难治性贫血和巨幼细胞性贫血骨髓形态学检验结果的比较  

Test result comparison of bone marrow morphology between refractory anemia and megaloblastic anemia

作　　者：张莹[1] ZHANG Ying(Department of Laboratory Medicine,Baotou Tumor Hospital,Inner Mongolia Autonomous Region,Baotou 014030,China)

机构地区：[1]内蒙古自治区包头市肿瘤医院检验科,内蒙古包头014030

出　　处：《中国当代医药》2020年第36期74-76,共3页China Modern Medicine

摘　　要：目的比较难治性贫血和巨幼细胞性贫血骨髓形态学的检验结果。结果选取2017年1月~2019年12月包头市肿瘤医院50例难治性贫血患者作为难治性贫血组,同期选取包头市肿瘤医院收治的50例巨幼细胞性贫血患者作为巨幼细胞性贫血组。两组患者均接受骨髓形态学检验,比较分析结果。结论难治性贫血组的有核红细胞过碘酸-碱性复红染色(PAS)阳性率高于巨幼细胞性贫血组,差异有统计学意义(P<0.05);难治性贫血组的淋巴样小巨核细胞阳性率、红系病变发生率高于巨幼细胞性贫血组,差异有统计学意义(P<0.05);难治性贫血组的粒系巨幼变发生率高于巨幼细胞性贫血组,差异有统计学意义(P<0.05);难治性贫血组的巨幼变原始红细胞体积、巨幼变早幼红细胞体积均小于巨幼细胞性贫血组,差异有统计学意义(P<0.05)。结论在鉴别诊断难治性贫血和巨幼细胞性贫血过程中应用骨髓形态学检验,操作者应对巨核系病态造血加以强调,特别是淋巴样小巨核细胞现象;其次,针对巨幼细胞性贫血疾病特点,操作者应重点检测巨幼变幼红细胞体积,同时可以将有核红细胞PAS阳性率作为鉴别诊断难治性贫血及巨幼细胞性贫血的临床依据。Objective To compare the results of bone marrow morphology of refractory anemia and megaloblastic anemia.Methods A total of 50 patients with refractory anemia in Baotou Tumor Hospital from January 2017 to December 2019 were selected as the refractory anemia group,and 50 patients with megaloblastic anemia Baotou Tumor Hospital were selected as the megaloblastic anemia group at the same time.Both groups received bone marrow morphology test and made a comparative analysis.Results The positive rate of periodate-alkaline red staining(PAS)of nucleated red blood cells in the refractory anemia group was higher than that in the megaloblastic anemia group,the differences were statistically significant(P<0.05);the rates of lymphoid small megakaryocytes and erythropathy in the refractory anemia group were higher than those in the megaloblastic anemia group,the differences were statistically significant(P<0.05);the incidence of granulomegaly in the refractory anemia group was higher than that in the megaloblastic anemia group,the differences were statistically significant(P<0.05);the volume of megaloblastic primordial erythrocytes and megaloblastic early erythrocytes in the refractory anemia group were smaller than those in the megaloblastic anemia group,the differences were statistically significant(P<0.05).Conclusion Application of bone marrow morphologic test in differential diagnosis of refractory anemia and megaloblastic anemia,especially the phenomenon of lymphoid small megakaryocyte.Secondly,according to the characteristics of megaloblastic anemia,the operator should focus on the detection of megaloblastic red blood cell volume,and at the same time,the positive rate of PAS of nucleated red blood cells can be used as the clinical basis for differential diagnosis of refractory anemia and megaloblastic anemia.

关 键 词：难治性贫血 巨幼细胞性贫血 骨髓形态学检验 结果 

分 类 号：R556[医药卫生—血液循环系统疾病]