病态巨核细胞在骨髓增生异常综合征中诊断和鉴别诊断的意义  

Diagnosis and differential diagnosis value of dysmegakaryocytopiesis in myelodysplastic syndrome

作　　者：邓明凤[1] 陈永玲[1] 汪永红[1] 黄俊[1] 王长征[1] 王昌富[1] 

机构地区：[1]华中科技大学同济医学院附属荆州医院检验医学部,荆州市434020

出　　处：《实用检验医师杂志》2012年第4期229-231,共3页Chinese Journal of Clinical Pathologist

摘　　要：目的探讨病态巨核细胞在骨髓增生异常综合征（myelodysplastic syndrome，MDS）中诊断及鉴别诊断的意义。方法选择我院2009年1月-2010年12月收治的31例MDS患者和89例其他全血细胞减少性疾病患者，对其骨髓涂片进行瑞一姬染色，观察骨髓巨核细胞，并计算病态巨核细胞的检出率。结果所有患者骨髓涂片均检出病态巨核细胞，溶血性贫血组、巨幼细胞贫血（megaloblastie anemia,MA）组、慢性再生障碍性贫血组和急性淋巴细胞白血病组病态巨核细胞检出率分别与MDS组比较，差异均有统计学意义（P均〈0．01）；各疾病组中，淋巴样小巨核细胞和单圆核小巨核细胞在MDS组中检出率最高（45．16％，48．39％），大单圆核巨核细胞和多圆核巨核细胞在MA组中检出率最高（45．45％，100．00％）。结论不同血液疾病中骨髓病态巨核细胞的表达不同，淋巴样小巨核细胞和单圆核小巨核细胞在MDS的诊断与鉴别诊断中有一定的临床价值。Objective To investigate the diagnosis and differential diagnosis value of dysmegakary- ocytopiesis in myelodysplastic syndrome （MDS）. Methods 31 cases MDS patients and 89 cases other pancy- topenia patients in our hospital were selected from January 2009 to December 2010. The bone marrow smears of these patients were stained by Wright-Giemsa staining method. The bone marrow megakaryocyte was observed and the detection rate of dysmegakaryocytopiesis was calculated. Results The dysmegakaryocytopiesis were detected in bone marrow smears of all patients. The detection rates of hemolytic anemia （HA） group, megaloblastic anemia （MA） group, chronic aplastic anemia （CAA） group and acute lymphocytic leukemia （ALL） group were compared with MDS group respectively, the differences all had statistical significance （Pall〈 0.01 ）. In disease groups, the detection rates of lymphocyte like micromegakaryocyte and single circle nuclear mi- cromegakaryocyte were highest in MDS group （45.16% ,48.39% ）. The detection rates of largest single circle nuclear megakaryocyte and multi circle nuclear megakaryocyte were highest in MA group （45.45%, 100.00%）. Conclusion Express of different bone marrow dysmegakaryocytopiesis were diffences in different hematopathy. The lymphocyte like micromegakaryocyte and single circle nuclear micromegakaryocyte had diagnosis and differential diagnosis clinical values in MDS.

关 键 词：巨核细胞 病态 骨髓增生异常综合征 诊断 鉴别诊断 

分 类 号：R551.3[医药卫生—血液循环系统疾病]