外周血及骨髓形态学在骨髓增生异常综合征诊断中的应用探讨  

Application of peripheral blood and bone marrow morphology in diagnosis of myelodysplastic syndrome

作　　者：陈琴琴[1] 刘军[1] 张传领[1] 沈丽芳[1] 

机构地区：[1]浙江萧山医院检验科,杭州311200

出　　处：《临床血液学杂志》2014年第2期94-95,共2页Journal of Clinical Hematology

摘　　要：目的：探讨外周血常规、外周血涂片、骨髓细胞检查的形态学改变在骨髓增生异常综合征（MDS）诊断中的临床意义，以提高其诊断的准确性。方法：对19例MDS患者的血液学特征进行回顾性分析。结果：19例中。外周血常规全血细胞减少9例（47%），两系减少8例（44％）。分类可见有核红细胞9例（47％），原始细胞6例（31％），血小板减少12例（62％）。骨髓学检查：增生极度活跃至活跃16例（84％），增生减低3例（16％），1系～2系病态造血17例（89％）。结论：MDS形态学改变异常复杂，部分MDS患者无病态造血，诊断困难，尤其是低危组诊断标准变异大，因此结合血常规、外周血涂片检查、骨髓细胞形态学检查是其诊断和分型的重要依据。Objective：To study the clinical diagnosis significance of the changes in peripheral hlood,peripheral blood smear and bone marrow morphology in myelodysplastic syndrome（MDS）,in order to improve its diagnostic accuracy. Method：From January 2010 to June 2012,the hematology features of 19 patients with MDS were retro- spectively analyzed. Result：Among 19 cases,in peripheral blood there were 9 cases with a complete blood reduce （47 % ）and 8 cases two lineage reduced（44 %）. For classification, there were 9 cases with visible nucleated eryhro- cytes（47 % ）, 6 cases primitive cells（31 %）, 12 cases thrombocytopenia（62 % ）. For bone marrow morphology there were 16 cases with hyperplasia to hyperactivity（84%）, 3 cases active hyperplasia reduce（16%）, 17 cases dysh- aematopoiesis in 1 -2 lineages（89% ）. Conclusion： MDS morphology change is extremely complex,and part of MDS patients might have no dyshaematopoiesis. MDS diagnosis would he difficult,especially for big differences of low- risk group diagnosis standard. Therefore combined detection of blood routine test, peripheral blood smear examina- tion and bone marrow morphology would he the important basis of diagnosis and classification.

关 键 词：骨髓增生异常综合征 形态学 外周血 骨髓细胞检查 

分 类 号：R551.3[医药卫生—血液循环系统疾病]