骨髓增生异常综合征239例病例分析  

Clinical analysis of 239 cases of myelodysplastic syndrome

作　　者：孟祥永 许洪志[1] 李英[1] 张凌岩[1] 刘新[1] 李颖[1] 王相华[1] 王欣[1] 

机构地区：[1]山东大学附属山东省立医院血液科,济南250021

出　　处：《临床血液学杂志》2018年第1期19-23,共5页Journal of Clinical Hematology

基　　金：国家自然科学基金(No:81270598和81473486);卫生行业公益性科研专项经费项目(No:201202017);山东省自然科学基金(No:2009ZRB14176;ZR2012HZ003);山东省科技发展计划项目(No:2008GG2NS02018;2010GSF10250;2014GSF118021);山东省优秀中青年科学家科研奖励基金项目(No:BS2013YY003;BS2013YY009);山东省医学领军人才和山东省泰山学者计划项目

摘　　要：目的:通过对骨髓增生异常综合征(MDS)患者的临床资料进行分析,探讨MDS发病的临床特征。方法:收集初治MDS患者239例,按照WHO分类标准确诊。回顾性分析患者性别、年龄、临床表现、分型、预后分组、血常规以及骨髓穿刺、活检和染色体检查。结果:239例MDS患者中,≥60岁104例,占43.51%;患者就诊时三系均低占56.49%;初诊时症状多为头痛头晕、面黄乏力等;染色体异常检出率为38.08%。不同MDS分型患者的临床相关指标比较,差异无统计学意义(P>0.05)。不同MDS预后分组与年龄、活检标本骨髓增生活跃度、FISH异常比例差异无统计学意义(P>0.05),与WBC、RBC、Hb、PLT、NEU、骨髓增生活跃度、染色体异常比例差异有统计学意义(P<0.05)。结论:MDS患者多为老年人,临床表现以贫血、出血、感染为主。初诊患者应完善相关检查,明确诊断、分型及预后分组,采取个体化治疗方案。Objective：To investigate the clinical manifestations and laboratory characteristics of myelodyslastic syndrome（MDS）,in order to summarize the common clinical features of MDS.Method：A total of 239 MDS patients were enrolled and analyzed.All the cases were diagnosed by Wright-Giemsa stained morphology of bone marrow and peripheral blood smears and chromosome results according to the WHO classification.We analyzed the sex,age,clinical manifestations,classification,prognostic risk categories,blood routine,bone marrow aspiration and biopsies and chromosome test.Result：Among the 239 MDS patients,104 cases were more than 60 years old,accounting for 43.51%.The patients with pancytopenia accounted for 56.49%.Headaches,dizziness and fatigue were the usual onset symptoms.All the patients did the chromosome test,with 38.08% of them being abnormal.There was no significant difference in the clinical relevant indexes between patients with different MDS types（P〉0.05）.There was no significant difference between the different MDS prognosis groups in the age,the bone marrow biopsy life span and the FISH abnormal proportion（P〉0.05）,and there was significant difference in the WBC,RBC,Hb,PLT,NEU,bone marrow increased life span,chromosome abnormalities ratio（P〈0.05）.Conclusion：The patients with MDS are mainly elderly people,and anemia,bleeding and infection were common clinical symptoms.All the newly diagnosed patients should complete thorough tests for clear diagnosis,classification and prognostic risk stratification,and receive individualized treatment.

关 键 词：骨髓增生异常综合征 分型 预后分组 治疗 

分 类 号：R733[医药卫生—肿瘤]