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目的:评价微小脑膜白血病与腰椎穿刺损伤阳性的儿童急性淋巴细胞性白血病患者5年中枢神经系统白血病复发率。方法:应用Cochrane国际协作网的系统评价方法,研究文献中关于儿童急性淋巴细胞性白血病患者微小脑膜白血病与腰椎穿刺损伤阳性患者5年中枢神经系统白血病复发率的比较的随机、半随机试验进行了系统评价。结果:6个试验共包括1172位患者,经异质性检验,x2=4.03,P=0.55,6个试验不存在异质性。采用固定效应模型法进行meta分析,合并效应量OR=I.18,95%的可信区间为0.86～1.61,经u检验,P=0.30,说明微小脑膜白血病患者与腰椎穿刺损伤阳性患者5年中枢神经系统白血病复发率无显著差异。结论:微小脑膜白血病患者与腰椎穿刺损伤阳性患者5年中枢神经系统白血病复发率可能无显著差异,临床上有必要开展更多设计良好的随机对照试验以证明这一结论,同时为将来早期对患者中枢神经系统白血病的诊断及治疗提供帮助。
PURPOSE: To evaluate the 5-year incidence of central nervous system leukemia in children with acute leukemia of childhood with micromecase leukemia and lumbar puncture injury. Methods: A systematic review of the Cochrane Collaboration was used to investigate the 5-year randomized, quasi-randomized trial of the relapse rate of 5-year central nervous system leukemia among patients with micromecase leukemia and lumbar puncture injury in childhood acute lymphoblastic leukemia system assesment. Results: A total of 1172 patients were included in the six trials. There was no heterogeneity among the 6 trials after heterogeneity test, x2 = 4.03, P = 0.55. The fixed effect model was used for meta-analysis. The combined effect was OR = I.18, and the 95% confidence interval was 0.86-1.61. After u test, P = 0.30, which indicated that patients with micromembranous leukemia and lumbar puncture injury-positive patients were 5 years Central nervous system leukemia recurrence rate was no significant difference. CONCLUSIONS: There is no significant difference in 5-year relapse rate of central nervous system leukemia among patients with micromembranous leukemia and patients with positive lumbar puncture injury. Clinically, it is necessary to carry out more well-designed randomized controlled trials to prove this conclusion. In the meantime, Central nervous system leukemia diagnosis and treatment to help.