论文部分内容阅读
目的探讨急性白血病(AL)患者脑脊液中白细胞介素6(IL6)、转化生长因子α(TGFα)和肿瘤坏死因子(TNF)水平的变化及其与病情和预后的关系。方法采用放射免疫分析法检测AL患者38例和对照组10例脑脊液中TNF、IL6和TGFα的水平,并对治疗前后病情变化及预后进行比较。结果AL患者部分缓解(PR)及合并中枢神经系统白血病(CNSL)时脑脊液TNF、IL6水平都明显高于对照组(P<0.05);治疗完全缓解(CR)后比PR时明显降低(P<0.05)。急性淋巴细胞白血病(ALL)PR时与急性粒细胞白血病(AML)合并CNSL时TGFα水平明显低于对照组(P<0.05),而ALLCR时TGFα水平接近对照组,CR时与PR时相比差异有显著性(P<0.05);而AML未合并CNSL时TGFα水平虽有变化,但无明显差异(P>0.05)。AML持续完全缓解(CCR)时3项细胞因子水平均与对照组相近(P>0.05)。结论动态检测AL患者脑脊液TNF、IL6水平有助于了解患者的病情变化及其预后,而IL6则是更敏感的指标之一;TGFα在ALL脑脊液中的变化对疗效评价有意义,AML只有在合并CNSL时才有明确的临床意义。
Objective To investigate the changes of interleukin 6 (IL 6), transforming growth factor α (TNFα) and tumor necrosis factor (TNF) in cerebrospinal fluid of patients with acute leukemia (AL) and its relationship with disease severity and prognosis. Methods Radioimmunoassay was used to detect the levels of TNF, IL6 and TGFα in cerebrospinal fluid of 38 AL patients and 10 control subjects. The changes of the disease and the prognosis were compared before and after treatment. Results The levels of cerebrospinal fluid TNF and IL6 were significantly higher in patients with AL with partial remission (PR) and with CNSL (P <0.05), and were significantly lower than those in PR after complete remission (CR) (P < 0.05). The levels of TGFα in acute lymphoblastic leukemia (ALL) with PR and acute myeloid leukemia (AML) were significantly lower than those in control group (P <0.05), while the level of TGFα in ALLCR was similar to that in control group (P <0.05). However, there was no significant difference (P> 0.05) in TGF-βlevels in AML without CNSL. The levels of the three cytokines in AML with CCR were similar to those in control group (P> 0.05). Conclusion Dynamic detection of cerebrospinal fluid levels of TNF and IL6 in patients with AL is helpful to understand the changes of patients’ condition and prognosis, while IL6 is one of the more sensitive indicators. The change of TGFα in ALL cerebrospinal fluid is of significance for the evaluation of therapeutic effects. CNSL when there is a clear clinical significance.