慢性苯中毒患者60例周围血象及骨髓象特点分析  

Study on peripheral blood and bone Marrow features of 60 patients with benzene poisoning

作　　者：刘征宇 杨祥丽 张志敏 李培茂 惠长野 

机构地区：[1]深圳市职业病防治院卫生检测科,广东深圳518001

出　　处：《中国现代医学杂志》2012年第21期83-85,共3页China Journal of Modern Medicine

摘　　要：目的分析职业性慢性苯中毒患者周围血及骨髓细胞形态学,探讨骨髓象分类及形态特征,以便提高苯中毒诊断的准确率。方法采用髂前或髂后部位抽取患者骨髓,综合分析60例住院苯中毒患者周围血象及骨髓细胞形态学特征,最后按诊断标准进行分组。结果除3例重度中毒再障贫血(AA)患者外,其它患者均表现骨髓增生活跃或明显活跃。除2例慢性粒细胞白血病(CML)患者粒红比值均数增高外,其余均数均低于正常值均数。随着轻、中、重分组变化,骨髓异常改变的比例也逐渐增加。粒、红、巨3系细胞主要病理变化为:粒系可见中毒颗粒、空泡变性等;红系可见病态造血,成熟红细胞形态大小不一;巨核细胞减少或无,偶见小巨核,周围血象可见1系、2系或3系减少等多种表现。结论长期接触苯及苯同系物,可导致人体骨髓造血功能异常,骨髓象检查是苯中毒诊断的必要项目;周围血常规可作为过筛检查。[ Objective ] To study morphological features of peripheral blood and bone marrow in occupational chronic benzene poisoning cases. [Methods] The objects were 60 hospitalized benzene poisoning patients, examined for morphological features of peripheral blood and bone marrow, and classified according to the diagnostic criteria. [ Results ] Except for three patients with severe aplastic anemia, all cases showed active proliferation or obvious pro- liferation of bone marrow. The mean ratios of granulocytes to erythrocytes were lower than normal except two patients with CML, The degree of bone marrow abnormalities was positively correlated with the severity of benzene poisoning. The main pathological changes were the following： Granular cells showed toxic particles and vacuolar degeneration; dysplasfie erythroid precursors and morphologic abnormalities in mature red blood cell could be seen; megakaryocytes were rare and even absent in some cases, and small megakaryocytes were occasionally observed. Three cell lines in peripheral blood decreased alone or in combination. [ Conclusion ] Lone term exposure to benzene and its analogues may result in bone marrow haemopoietic dysfunction. Peripheral blood routine examination should be considered as a screening test, and bone marrow examination as a necessary item for benzene poisoning.

关 键 词：苯中毒 周围血 骨髓 细胞形态学 

分 类 号：R44[医药卫生—诊断学]