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目的：探讨脑脊液α肿瘤坏死因子（ＣＳＦＴＮＦα） 在中枢神经系统白血病（ＣＮＳＬ） 的临床意义。方法：用放射免疫法测定了４０ 例急性白血病患者ＣＳＦＴＮＦα含量。结果：ＣＮＳＬ患者ＣＳＦＴＮＦα含量全部升高，与对照组及无ＣＮＳＬ组比较有极显著性差异（ Ｐ＜ ０．０１） 。１０ 例ＣＮＳＬ患者治疗后８ 例缓解的ＣＳＦＴＮＦα含量明显下降；１ 例虽缓解但下降不明显，半月后复发。另１ 例病情恶化，ＣＳＦＴＮＦα含量反较治疗前升高。无ＣＮＳＬ组３０ 例患者７ 例ＴＮＦα增高，随访８０ ｄ ，有５ 例确诊为ＣＮＳＬ。结论：ＣＮＳＬ确诊前中枢神经系统（ＣＮＳ） 已受到白血病细胞的浸润；ＣＳＦＴＮＦα是诊断ＣＮＳＬ的敏感指标，有助于ＣＮＳＬ的早期诊断和疗效监测。
Objective: To investigate the clinical significance of cerebrospinal fluid α-tumor necrosis factor (CSFTNFα) in central nervous system leukemia (CNSL). Methods: The content of CSF TNFα in 40 patients with acute leukemia was determined by radioimmunoassay. Results: The levels of CSF TNF-α in CNSL patients were all increased. There was a significant difference between the control group and the non-CNSL group (P<0.01). In 10 cases of CNSL patients, the remission of CSF TNF-alpha was significantly reduced in 8 cases after treatment; in 1 case, although the decrease was not significant, relapse occurred after half a month. In the other case, the condition deteriorated, and the content of CSF TNF-α was higher than that before treatment. In 30 cases without CNSL group, 7 cases of TNF-alpha increased, followed up for 80 days, and 5 cases were diagnosed as CNSL. Conclusion: Before CNSL diagnosis, the central nervous system (CNS) has been infiltrated by leukemia cells. CSF TNFα is a sensitive index for the diagnosis of CNSL, which is helpful for the early diagnosis and therapeutic monitoring of CNSL.