrelapsing stage. This investigation suggests that TEEM test may be used as a monitory test and predic-tive parameter for CNL, and LDH isoenzymes may be helpful to early diagnosis of CNL.However, further observation and study are necessary.