发热伴血小板减少综合征28例骨髓象特征分析  

Morphological characteristics of bone marrow in severe fever with thrombocytopenia syndrome：analysis of 28 cases

作　　者：方汉波[1] 李世波[2] 庄晓玲[1] 方国安[1] 鲍舟君[1] 

机构地区：[1]浙江省舟山医院检验中心,316000 [2]浙江省舟山医院感染病科,316000

出　　处：《中华临床感染病杂志》2016年第3期260-264,共5页Chinese Journal of Clinical Infectious Diseases

基　　金：浙江省舟山市科技局公益类项目（2014C31069）;浙江省医药卫生平台重点资助计划（2012ZDA044）

摘　　要：目的：探讨发热伴血小板减少综合征（SFTS）患者的骨髓象特征及其在 SFTS 诊断中的价值。方法回顾性分析2012年1月至2015年12月舟山医院新型布尼亚病毒核酸阳性的28例SFTS 患者的骨髓象特征，并用 t 检验分析骨髓巨噬细胞变化与外周血细胞的关系。结果患者外周血血小板、白细胞减少；23例（82％）患者骨髓造血功能减低，多数患者粒、红、巨核三系细胞增生减低，未见病态造血象；18例（64％）患者可见不同程度的骨髓巨噬细胞增多，巨噬细胞≥0．5％组的外周血白细胞、血小板均低于巨噬细胞＜0．5％组，两组差异有统计学意义（t ＝3．836和4．499，P ＜0．01）。结论SFTS 患者骨髓象具有一定的特征性改变，骨髓形态学检查有利于 SFTS 与血液淋巴组织系统疾病及其他病毒感染的鉴别。Objective To assess the morphological characteristics of bone marrow in patients of severe fever with thrombocytopenia syndrome （ SFTS） and its value in diagnosis.Methods The bone marrow morphology was retrospectively reviewed in 28 laboratory confirmed patients with SFTS from Zhoushan Hospital during January 2012 and December 2015.The correlation between bone marrow -derived macrophage and peripheral blood cells was analyzed with t test.Results All patients presented leukocytopenia and thrombocytopenia.Poor bone marrow hematopoietic function was observed in 23 patients （82%） showing granulocyte, erythrocyte and megakaryocyte hypoplasia , but no pathological hematopoietic disorder was observed.Eighteen patients （64%） had various degrees of increased amount of macrophage in the bone marrow; peripheral white blood cell count and platelets in patients with macrophage ≥0.5% were lower than those with macrophage 〈0.5%, and the difference was of statistical significance （t =3.836 and 4.499, P〈0.01）.Conclusion SFTS patients have characteristic bone marrow morphology , and bone marrow examination is beneficial for differentiation of SFTS from blood lymphatic system diseases and other virus infection.

关 键 词：布尼亚病毒科感染 血小板减少症 骨髓细胞学检查 

分 类 号：R510[医药卫生—内科学] R446.11[医药卫生—临床医学]