外周血细胞检验诊断报告的临床应用价值  

Clinical Application Value of Peripheral Blood Diagnostic Report

作　　者：邢莹[1] 王建中[1] 普程伟[1] 屈晨雪[1] 尚柯[1] 董宁[1] 伍平 王厚芳 Xing Ying Wang Jianzhong Pu Chengwei Qu Chenxue Shang Ke Dong Ning Wu Ping Wang Houfang.(Clinnical Laboratory, Peking University First Hospital, Beijing 100034, China)

机构地区：[1]北京大学第一医院检验科,100034

出　　处：《中华医学杂志》2017年第38期2987-2995,共9页National Medical Journal of China

摘　　要：目的探讨外周血细胞检验诊断报告在临床中的应用价值。方法选择2016年4月至2017年3月之间北京大学第一医院、燕达陆道培医院和北京和睦家医院的外周血细胞检验诊断报告共557份，针对初次就诊和复查病例分别根据其不同形态学特征进行分类汇总。结果初次就诊发现血细胞计数或白细胞分类异常的标本有201份，根据不同情况总结为贫血、贫血伴白细胞和（或）血小板减少、白细胞数量或分类计数异常和血小板数量异常共四大类，每种情况再根据不同形态学特征进行细分，比较特异或典型的形态改变提出初步诊断或进一步检查的意见，不典型或形态未见明显异常的客观描述形态特征。在22例复查病例中，包括急性和慢性白血病、骨髓增生异常综合征、浆细胞骨髓瘤、传染性单核细胞增多症等多种良性和恶性疾病，根据血细胞计数和形态学特点可观察疗效、判断疾病进展，并提出下一步检查意见。结论外周血细胞检验诊断报告可为临床提供更加准确和完善的信息，为疾病初步诊断、鉴别诊断、治疗监测、评估进展等提供重要参考依据。Objective To explore the clinical application value of peripheral blood diagnostic report. Methods 557 peripheral blood diagnostic reports were collected from Peking University First Hospital, YANDA LU DAOPEI Hospital and Beijing United Family Hospital. The results were analyzed and summarized according to different blood cell morphology character for the first time and review cases, respectively. Results Two hundred and one samples from first time patients were found abnormal complete blood count or leukocyte differential count, they were summarized as anemia, anemia accompanied with leukopenia or thrombopenia, abnormal white blood cell count or leukocyte differential count and abnormal platelet count. Each condition was further distinguished on the basis of different morphology character. Initial diagnosis or further examination could be proposed if abnormal morphology was specific or typical, when blood cell morphology was atypical or normal, the morphology was described objectively. 22 review cases included many benign and malignant disorders such as acute leukemia, chronic leukemia, myelodysplastic syndrome, multiple myeloma, infectious mononucleosis and so on. Suggestion of therapeutic effect, progression of diseases or further examination could be present according to complete blood cell count and morphology character. Conclusion Peripheral blood diagnostic report can provide more comprehensive and accurate information for clinic, and propose important advisory opinions for primary diagnosis, differential diagnosis, treatment monitoring and progression assessment.

关 键 词：血液 血细胞 诊断 

分 类 号：R446.11[医药卫生—诊断学]