儿童再生障碍性贫血的分型研究  

Diagnosis of childhood aplastic anemia

作　　者：宋鲁燕[1] 竺晓凡[1] 李武殷 刘恩 李梅[1] 钱林生[1] 

机构地区：[1]中国医学科学院中国协和医科大学血液学研究所血液病医院,天津300020

出　　处：《中国实用儿科杂志》2000年第7期414-416,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的　探讨儿童再生障碍性贫血 (再障 )的分型标准。方法　对已经确诊的 6 1例儿童急性再障和 45例儿童慢性再障病例进行回顾性分析。结果　急性再障患儿有如下特点 :外周血呈全血细胞减少 ,淋巴细胞比例明显增高 ;髂骨及胸骨骨髓呈多部位增生不良 ,造血细胞明显减少 ,非造血细胞明显增多 ,巨核细胞明显减少 ,小粒细胞面积 <5 0 % ,细胞成分以非造血细胞为主 ;增生活跃患儿的骨髓中 ,非造血细胞比例明显增多 ,巨核细胞明显减少。慢性再障患儿的特点是 :外周血呈血小板减少和 (或 )白细胞减少和 (或 )贫血的血象 ,淋巴细胞比例增高 ;髂骨骨髓以增生活跃为主 ,但粒细胞系比例减低 ,红细胞系比例可正常 ,非造血细胞比例增高 ,巨核细胞减少 ,小粒细胞面积 <5 0 % ,细胞成分以非造血细胞为主。结论　儿童急性再障的表现与Camitta提出的重型再障的诊断标准相似 ,而儿童慢性再障的表现与Camitta提出的轻型再障不同 ,根据本文结果提出儿童再障的分型标准及胸骨骨髓在诊断急。Objective To investigate the diagnostic criteria of childhood aplastic anemia.Methods Hematological parameters of 61 acute aplastic anemia and 45 chronic aplastic anemia patients were retrospectively analyzed.Results Acute aplastic anemia cases showed the following hematological features: pancytopenia,absolute granulocytopenia and reticulocytopenia,higher percentage of lymphocyte;marrow hypoplasia with a few myeloid cells and an almost complete absence of megakaryocytes,smears revealed fatty material with diffuse,sparse accumulation of lymphocytoid cells,mast cells and plasma cells;higher percentage of non-myeloid cells and the decreased number of megakaryocytes in the active marrow.Chronic aplastic anemia cases:thrombocytopenia in combination with granulocytopenia and/or anemia in peripheral blood;active marrow with lower percentage of granulocytic lineage,normal percentage of erythroid lineage,higher percentage of non-myeloid cells and the decreased number of megakaryocytes.Conclusion The hematological features of childhood acute aplastic anemia are similar to Camitta's diagnostic criteria of severe aplastic anemia,while the hematological features of childhood chronic aplastic anemia is different from Camitta's diagnostic criteria of mild aplastic anemia .Based on these findings,a diagnostic criteria of childhood aplastic anemia was proposed.

关 键 词：儿童 再生障碍性贫血 分型标准 诊断 

分 类 号：R725.565[医药卫生—儿科]