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目的:探讨分析急性白血病儿童血液和脑脊液中TNF-α的临床变化及其意义。方法:选取2011年5月~2013年5月收治的50例急性白血病儿童患者,分成17例急性骨髓性白血病(AML)和18例急性淋巴细胞白血病(ALL),以及15正常例对照患儿。给予50例患儿采用放射免疫法分析检测患儿治疗前、完全缓解(CR)时、连续缓解时血液及脑脊液中TNF-α水平。结果:急性骨髓性白血病和急性淋巴细胞白血病患儿治疗前血液TNF-α明显高于正常对照患儿,经对比,具有明显统计学意义(P<0.05)。后经CR后将至正常水平并在连续CR期中处于正常水平。急性淋巴细胞白血病患儿和急性骨髓性白血病患儿治疗前脑脊液的TNF-α明显高于15例正常对照患儿,经对比,具有明显统计学意义(P<0.05),经采用鞘内注射治疗后TNF-α逐渐恢复正常水平。结论:TNF-α是具有广泛生物学作用的细胞因子,脑脊液中的TNF-α和血液水平可充分反应急性白血病患儿肿瘤负荷受累程度,为后续治疗起着重要的指导意义。
Objective: To investigate the clinical significance of TNF-α in blood and cerebrospinal fluid in children with acute leukemia. Methods: Fifty children with acute leukemia admitted from May 2011 to May 2013 were divided into 17 cases of acute myeloid leukemia (AML) and 18 cases of acute lymphoblastic leukemia (ALL), and 15 normal control children. Fifty patients were treated with radioimmunoassay to detect the levels of TNF-α in blood and cerebrospinal fluid before treatment, complete remission (CR), continuous remission. Results: The blood levels of TNF-α in children with acute myeloid leukemia and acute lymphoblastic leukemia before treatment were significantly higher than those in the normal control children (P <0.05). After CR will be normal to the level and in the continuous CR period at normal levels. In children with acute lymphoblastic leukemia and children with acute myeloid leukemia, the level of TNF-α in cerebrospinal fluid of patients before treatment was significantly higher than that of 15 normal controls, and the difference was statistically significant (P <0.05). After intrathecal injection After TNF-α gradually returned to normal levels. CONCLUSION: TNF-α is a cytokine with a wide range of biological effects. The levels of TNF-α and blood in cerebrospinal fluid can fully reflect the extent of tumor burden in children with acute leukemia, which plays an important guiding role in the follow-up treatment.