骨髓细胞形态检验在难治性贫血与巨幼细胞性贫血鉴别中的临床价值(1)
[摘要]目的 对比分析骨髓细胞形态检验在难治性贫血与巨幼细胞性贫血鉴别中的临床价值。方法 选取2013年10月～2016年10月在我院治療的64例贫血患者作为研究对象，其中难治性贫血组占32例，巨幼细胞性贫血组占32例。两组患者均进行骨髓细胞形态的临床检验，并将检验结果进行分析对比。结果 难治性贫血组的有核红细胞PAS阳性率为71.88%，红系病态占比为65.63%，粒系病态占比为75.00%，淋巴样小巨核占比为100.00%，与巨幼细胞性贫血组的3.13%、15.63%、6.25%、0.00%比较，差异有统计学意义(P<0.05)。难治性贫血组的巨幼变原始红细胞直径为(18.64±4.23)μm，巨幼变早幼红细胞直径为(17.64±2.84)μm，显著短于巨幼细胞性贫血组的(23.84±6.49)μm、(20.87±4.69)μm，差异有统计学意义(P<0.05)。巨幼细胞性贫血组的红细胞分布宽度为(16.35±3.47)%，低于难治性贫血组的(28.94±7.22)%，差异有统计学意义(P<0.05)。两组的血红蛋白、血小板以及白细胞水平比较，差异无统计学意义(P>0.05)。结论 骨髓细胞形态检验在难治性贫血与巨幼细胞性贫血中的临床检验价值可观，值得进一步推广。
[关键词]骨髓细胞形态；难治性贫血；巨幼细胞性贫血
[中图分类号] R446.11 [文献标识码] A [文章编号] 1674-4721(2017)06(c)-0118-03
[Abstract]Objective To compare and analyze the clinical value of morphological examination of bone marrow cells in the identification of refractory anemia and megaloblastic anemia.Methods 64 anemia patients treated in our hospital from October 2013 to October 2016 were selected as observation objects，and 32 cases were refractory anemia，32 cases were megaloblastic anemia.Participants in the two groups were all provided with the clinical test of morphological examination of bone marrow cells，and test results were analyzed and compared.Results In the refractory anemia group，the positivity rate of PAS was 71.88%，the proportion rates of erythroid pathosis，granulocytic pathosis，and lymphoid megakaryocytes was 65.63%，75.00%，and 100.00%；while in the megaloblastic anemia group，they were 3.13%，15.63%，6.25%，and 0.00% respectively，which were displayed great differences after comparisons (P<0.05).In the refractory anemia group，the diameters of megaloblastic pronormoblast and normoblast were (18.64±4.23)μm and (17.84±2.84)μm，which was shorter than (23.84±6.49)μm and (20.87±4.69)μm in the megaloblastic anemia group，with significant difference (P<0.05).Meanwhile，the red cell distribution width in the megaloblastic anemia group was (16.35±3.47)%，which was much lower than (28.94±7.22)% in the refractory anemia group，with significant difference (P<0.05).There was no significant difference in the level of hemoglobin，platelet and white blood cells between the two groups (P>0.05).Conclusion The clinical value of morphological examination of bone marrow cells in refractory anemia and megaloblastic anemia is substantial，and is worthy of further promotion.
[Key words]Morphology of bone marrow cell；Refractory anemia；Megaloblastic anemia
在临床上，贫血的发病人数近年来逐渐增加[1]。难治性贫血属于骨髓增生异常综合征中的一种类型，年龄在50岁以上的人群发病率较高。骨髓异常增生属于难治性贫血的主要临床表现，部分患者伴有进行性血细胞减少[2]。患者骨髓的造血细胞匮乏可导致巨幼细胞性贫血，其主要临床表现与难治性贫血有着很大的相似处，导致临床难以确诊，误诊概率较大[3]。，为进一步提高以上两种贫血疾病的临床诊断率，本研究对其进行骨髓细胞形态进行检验，并分析其检验结果，现报道如下。, http://www.100md.com(袁晓凤)
[关键词]骨髓细胞形态；难治性贫血；巨幼细胞性贫血
[中图分类号] R446.11 [文献标识码] A [文章编号] 1674-4721(2017)06(c)-0118-03
[Abstract]Objective To compare and analyze the clinical value of morphological examination of bone marrow cells in the identification of refractory anemia and megaloblastic anemia.Methods 64 anemia patients treated in our hospital from October 2013 to October 2016 were selected as observation objects，and 32 cases were refractory anemia，32 cases were megaloblastic anemia.Participants in the two groups were all provided with the clinical test of morphological examination of bone marrow cells，and test results were analyzed and compared.Results In the refractory anemia group，the positivity rate of PAS was 71.88%，the proportion rates of erythroid pathosis，granulocytic pathosis，and lymphoid megakaryocytes was 65.63%，75.00%，and 100.00%；while in the megaloblastic anemia group，they were 3.13%，15.63%，6.25%，and 0.00% respectively，which were displayed great differences after comparisons (P<0.05).In the refractory anemia group，the diameters of megaloblastic pronormoblast and normoblast were (18.64±4.23)μm and (17.84±2.84)μm，which was shorter than (23.84±6.49)μm and (20.87±4.69)μm in the megaloblastic anemia group，with significant difference (P<0.05).Meanwhile，the red cell distribution width in the megaloblastic anemia group was (16.35±3.47)%，which was much lower than (28.94±7.22)% in the refractory anemia group，with significant difference (P<0.05).There was no significant difference in the level of hemoglobin，platelet and white blood cells between the two groups (P>0.05).Conclusion The clinical value of morphological examination of bone marrow cells in refractory anemia and megaloblastic anemia is substantial，and is worthy of further promotion.
[Key words]Morphology of bone marrow cell；Refractory anemia；Megaloblastic anemia
在临床上，贫血的发病人数近年来逐渐增加[1]。难治性贫血属于骨髓增生异常综合征中的一种类型，年龄在50岁以上的人群发病率较高。骨髓异常增生属于难治性贫血的主要临床表现，部分患者伴有进行性血细胞减少[2]。患者骨髓的造血细胞匮乏可导致巨幼细胞性贫血，其主要临床表现与难治性贫血有着很大的相似处，导致临床难以确诊，误诊概率较大[3]。，为进一步提高以上两种贫血疾病的临床诊断率，本研究对其进行骨髓细胞形态进行检验，并分析其检验结果，现报道如下。, http://www.100md.com(袁晓凤)