263例慢性淋巴细胞白血病临床与实验室检查分析  

The clinical and laboratory features of 263 cases of chronic lymphocytic leukemia

作　　者：李增军[1,2] 邱录贵[1,2] 吴瞳[1,2] 王亚非[1,2] 邹德慧[1,2] 赵耀中[1,2] 齐军元[1,2] 杨仁池[1,2] 钱林生[1,2] 

机构地区：[1]中国医学科学院血液学研究所、血液病医院 [2]实验血液学国家重点实验室

出　　处：《中华血液学杂志》2008年第5期300-303,共4页Chinese Journal of Hematology

基　　金：天津市自然科学基金（06YFJMSC08500）

摘　　要：目的探讨慢性淋巴细胞白血病（CLL）的临床和主要实验室检查特点。方法回顾性分析263例CLL患者的临床及实验室检查资料。结果患者中位发病年龄为60岁，男女比例为2．17：1。35．4％的患者因查体或其他疾病检查发现，多处于疾病早期。乏力倦怠和淋巴结肿大是患者就诊最常见的原因，后者也是最常见的体征（54．8％）。CLL患者常合并感染、结缔组织病和继发肿瘤，但发生自身免疫性溶血性贫血（AIHA）的概率较小，为1．5％。初诊患者外周血白细胞多在（10～100）×10^9／L，97．1％的患者淋巴细胞比例在0.50以上。骨髓增生活跃，99．4％的患者骨髓淋巴细胞比例在0．300以上。骨髓病理检查以弥漫性浸润为主（72．2％）。细胞免疫表型CD5阳性细胞率为85．1％，CD25阳性细胞率为78．9％。CLL患者常合并免疫球蛋白降低，以IgM降低最常见。常规染色体检查不易发现异常。结论CLL多发于老年人，男性多见，临床特征和免疫表型有一定特点。Objective To analyze the clinical and laboratory features of chronic lymphocytic leukemia（CLL）. Methods Retrospective investigation of 263 patients with CLL in our hospital between Feb. 2000 and Jan. 2007. Results The median age was 60 years with male/female ratio of 2. 17： 1. Patients who were asymptomatic at diagnosis （35.4%） had low Rai grades. Fatigue and lymphadenopathy （54.8%） were the most common features at presentation. Infections, connective tissue diseases and secondary tumors frequently occured in CLL. WBC counts were between （ 10 - 100 ） × 10^9/L, with lymphocytes percentages more than 0.50 in 97.1% patients. Bone marrow was normal- to hyper-cellularity with lymphocytes percenta- ges more than 0. 300 in 99.4% patients. Diffuse infiltrations in bone marrow section were found in 72.2% patients. There were lower CD5 （85.1%） and higher CD25（78.9% ） positivities in the present series as compared with that in other reports. Hypogammaglobulinemia, especially hypo-IgM, usually occured. Chromosome abnormality were rarely found by routine chromosome examination. Conclusions There were some clinical and laboratory characteristics different from that of abroad data. Further exploration of new markers is required for prognosis prediction and treatment choice.

关 键 词：白血病 淋巴细胞 慢性 临床研究 

分 类 号：R686[医药卫生—骨科学]