论文部分内容阅读
目的 :探讨脑脊液中肿瘤坏死因子受体水平的检测对中枢神经系统白血病 (CNSL)的诊断、疗效评价及预后价值。方法 :采用双抗体夹心酶联免疫吸附法检测可溶性肿瘤坏死因子受体Ⅰ(sTNFRⅠ )和可溶性肿瘤坏死因子受体Ⅱ (sTNFRⅡ ) ,同时采用放射免疫法检测 β2 微球蛋白(β2 MG)作为参考 ,检测 5 5例急性白血病患者脑脊液 ,其中CNSL2 5例 ,并动态观察 6例CNSL鞘内化疗前后sTNFRⅠ、sTNFRⅡ和 β2 MG的变化 ,用logistic回归分析影响CNSL疗效的因素。结果 :CNSL组的sTNFRⅠ、sTNFRⅡ和 β2 MG明显高于无CNSL组 (P <0 .0 5 ) ,而无CNSL组与对照组比较 ,sTNFRⅠ、sTNFRⅡ和β2 MG未见显著性差异。动态观察发现 ,随着CNSL病情的好转 ,sTNFRⅠ、sTNFRⅡ和 β2 MG水平明显下降 ,CNSL的病情恶化 ,sTNFRⅠ、sTNFRⅡ和β2 MG水平也进一步上升。对可能影响CNSL患者疗效的 6种因素作了logistic回归分析 ,发现脑脊液中sTNFRⅠ水平对预测预后更具价值。结论 :脑脊液中sTNFR水平检测可作为诊断CNSL的一项指标 ,是疗效评价、预测预后的因素之一。
Objective: To investigate the detection of tumor necrosis factor receptor in cerebrospinal fluid (CSF) in the diagnosis, curative effect and prognosis of central nervous system leukemia (CNSL). Methods: The soluble tumor necrosis factor receptor Ⅰ (sTNFR Ⅰ) and soluble tumor necrosis factor receptor Ⅱ (sTNFR Ⅱ) were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA), β2 microglobulin (β2 MG) was detected by radioimmunoassay , Detected cerebrospinal fluid in 55 patients with acute leukemia, including CNSL2 in 5 cases. The changes of sTNFRⅠ, sTNFRⅡ and β2 MG before and after intrathecal chemotherapy in 6 cases of CNSL were observed dynamically. Logistic regression analysis was used to analyze the factors affecting the efficacy of CNSL. Results: The sTNFRⅠ, sTNFRⅡ and β2 MG in CNSL group were significantly higher than those in the CNSL group (P <0.05), but there was no significant difference in sTNFRⅠ, sTNFRⅡ and β2 MG between the CNSL group and the control group. Dynamic observation showed that as the condition of CNSL improved, the levels of sTNFRⅠ, sTNFRⅡ and β2 MG were significantly decreased, the condition of CNSL was worsened and the levels of sTNFRⅠ, sTNFRⅡ and β2 MG were further increased. Logistic regression analysis of the six factors that may affect the efficacy of CNSL patients found that sTNFRI levels in cerebrospinal fluid more valuable prognostic prognosis. Conclusion: The detection of sTNFR level in cerebrospinal fluid can be used as an index in the diagnosis of CNSL. It is one of the factors in evaluating the curative effect and predicting the prognosis.