重症SARS与高度疑似SARS患者骨髓像分析  

Myelograms in Patients with Severe Type Severe Acute Respiratory Syndrome

作　　者：黎庆恩[1] 陈福雄[1] 王鹏鲲[1] 

机构地区：[1]广东省广州医学院第一附属医院,广东广州510120

出　　处：《中华医院感染学杂志》2005年第5期484-486,i002,共4页Chinese Journal of Nosocomiology

摘　　要：目的　对重症严重急性呼吸综合征(下称SARS)患者和高度疑似SARS的患者进行骨髓形态学分析,从而对诊断和治疗方面提出有益的建议。方法　抽取3例确诊重症SARS患者和1例高度疑似SARS患者骨髓作骨髓涂片,经瑞氏染色后镜下观察细胞形态,同时结合血常规结果进行分析。结果　3 例SARS患者骨髓均出现数量不等的噬血细胞和吞噬细胞,同时有不同程度的一系或多系的骨髓抑制现象;1 例疑似SARS患者在吞噬细胞中发现荚膜组织胞浆菌。结论　重症SARS患者的骨髓表现很可能与病毒本身的毒性、用药种类、用药量有关;结合患者的临床表现进行严密的实验室检验数据的监测,将有利于及时调整药物用量、及时对症治疗,从而杜绝因感染而引起的并发症,对高度疑似SARS患者的血像及骨髓则应注意有没有其他致病原,如原虫、真菌等。OBJECTIVE To investigate the morphology of bone marrow cells in three patients with severe type severe acute respiratory syndrome (SARS) and one doubt the SARS patient and raise available suggestion in the diagnosis and therapy. METHODS Do bone marrow puncture and make bone marrow smears from 4 patients. Observe the configuration of bone marrow cell and blood cell under the microscope after staining with Wright - Giemsa′s stain, and analyze the myelograms. RESULTS The morphology showed that there were uncertain phagocytes appeared into the three patients′ bone marrow. Three cases all had different degree arrest of bone morrow in one or three series. In the phagocytes of the doubtful SARS patient had Histoplasma. CONCLUSIONS The bone marrow morphologic manifestation of severe type SARS patient is probably concerned with the toxicity of virus, the scheme and the dosage of medicines. Inspect the examined data strictly will be good to adjust the scheme and dosage of medicines and treat expectantly in good time. So it will avoid the complication on account of the secondary infection.

关 键 词：重症严重急性呼吸综合征 骨髓 

分 类 号：R183.3[医药卫生—流行病学]