完全缓解急性白血病脑脊液检出白血病细胞检验分析.docVIP

完全缓解急性白血病脑脊液检出白血病细胞检验分析 　　摘 要：目的 探讨完全缓解的急性白血病患者脑脊液检出白血病细胞的检验分析。方法 回顾性分析我院2010年8月～2016年8月共38例完全缓解的急性白血病患者，而脑脊液常规检验和FCM检验中却发现白血病细胞的临床特点及实验室资料，对其结果进行总结。结果 38例急性白血病化疗患者在脑脊液常规检测和FCM中，发现白血病细胞侵犯中枢神经系统而确诊为中枢神经系统白血病（CNSL）。结论 ?于缓解期的急性白血病患者，即使没有白血病细胞脑部浸润的症状，治疗前也应做腰穿行脑脊液细胞学常规检查，有利于脑膜白血病的早期发现，在急性白血病患者中应引起重视。 　　关键词：完全缓解；急性白血病；脑脊液检出白血病细胞；中枢神经系统白血病 　　中图分类号：R733.71 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.06.051 　　文章编号：1006-1959（2018）06-0146-03 　　Detection and Analysis of Leukemic Cells in Cerebrospinal Fluid for Complete Remission of Acute Leukemia 　　LI Rui-zhen，ZHANG Yue-rong 　　（Department of Laboratory，Dujiangyan Peoples Hospital，Dujiangyan 611830，Sichuan，China） 　　Abstract：Objective To investigate the detection and analysis of leukemic cells in cerebrospinal fluid（CSF）of patients with complete remission of acute leukemia.Methods 38 patients with complete remission of acute leukemia from August 2010 to August 2016 were retrospectively analyzed.The clinical characteristics and laboratory data of leukemic cells were found in routine cerebrospinal fluid test and FCM test，and the results were summarized.Results In 38 cases of acute leukemia，in the routine detection of cerebrospinal fluid and FCM，leukemia cells were found to invade the central nervous system and diagnosed as central nervous system leukemia（CNSL）. Conclusion In patients with acute leukemia in remission，even if there are no symptoms of brain infiltration of leukemic cells，routine examination of cerebrospinal fluid cytology should be performed before treatment to facilitate early detection of meningeal leukemia. Attention should be paid to acute leukemia patients. 　　Key words：Complete remission；Acute leukemia；Cerebrospinal fluid detection of leukemic cells；Central nervous system leukemia 　　白血病（leukemia）是造血干细胞克隆性疾病，是一组高度异质性的恶性血液病，其特点为白血病细胞异常增生，分化成熟障碍，并伴有凋亡减少。细胞成熟障碍可阻滞在不同阶段，阻滞发生在较早阶段称为急性白血病，阻滞发生在较晚阶段称为慢性白血病[1]。中枢神经系统白血病（central nervous system leukemia，CNSL）可见于白血病病程的任何阶段，但多发生在白血病化疗后缓解期或复发病例[2]。临床主要表现为头晕，恶心，呕吐，视乳头