慢性病贫血骨髓细胞学及病理学改变的观察研究  

Studies on the cytological and pathological changes of bone marrow in patients with anemia of chronic disease

作　　者：谢品浩[1] 张谦[1] 周荣富[1] 袁翠英[1] 董海波[1] 欧阳建[1] 

机构地区：[1]南京大学医学院附属鼓楼医院血液科实验室,江苏南京210008

出　　处：《徐州医学院学报》2009年第3期183-185,共3页Acta Academiae Medicinae Xuzhou

基　　金：南京市卫生局科研基金(YKK05105)

摘　　要：目的研究慢性病贫血（ACD）和缺铁性贫血（IDA）骨髓涂片及骨髓活检的特点及临床意义。方法患者行两步法骨髓穿刺术，获取骨髓涂片和骨髓活组织标本。骨髓涂片常规做瑞氏染色和铁染色，骨髓活检切片做苏木精-姬姆萨-酸性品红（HGF）染色和Gomori网状纤维染色。结果骨髓涂片中：ACD骨髓增生程度高于IDA，ACD患者的粒红比高于IDA患者，ACD患者的铁染色中外铁增高，多为2＋～3＋。骨髓活检中：ACD患者中约有1／3的患者可见到反应性浆细胞增多，有将近一半的ACD患者可见到网状纤维染色增高。结论骨髓活检塑料包埋切片在ACD诊断及鉴别诊断中有重要的参考意义，骨髓涂片和骨髓活检切片的联合应用可以提高ACD实验诊断的准确率。Objective To investigate the characteristics and clinical significance of bone marrow smears and biopsy in patients with anemia of chronic disease （ACD） and iron deficiency anemia （IDA）. Methods Bone marrow smears and biopsy specimens were obtained by bone marrow puncture with two - step method. Marrow smears were routinely stained with Wright staining and iron staining, while sections of biopsy specimens embedded in plastic were stained with Hematoxylin - Giemsa - Acid Fuchsine （HGF） and Gomori reticular fiber staining. Results The degree of proliferation and the granulocyte/erythrocyte ratio in ACD marrow plates were higher than in IDA marrow plates. In the iron - stained bone marrow smears from ACD patients, extracellular iron increased, usually by 2 ＋ - 3 ＋. Reactive plasmacytosis and reticular fibroplasia were visible in about 1/3 and 1/2 patients with ACD, respectively. Conclusion Plastic - embedded bone marrow section observation has great reference value in the diagnosis and differential diagnosis of ACD. Combination of bone marrow smears and sections of bone marrow biopsy may improve the accuracy of ACD diagnosis.

关 键 词：慢性病贫血 缺铁性贫血 瑞氏染色 骨髓活检 网状纤维染色 

分 类 号：R556.9[医药卫生—血液循环系统疾病]