本文選題：巨幼細(xì)胞性貧血 + 難治性貧血��； 參考：《中國(guó)實(shí)驗(yàn)血液學(xué)雜志》2016年03期

【摘要】：目的:探討骨髓形態(tài)差異在巨幼細(xì)胞性貧血與難治性貧血鑒別診斷中的臨床意義。方法:收集�？谑械谌嗣襻t(yī)院2004年4月至2015年4月收治的60例貧血患者,依照臨床診斷分為巨幼細(xì)胞性貧血組(megaloblastic anemia,M A)和難治性貧血組(refractory anemia,RA),每組30例。對(duì)比兩組患者臨床表現(xiàn)、骨髓形態(tài)、血象檢查及外周血涂片結(jié)果、紅系巨幼變率及有核紅細(xì)胞數(shù)。結(jié)果:MA組患者出現(xiàn)發(fā)熱、出血、消化系反應(yīng)、脾大、疲乏無(wú)力、淋巴結(jié)腫大等臨床表現(xiàn)率、血紅蛋白、血小板及白細(xì)胞含量與RA組相似,兩組組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);M A組患者紅系病態(tài)、粒系病態(tài)、幼稚粒細(xì)胞、淋巴樣小巨核百分率、PAS陽(yáng)性率及紅細(xì)胞分布寬度均明顯低于RA組(P0.05),而紅系巨幼變率(90.00%)明顯高于RA組(10.00%)(P0.05),而MA組幼稚紅細(xì)胞百分率(53.33%)與RA組接近(60.00%)。結(jié)論:巨幼細(xì)胞性貧血與難治性貧血患者大多數(shù)臨床表現(xiàn)、外周血涂片結(jié)果較為一致,RA組骨髓形態(tài)檢驗(yàn)在診斷時(shí)應(yīng)重點(diǎn)觀察淋巴樣小巨核細(xì)胞,而在MA組則應(yīng)強(qiáng)調(diào)紅系巨幼變的胞體,有核紅細(xì)胞百分率(PAS)可作為臨床診斷參考。
[Abstract]:Objective: to investigate the clinical significance of bone marrow morphology difference in differential diagnosis of megaloblastic anemia and refractory anemia. Methods: sixty patients with anemia were collected from April 2004 to April 2015 in the third people's Hospital of Haikou City. According to the clinical diagnosis, they were divided into megaloblastic anemiaAA group and refractory anemia group (30 cases in each group). The clinical manifestations, bone marrow morphology, hematologic examination and peripheral blood smear results, erythroid megaclastic rate and nucleated red blood cell count were compared between the two groups. Results the clinical manifestations, such as fever, hemorrhage, digestive system reaction, splenomegaly, fatigue, lymphadenopathy, hemoglobin, platelet and white blood cell contents, were similar to those in RA group. There was no significant difference between the two groups in erythroid, granulocytic and immature granulocytes. The positive rate of pas and the distribution width of red blood cells in lymphoid micronuclei were significantly lower than those in RA group (P 0.05), while the erythroid megaloblastic degeneration rate was significantly higher than that in RA group (10.00%), while the percentage of immature erythrocytes in MA group (53.33%) was close to 60.005% in RA group. Conclusion: most of the clinical manifestations of patients with megaloblastic anemia and refractory anemia are consistent with the results of peripheral blood smear. In RA group bone marrow morphologic examination should focus on the observation of lymphoid megakaryocyte in diagnosis. In MA group, the cell body of erythroid megaloblastic degeneration should be emphasized, and the percentage of nucleated red blood cells (PAS) could be used as a reference for clinical diagnosis.
【作者單位】： 海口市第三人民醫(yī)院檢驗(yàn)科;中國(guó)人民解放軍187醫(yī)院檢驗(yàn)科;中山大學(xué)孫逸仙紀(jì)念醫(yī)院血液內(nèi)科;
【分類(lèi)號(hào)】：R556;R446.11

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