45例系统性红斑狼疮血液学改变的分析  

the analysis of hematology abnormality in 45 systemic lupus erythematosus patients

作　　者：吴文胜[1] 廖爱能[1] 温翠英[1] 

机构地区：[1]福建中医药大学第五临床医学院(福建省三明市第二医院)肾脏风湿科,福建永安366000

出　　处：《中国当代医药》2013年第30期174-175,177,共3页China Modern Medicine

摘　　要：目的了解系统性红斑狼疮（SLE）血液学异常情况。方法通过回顾性分析45例SLE患者的临床资料，对患者血常规、骨髓象及细胞形态学检查结果进行比较分析。结果血常规改变患者中以贫血最为常见，其中，贫血并发血小板减少13例，并发白细胞减少11例，全血细胞减少3例，单纯血小板减少1例，溶血性贫血2例。骨髓有核细胞增生活跃者26例（占57.8％），增生明显活跃者19例（占42．2％）。粒细胞：红细胞（G／E）〉3者23例（占51．1％），G／E〈3者22例（占48．9％）；2例溶血性贫血患者直接法Coombs试验均为阳性，C／E均〈1。中性粒细胞大小不均、浆内颗粒增多、增粗者9例（占20．0％），红细胞形态正常者36例（占80．0％）；巨幼样变者2例，小细胞低色素者7例；巨核细胞1～104[平均（32．3±27．1）1个／片。铁染色正常者37例（占82．2％）。结论SLE并发血液系统损害多见．以贫血最为常见，部分患者早期易误诊为再生障碍性贫血、特发性血小板减少性紫癜（ITP）等，经过皮质醇激素及（或）免疫抑制剂治疗后，多数患者外周血象有不同程度的改善。Objective To understand the hematology abnormality in systemic lupus erythematosus（SLE）. Methods The cnilic datas of 45 cases of SLE patients was retrospectively analyzed,and the blood routine examination,myelogram and cell morphology examination results of the patients were compared. Results Anemia is the most common in changes of blood routine,in which included 13 cases of anemia combined with thrombocytopenia,11 cases of concurrent leukope- nia,3 cases of pancytopenia,1 case was alone thrombocytopenia, 2 cases of hemolytic anemia.Actlve proliferation of bone marrow cells in 26 cases（accounted for 57.8%）,hyperplasia was active in 19 cases（accounted for 42.2%）.granular cells：erythrocyte（G/E）〉3 in 23 cases（accounted for 51.1%）,G/E〈3 in 22 cases（accounted for 48.9%）;2 cases of hemolyt- ic anemia were positive direct Coombs test method,G/E were 〈 l .Neutrophils had unequal size,the pulp particles in- creased and thickening in 9 cases（accounted for 20.0%）,erythroid cells were normal in 36 patients（accounted for 80%）; megaloblastic degeneration in 2 cases and small cell hypochromic in 7 cases;megakaryocytes from 1 to 104 [mean（32.3 ± 27.1）]/film.Iron stain normal in 37 cases （accounted for 82.2%）. Conclusion SLE combined with blood system damage is common and anemia is the most common,some patients with early misdiagnosed as aplastic anemia,idiopathic thrombocytopenic purpura （ITP） and so on.After cortisol hormones and （or） after immunosuppressive therapy,most patients peripheral blood have different degrees of improvement.

关 键 词：系统性红斑狼疮 贫血 血小板减少 白细胞减少 骨髓检查 

分 类 号：R593.241[医药卫生—内科学]