�����ܰ�ϸ����Ѫ����������ʱ�Լ�Һ��Ԫ������ϩ����ø�ı仯������

目的探讨大剂量甲氨蝶呤静滴+鞘内注射治疗急性淋巴细胞白血病(ALL)患儿时中枢神经系统损伤的监测指标。方法2003年1～12月在青岛大学医学院附属医院收治的42例标危ALL患儿中。在行大剂量甲氨蝶呤静滴+鞘内注射化疗前及化疗后15、30、45d腰穿留取脑脊液(CSF)各1mL,用双抗体夹心酶联免疫法测定CSF中神经元特异性烯醇化酶(NSE)的质量浓度。结果化疗后,CSF中NSE质量浓度升高,于第15天达峰值,化疗30dNSE质量浓度下降,与化疗前比较差异有统计学意义;化疗45d后NSE质量浓度与化疗前比较差异无统计学意义。结论CSF中NSE是ALL患儿行大剂量甲氨蝶呤静滴+鞘内注射化疗时,神经细胞急性损伤的一个有价值的预报因子。

Changes of neuron-specific enolase in children with acute lymphoblastic leukemia during chemotherapy and its significance

??Abstract Objective To investigate the monitoring factors for the central nervous system from intrathecal injections and high??dose methotrexate therapy (HDMTX+IT) given during treatment for acute lymphoblastic leukemia in children.Methods Forty??two children aged from 5 to 11 years with ALL participated in the study.children had the history of ALL less than one year,while twenty??two children had ALL more than one year.CSF was sampled for analyses of NSE on four occasions.Results No difference was found between the NSE concentration of the children who had ALL more or less than one year.The NSE content in the CSF samples increased from (3.9??0.5) ng/mL before the start of treatment to (6.5??1.1) ng/mL at day 15 and then gradually decreased to (4.3??0.9) ng/mL at day 30 and to (4.0 0.7) ng/mL at day 45.Conclusion NSE is a useful marker for acute brain damage in acute lymphoblastic leukemia children.