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目的研究急性早幼粒细胞性白血病(APL:acute promyelocytic leukemia)并发中枢神经系统白血病(CNSL:central nervous system leukemia)的临床特点,并分析预防性鞘内注射化疗对患者机体及CNSL的影响。方法从武冈市人民医院2007年4月~2013年3月收治APL患者中随机抽取165例作为研究对象,根据其是否实施预防性鞘内注射化疗分为2组,非鞘内注射组仅实施常规化疗,鞘内注射组在此基础上实施鞘内注射化疗,对比观察2组患者复发及并发CNSL情况;并根据是否并发CNSL分为实验组(并发CNSL)、对照组(未并发CNSL),对比观察2组患者相关指标水平及复发情况。结果鞘内注射组患者复发率及CNSL并发率显著低于非鞘内注射组(P﹤0.05);实验组与对照组相比,WBC(white blood cell)水平明显较高、PLT(blood platelet)水平明显较低,复发率高于对照组,差异有统计学意义(P﹤0.05)。结论 APL并发CNSL后患者机体状况较差,病情明显较为严重,且预后与单纯APL患者相比较差,在临床上需加强对CNSL并发症的防治措施;对APL患者实施预防性鞘内注射化疗,能够有效降低复发及并发CNSL,具有较理想临床疗效。
Objective To study the clinical features of central nervous system leukemia (APL) complicated with acute promyelocytic leukemia (CNSL) and to analyze the effect of prophylactic intrathecal chemotherapy on CNSL. Methods A total of 165 patients randomly selected from April 2007 to March 2013 in Wugang People’s Hospital for APL were divided into two groups according to whether they were administered prophylactic intrathecal injection of chemotherapy or not, The conventional chemotherapy and intrathecal injection group were given intrathecal chemotherapy to observe the relapse and CNSL of the two groups. According to whether the CNSL was complicated or not, the patients were divided into experimental group (CNSL), control group (without CNSL) The levels of the relevant indicators and recurrence in the two groups were observed. Results The recurrence rate and CNSL incidence of patients in intrathecal injection group were significantly lower than those in non-intrathecal injection group (P <0.05). Compared with control group, WBC (white blood cell) The level was significantly lower, the recurrence rate was higher than the control group, the difference was statistically significant (P <0.05). CONCLUSIONS: Patients with APL complicated with CNSL have poorer body condition and obviously worse condition, and the prognosis is poor compared with APL patients. In clinical practice, it is necessary to strengthen the prevention and treatment measures for CNSL complications. To prevent and treat APL patients with prophylactic intrathecal chemotherapy, Can effectively reduce the recurrence and concurrent CNSL, has a more ideal clinical effect.