巨核细胞定量涂片法  

Study on megakaryocyte quantity counting method in normal adults and hematologic disorders diagnose

作　　者：邢宝利[1] 李秀红 王伟良[1] 刘辉[1] 常乃柏[1] 

机构地区：[1]卫生部北京医院血液科,北京100730 [2]内蒙古通辽铁路医院

出　　处：《临床血液学杂志》2006年第5期300-302,共3页Journal of Clinical Hematology

摘　　要：目的:通过定量涂片法与传统法形态学巨核细胞计数的比较,寻找部分血液病形态学诊断的依据。方法:巨核细胞计数方法:取5μl新鲜骨髓均匀涂在7cm2玻片(2.0cm×3.5cm或2.5cm×3.0cm),计数全片巨核细胞数,再换算成每升骨髓所占巨核细胞数。传统法形态学巨核细胞计数:取一滴新鲜骨髓均匀涂面积大约4.5cm2玻片(1.5cm×3.0cm),同样计数全片巨核细胞数。结果:28例大致正常骨髓像做对照组,观察6例包括慢性粒细胞白血病(CML)、原发性血小板减少性紫癜(ITP)、骨髓异常增生综合征(MDS)、再生障碍性贫血(AA)等不同血液病定量涂片法与传统法形态学巨核细胞计数对诊断的影响。在28例正常组中,定量法巨核细胞计数的正常值(80.0±47.6)×105/L;传统法相对值(43.6±24.4)个/片;而定量涂片法巨核细胞总数绝对值为1029×105/L,较正常组(80.0±47.6)×105/L显著增高,说明骨髓处于过度增殖状态,而成为诊断骨髓增殖性疾病的有利证据;在巨核细胞减少组(2例MDS、1例AA)中,2种方法相对值也较一致,相对值及绝对值均明显减少,符合巨核细胞减少性疾病巨核细胞的变化。结论:定量涂片法计数巨核细胞较传统法更准确、可靠,值得推广。Objective：To explore accuracy and reliability of megakaryocyte quantity counting method in normal adults and hematological disorders. Method： Megakaryocyte quantity counting method： 5 ul marrow aspiration was drawn to make a about 7 cm^2 area smear （2.0×3.5 cm or 2.5×3.0 cm）, megakaryocytes were counted in whole smear, and then were changed into amounts per liter marrow. Megakaryocyte classical counting method： a drop marrow aspiration was droped to make a smear and then megakaryocytes were counted in 4.5 cm^2 area （1.5×3.0 cm）. Result：Megakaryocyte amounts in 28 normal adult were： 40.0±23.8 per 5 ul morrow （relative value） and 80.0±47.6×10^5/L （absolute value）with quantity counting method; 43.6±24.4 per 4.5 cm^2 area smear （relative value） with classical counting method. In megakaryocytosis （CML and ITP）, total megakaryocyte amounts were： 546 per 5 μl morrow （relative value） and 1029×10^5/L （absolute value） with quantity counting, 529 per 4.5 cm^2 area smear （relative value） with classical counting method. In megakaryocytopenia （MDS.and AA）, total megakaryocyte amounts were： 8 per 5 ul morrow （relative value） and 16×10^5/L （absolute value） with quantity counting , 6 per 4.5 cm^2 area smear （relative value） with classical counting method. Conclusion： Megakaryocyte quantity counting method is more accurate and reliable than classical megakaryocyte counting method. Normal megakaryocyte referential amounts should be re-valued.

关 键 词：定量涂片法 传统法 巨核细胞计数 血液疾病 形态学 

分 类 号：R733.71[医药卫生—肿瘤]