本文選題：骨髓增生異常綜合征 + 環(huán)形鐵粒幼細(xì)胞　； 參考：《山東醫(yī)藥》2017年37期

【摘要】：目的探討環(huán)形鐵粒幼細(xì)胞(RS)水平變化與骨髓增生異常綜合征(MDS)患者染色體核型、基因突變及預(yù)后的關(guān)系。方法取203例MDS患者的血液及骨髓樣本,檢測血紅蛋白、白細(xì)胞、血小板;行骨髓細(xì)胞形態(tài)學(xué)檢查,觀察紅系增生、病態(tài)造血(紅系巨幼變),計(jì)算RS占有核紅細(xì)胞比例。RS計(jì)數(shù)15%者為非RS增高M(jìn)DS組(n=139)、≥15%者為RS增高M(jìn)DS組(n=64);骨髓原始細(xì)胞計(jì)數(shù)5%分為低原始細(xì)胞非RS增高M(jìn)DS組(n=47)、低原始細(xì)胞RS增高M(jìn)DS組(n=53),骨髓原始細(xì)胞數(shù)≥5%分為非RS增高難治性貧血伴原始細(xì)胞增多(RAEB)組(n=92)、RS增高RAEB組(n=11)。用染色體圖像自動(dòng)分析系統(tǒng)進(jìn)行染色體核型分析;用實(shí)時(shí)定量PCR法檢測基因突變率。通過電話、門診復(fù)診等方式對(duì)患者進(jìn)行隨訪,記錄生存時(shí)間。采用COX回歸模型分析MDS患者預(yù)后影響因素。結(jié)果與非RS增高M(jìn)DS組比較,RS增高M(jìn)DS組年齡、白細(xì)胞計(jì)數(shù)、血小板計(jì)數(shù)、紅系增生程度及巨幼變陽性率、基因突變率高(P均0.05);與低原始細(xì)胞非RS增高M(jìn)DS組比較,低原始細(xì)胞RS增高M(jìn)DS組以上指標(biāo)高(P均0.05);與非RS增高RAEB組比較,RS增高RAEB組白細(xì)胞計(jì)數(shù)、紅系增生程度高,核型分布較差(P均0.05)。伴RS增高組的中位生存時(shí)間短于非RS增高組(P0.05)。采用COX回歸模型分析結(jié)果顯示,RS是MDS患者預(yù)后的獨(dú)立影響因素。結(jié)論 RS水平升高的MDS患者染色體核型分布差、基因突變率高、預(yù)后差。
[Abstract]:Objective to investigate the relationship between the level of ring-iron granulocyte RSv and chromosome karyotype, gene mutation and prognosis in patients with myelodysplastic syndrome (MDS). Methods Blood and bone marrow samples were collected from 203 patients with MDS, hemoglobin, white blood cells, platelets, bone marrow cell morphology, erythroid proliferation were observed. Morbid hematopoiesis (erythroid megaloblastic degeneration), the percentage of RBC occupied by RS. RS count was 15% in the non-RS increased MDS group, and 鈮，

本文編號(hào)：1909184