大骨节病病儿外周血及骨髓吸出物血细胞的病理形态学观察  

A pathomorphological observation on blood cells in peripheral bloods and bone marrow aspirates of the children with Kaschin - Beck disease

作　　者：毕华银[1] 王治伦[1] 陈静宏[1] 左弘[1] 耿冬[1] 谭希旺[1] 李星慧[2] 叶光英 刘俊林[2] 孙秀芳[2] 席生清 关红 

机构地区：[1]西安交通大学医学院地方病研究所,西安710061 [2]榆林市第二医院 [3]西安交通大学第一医院骨髓室

出　　处：《中国地方病防治》2001年第5期266-269,共4页Chinese Journal of Control of Endemic Diseases

基　　金：国家自然科学基金39770667项目资助

摘　　要：目的 本文对大骨节病（ＫＢＤ）病儿外周血等血细胞进行了形态学观察以便和ＫＢＤ病尸骨髓血细胞坏死病变相对照。方法 在临床Ｘ线普查基础上，采病儿外周血及骨髓吸出物涂片、Ｗｒｉｇｈｔ－Ｇｉｅｍｓａ染色、光镜观察。结果 在部分外周血白细胞及骨髓血细胞的核染色质粒间出现淡紫红色点状物伴其周染色质溶解，进而点状物融合形成斑块，直至整个核转化为均质大团块。外周血白细胞病变阳性例的检出率占病区受检例总数的８３．１％。讨抡和结论 白细胞等核内出现的点状物、斑块和团块都应是核内病毒包涵体；病儿外周血白细胞坏死与ＫＢＤ病尸骨髓血细胞坏死、软骨细胞Ｂ型凝固性坏死是性质同一的病理过程，都是ＫＢＤ病理变化的一部分，三者坏死病变可能都是ＫＢＤ的同一病毒病因所引起。Objective A morphological observation on blood cells in peripheral bloods and so on of the children with Kaschin - Beck disease ( KBD) was performed in order that its results would be compared with the necrotic lesions of blood cells discovered previously in bone marrows of the corpses with KBD. Methods On the basis of a general survey by clinic and X - ray, peripheral bloods and bone marrow aspirates of the diseased children were sampled, smeared, stained (Wright - Giemsa staining) and observed with a light microscope. Results In some leukocytes of peripheral bloods and blood cells of bone marrows, there were obvious lesions in their nudei. As for a lesion cell, the processes were as follows. Much dotted substances in light purple - red developed among chromatin granules in a cell nucleus associated with chromatin lyses around the dotted substances. Later, the dotted substances were combined with each other to form many spots, until the whole nucleus transfonned into a homogeneous large mass. The discovery rate of the positive cases with the leukocytic lesions in peripheral bloods was83. 1 per cent of the sum examined cases in diseased areas. Discussions and condusions All the dotted substances, the spots and the masses which developed in the nuclei of leukocytes and so on ought to be belonged to an intranuclear viral inclusion. All the necrosis of leukocytes in peripheral bloods of the diseased children, the necrosis of blood cells in bone marrows and the type B coagulation necrosis of chondrocytes in the corpses with KBD were the same pathological processes in nature, and each was a part of the pathological changes of KBD. The three kinds of necrotic lesions might be induced by the same viral cause of KBD.

关 键 词：大骨节病 外周血 白细胞坏死 骨髓吸出物 病理 

分 类 号：R684.103[医药卫生—骨科学]