巨核细胞形态学观察在血小板减少疾病诊断中的意义  

Significance of megakaryocyte morphological observation in the diagnosis of thrombocytopenia

作　　者：何昕[1] 王巍[1] HE Xin;WANG Wei(Department of Hematology,The Second Affiliated Hospital of Harbin Medical University,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学附属第二医院血液科,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2022年第6期566-569,共4页Journal of Harbin Medical University

摘　　要：目的研究巨核细胞的形态学观察对诊断血小板减少疾病的意义。方法选取2020年3月~2021年9月本院门诊及住院患者的骨髓穿刺标本,按外周血小板计数分为血小板减少组(n=607)及健康对照组(n=100)。对血小板减少的患者进行骨髓象分析,并对巨核细胞数量、分类和形态学进行观察和统计。结果607例血小板减少患者中,病因明确者459例(75.6%),其中免疫性血小板减少性紫癜和急性白血病血小板减低最为常见,再生障碍性贫血与急性白血病巨核细胞数量明显下降,甚至缺如(P<0.01)。与健康对照组比较,血小板减少组病例巨核细胞出现不同程度的成熟障碍和/或产板不良,骨髓增生异常综合征、巨幼细胞贫血等疾病巨核细胞形态有特征性改变。结论在对血小板减少疾病进行骨髓涂片检查过程中,巨核细胞的数量、分类及形态学改变对查找病因及疾病的明确诊断具有重要意义。Objective To study the significance of morphological observation of megakaryocyte in the diagnosis of thrombocytopenia.Methods A total of 607 bone marrow puncture specimens of outpatients and inpatients in our hospital from March 2020 to September 2021 were selected and divided into thrombocytopenia group(n=607)and healthy control group(n=100)according to peripheral blood plate counts.Bone marrow images of patients with thrombocytopenia were analyzed,and the number,classification and morphology of megakaryocytes were observed and counted.Results Among 607 thrombocytopenia patients,459 cases(75.6%)had definite etiology,among which thrombocytopenia in immunologic thrombocytopenic purpura and acute leukemia were the most common.Megakaryocytes in patients with aplastic anemia and acute leukemia were significantly reduced or even absent(P<0.01).Compared with the healthy control group,the megakaryocytes in the thrombocytopenia group had different degrees of mature plate production disorder and/or poor plate production,and the morphology of megakaryocytes in diseases such as myelodysplastic syndrome and megaloblastic anemia had characteristic changes.Conclusion In the process of bone marrow examination of thrombocytopenia,the number,classification and morphological changes of megakaryocytes have great significance for finding the cause and diagnosis of the disease.

关 键 词：血小板减少 骨髓检查 巨核细胞 

分 类 号：R558.2[医药卫生—血液循环系统疾病]