艾滋病患者骨髓细胞学特征分析  

Cytological characteristics of bone marrow of patients with AIDS

作　　者：韦善求 罗晓璐[1] 苏国生[1] 梁娟英[1] 

机构地区：[1]南宁市第四人民医院广西艾滋病临床治疗中心(南宁),广西南宁530023

出　　处：《中华医院感染学杂志》2015年第6期1248-1250,共3页Chinese Journal of Nosocomiology

基　　金：广西壮族自治区卫生厅科研基金资助项目(Z20120631)

摘　　要：目的探讨获得性免疫缺陷综合征(AIDS)患者骨髓细胞学特征,对艾滋病的快速诊断提供依据。方法采用回顾性研究的方法,对医院2011年1月-2012年5月278例AIDS患者骨髓细胞学检查结果进行统计分析。结果取材满意189份,占68.0%,其中95.8%以上有核细胞增生活跃;常见细胞学异常表现型及分布率依次是淋巴细胞减少84.7%、红细胞核形态异常71.4%、红细胞缗钱状排列59.8%、血小板减少55.0%、中性粒细胞核发育异常54.5%、粒红比值升高45.5%、巨核细胞成熟障碍32.3%、组织细胞活化24.9%,其中淋巴细胞减少、中性粒细胞核发育异常、红细胞核形态异常、红细胞缗钱状排列和血小板分布减少的比率与其他表现型比较差异有统计学意义(P<0.05);在取材满意病例中,镜检检出马尔尼菲青霉菌(penicillium marneffei,PM)阳性36例、淋巴瘤细胞2例。结论 AIDS患者的骨髓细胞学特点主要表现为粒细胞、红细胞、巨核细胞系统一系或多系病态造血,淋巴细胞比率减低,常伴组织细胞反应性增殖或活化,南方地区患者于涂片中较易见PM。OBJECTIVE To explore the cytological characteristics of bone marrow of the patients with acquired im -munodeficiency syndrome （AIDS） so as to provide guidance for rapid diagnosis of AIDS .METHODS By means of retrospective study ,the results of the cytological examination of bone marrow of 278 AIDS patients who were treated in the hospital from Jan 2011 to May 2012 were statistically analyzed .RESULTS Totally 189 cases were sat-isfactory for bone marrow sampling ,accounting for 68 .0% ,of which 95 .8% were active in nucleus proliferation . The common abnormal cytological phenotypes were as follows ：the lymphopenia （84 .7% ） ,the abnormal nucleus shape of nucleated erythrocytes （71 .4% ） ,the rouleaux formation of erythrocytes （59 .8% ） ,the thrombocytope-nia （55 .0% ） ;the abnormal nucleus of neutrophils （54 .5% ） ,the increase of G /E ratio （45 .5% ） ,the dysmaturi-ty of megakaryocytes （32 .3% ） ,the activation of histocytosis （24 .9% ） .As compared with other cytological phe-notypes ,there was significant difference in the rate of lymphopenia ,abnormal-nuclei neutrophils ,abnormal-nuclei erythrocytes ,rouleaux-formation erythrocytes ,or thrombocytopenia （P 〈 0 .05） .Totally 36 cases were detected positive for Penicillium marne ffei（PM ） in the satisfying sampling cases through the microscopy ,and 2 cases were tested positive for lymphoma cells .CONCLUSION The major cytological features of bone marrow of the AIDS patients included the dyshaematopoiesis of at least one cell line （myelogenous ,granulocytes or erythrocytes） ,de-creased ratio of lymphocytes ,and reactive proliferation or activation of histocytosis .Secondary infection of PM is common for the AIDS patients in the southern region .

关 键 词：获得性免疫缺陷综合征 骨髓 细胞学 人类免疫缺陷病毒 

分 类 号：R446[医药卫生—诊断学]