骨髓细胞学检查在低增生性骨髓增生异常综合征与再生障碍性贫血鉴别诊断中的价值分析
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摘要
目的:探讨骨髓细胞学检查在低增生性骨髓增生异常综合征(Hypo-MDS)与再生障碍性贫血(AA)鉴别诊断中的价值。方法:收治22例Hypo-MDS和58例AA患者,所有患者均行外周血涂片以及骨髓细胞学检查。结果:Hypo-MDS患者PLT、RDW、MCV和Ret水平及成熟红细胞异常率均显著高于AA患者(P<0.05);Hypo-MDS患者巨核系、粒系、红系细胞减少程度以及细胞外铁阳性分布率均较AA患者低,而前者其细胞内铁比例、小巨核细胞、核浆发育不平衡、原粒细胞>50%、类巨幼改变、成熟红细胞异常率均较后者高(P<0.05)。结论:骨髓细胞学检查可准确显示出Hypo-MDS和AA相关病理的差异性,可作为鉴别该两种疾病的有效检查手段。
Objective:To explore the value of bone marrow cytology in the differential diagnosis of hypoplastic myelodysplastic syndrome and aplastic anemia.Methods:22 patients with Hypo-MDS and 58 patients with AA were selected.They were given peripheral blood smear and bone marrow cytology.Results:The levels of PLT,RDW,MCV and the rate of abnormal erythrocyte abnormality in patients with Hypo-MDS were significantly higher than in the patients with AA(P<0.05);Hypo-MDS patients,granulocyte and erythrocytes of three cells and reduce the extent of extracellular iron distribution of positive rate than those with lower AA,while the former iron,the proportion of cells in micromegakaryocytes,karyoplasmic unbalanced growth, myeloblasts>50%,megaloblastoid changes,mature red blood cells abnormal rate was higher(P<0.05).Conclusion:Bone marrow cytology can accurately show the pathological differences of Hypo-MDS and AA diseases.It can be used as an effective method for the identification of the two diseases.
Objective:To explore the value of bone marrow cytology in the differential diagnosis of hypoplastic myelodysplastic syndrome and aplastic anemia.Methods:22 patients with Hypo-MDS and 58 patients with AA were selected.They were given peripheral blood smear and bone marrow cytology.Results:The levels of PLT,RDW,MCV and the rate of abnormal erythrocyte abnormality in patients with Hypo-MDS were significantly higher than in the patients with AA(P<0.05);Hypo-MDS patients,granulocyte and erythrocytes of three cells and reduce the extent of extracellular iron distribution of positive rate than those with lower AA,while the former iron,the proportion of cells in micromegakaryocytes,karyoplasmic unbalanced growth, myeloblasts>50%,megaloblastoid changes,mature red blood cells abnormal rate was higher(P<0.05).Conclusion:Bone marrow cytology can accurately show the pathological differences of Hypo-MDS and AA diseases.It can be used as an effective method for the identification of the two diseases.
引文
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[12]何苗,赵强,韩燕霞,等.难治性贫血与巨幼细胞贫血、再生障碍性贫血的细胞形态学对比分析[J].现代肿瘤医学,2016,24(11):1808-1812.
[2]赵生敏,高弘,文振宇.骨髓病理学、外周血涂片、骨髓细胞学联合检查在Hypo-MDS与再生障碍性贫血鉴别诊断中的应用效果[J].临床和实验医学杂志,2016,15(6):549-552.
[3]吕远飞,闫振宇,陈乃耀,等.淋巴细胞亚群在再生障碍性贫血和低增生性骨髓增生异常综合征患者外周血中的表达分析[J].中国实验血液学杂志,2016,24(5):1505-1510.
[4]杨强.骨髓细胞学检查在贫血诊断中的临床价值探讨[J].中外医学研究,2013,10(36):67-68.
[5]王蔚,朱萍,顾静文,等.CD34和CD117在鉴别低增生性骨髓增生异常综合征RCMD亚型和再生障碍性贫血中的最佳临界值[J].中华血液学杂志,2017,38(1):264-266.
[6]周开慧,华文密.铁代谢参数对骨髓增生异常综合征和再生障碍性贫血的诊断意义[J].检验医学,2017,32(7):623-627.
[7]顾李霖,康慧媛,潘玉玲,等.骨髓细胞形态、细胞化学染色及骨髓活检切片联合检测在低原始细胞骨髓增生异常综合征与溶血性贫血鉴别诊断中的价值[J].中国实验血液学杂志,2016,24(1):138-143.
[8]王海波,于红博.骨髓细胞学检查诊断再生障碍性贫血与临床关系的研究[J].重庆医学,2017,45(1):288-290.
[9]董海波,谢品浩,袁翠英,等.病态造血在骨髓增生异常综合征诊断中的意义[J].检验医学与临床,2016,13(5):685-688.
[10]卢焰,宋建新.以骨髓转移癌为首发表现的骨髓外肿瘤57例分析[J].中外医学研究,2013,10(11):9-10.
[11]林晓岚,陈万紫,傅蔷,等.荧光原位杂交在诊断骨髓形态学拟诊的再生障碍性贫血中的应用[J].中华医学遗传学杂志,2016,33(1):5-8.
[12]何苗,赵强,韩燕霞,等.难治性贫血与巨幼细胞贫血、再生障碍性贫血的细胞形态学对比分析[J].现代肿瘤医学,2016,24(11):1808-1812.