失代偿期肝硬化患者全血细胞减少的临床病因与血象、骨髓象分析  

Analysis of the clinical etiology of pancytopenia,blood marrow and bone marrow in patients with loss compensation period liver cirrhosis

作　　者：符火[1] 林尤仕[1] 

机构地区：[1]海南医学院附属医院检验科,海南海口570102

出　　处：《中国卫生检验杂志》2016年第1期90-92,97,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨失代偿期肝硬化患者全血细胞减少的临床病因和外周血、骨髓细胞形态学特点,以提高对此类疾病的认识。方法对2012年1月-2015年6月本院87例失代偿期肝硬化合并全血细胞减少患者的临床资料进行回顾性分析。结果 87例患者主要病因为乙型肝炎肝硬化(64.4%);血象主要表现为三系轻度异常,以血小板为主;骨髓象主要表现为脾功能亢进(47.1%);失代偿期肝硬化患者的骨髓细胞学检查增生度呈多样性,以增生活跃为主,骨髓细胞分类主要表现为红细胞系增生、粒细胞系和巨核细胞系成熟障碍。增生减低组、增生活跃组和增生明显活跃组3组间的粒细胞系与红细胞系比值、粒细胞系、红细胞系、巨核细胞数不全相同,差异有统计学意义(P<0.05)。结论失代偿期肝硬化全血细胞减少的病因是多方面的,肝炎后肝硬化是主要病因,脾亢是肝硬化患者全血细胞减少的主要骨髓象。肝硬化患者骨髓细胞学检查对明确全血细胞减少的诊断、治疗和估计预后有重要的临床意义。Objective To investigate the clinical etiology of pancytopenia and the cell morphology of blood marrow and bone marrow in patients with loss compensation period liver cirrhosis, in order to improve the understanding of this kind of disease. Methods The clinical data of 87 patients with liver cirrhosis complicated with cirrhosis in the hospital from January 2012 to June 2015 were retrospectively analyzed. Results 87 cases of patients were with hepatitis B cirrhosis （64.4%） ; the blood mainly manifested as mild abnormality in three lines, mainly to platelet; the main feature of the bone marrow was as the spleen （47.1%） ; the proliferation of bone marrow cytology in patients with liver cirrhosis and cirrhosis were varied, mainly the active proliferation, the classification of bone marrow cells was mainly red, grain and giant nuclear maturation disorders. The red tablets, tablets, the red, and huge nuclear cell count in the 3 groups of hyperplasia reduction group, hyperplasia increasing group and obvious hyperplasia increasing group were not the same, and the differences were statistically significant（ P 〈0.05 ）. Conclusion The causes of the decrease of the whole blood cell in the patients with the loss compensation period liver cirrhosis are many, cirrhosis is the main cause of hepatitis, the main bone marrow image of the patients with liver cirrhosis is the spleen function. Bone marrow cytology in patients with cirrhosis to clear pancytopenia of diagnosis, treatment and prognosis have important clinical significance.

关 键 词：肝硬化 全血细胞减少 临床病因 骨髓象 

分 类 号：R575.2[医药卫生—消化系统]