乙型肝炎肝硬化与酒精性肝硬化患者骨髓细胞学检查结果分析  

Analysis of hepatitis B liver cirrhosis and alcoholic fiver cirrhosis patients with bone marrow cytology

作　　者：武鹏 苑文雯[2] 李沛然[2] 陈澎[2] 王晗[2] 李妍[2] 卞成蓉[2] 王大刚[2] 何叶莉 杨宁[2] 

机构地区：[1]后勤学院门诊部,北京100858 [2]解放军302医院临床检验医学中心

出　　处：《中国急救复苏与灾害医学杂志》2014年第4期324-327,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨乙肝肝硬化和酒精性肝硬化患者骨髓象变化不同特点和意义。方法对本院近5年明确诊断为慢性HBV感染的肝硬化和酒精性肝硬化且临床表现为三系减低患者的骨穿结果进行回顾性分析。结果两种不同诱因的肝硬化均可导致患者造血系统发生改变。慢性HBV感染的肝硬化患者的骨髓增生程度高于酒精性肝硬化患者；两组肝硬化患者粒、红两系不同阶段细胞存在病态造血率，中途凋亡比例增加，乙型肝炎肝炎后肝硬化组病态造血率高于酒精性肝硬化组；两组肝硬化患者巨核系统均明显存在成熟障碍。结论慢性HBV感染对骨髓造血细胞的成熟过程存在影响。酒精性肝硬化对骨髓造血细胞增殖、分化存在影响。Objective To study the difference and significance of bone marrow cytology between the patients with hepatitis B liver cirrhosis and alcoholic liver cirrhosis. Methods A retrospective analysis was performed on those 50 patients with hepatitis B liver cirrhosis and 60 patients with alcoholic liver cirrhosis who characterize WBC, RBC and PLT levels who visited our clinic in the past five years. Results Two kinds of cirrhosis could lead to hematopoietic system changes. The extents of bone marrow hyperplasia in patients with chronic HBV infection were higher than that in patients with alcoholic liver cirrhosis. The rate of dyshaematopoiesis and the proportions of midway apoptosis were all increased in two groups of patients in different stages of erythropoiesis and myelopoiesis. And the rate of dyshaematopoiesis of patients with hepatitis B liver cirrhosis were higher than that of patients with alcoholic liver cirrhosis. The obstacles in mature of megakaryocyte system were obvious in all two groups. Conclusion Chronic HBV infection may have an impact on mature of myeloid element, while alcoholic liver cirrhosis may have an impact on proliferation and differentiation of bone marrow hematopoietic cells.

关 键 词：慢性乙型肝炎 酒精性肝硬化 骨髓细胞学 

分 类 号：R512.62[医药卫生—内科学]