三种自身免疫性疾病血液学异常分析  

Analysis of Hematological Abnormalities in Three Autoimmune Diseases

作　　者：贺元 张娟[2] 李玉芹[2] 许颖[1,3] 蒋康 He Yuan;Zhang Juan;Li Yuqin(School of Laboratory Medicine,Chengdu Medical College,Chengdu,Sichuan 610500;Department of Laboratory Medicine,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu,Sichuan 610072,China)

机构地区：[1]成都医学院检验医学院,四川成都610500 [2]四川省人民医院临床医学检验中心,四川成都610072 [3]成都医学院第一附属医院检验科,四川成都610500 [4]石棉县人民医院检验科,四川雅安625400

出　　处：《四川医学》2020年第12期1233-1237,共5页Sichuan Medical Journal

基　　金：国家自然科学基金青年基金项目(编号:81802075);四川省卫生健康委员会基金项目(编号:19PJ118、20PJ320)。

摘　　要：目的探讨系统性红斑狼疮(SLE)、类风湿关节炎(RA)和干燥综合征(SS)患者外周血常规、骨髓象及铁染色特点,为临床提供可靠的实验室依据。方法回顾性分析2017年1月至2019年4月我院确诊的自身免疫性疾病患者461例(SLE 173例,RA 154例,SS 134例)外周血常规、骨髓象及铁染色结果等临床资料。结果三组病例在发病年龄、WBC、RBC、HGB、PLT均存统计学差异(P<0.05)。SLE组WBC、HGB最低,SS组PLT最低。SLE组最易发生贫血(78.47%)和WBC减低(62.03%),SS组最易发生PLT减低(52.94%),差异均有统计学意义(χ~2=12.00,P=0.017)。骨髓分析显示,三组患者主要以增生明显活跃或活跃为主,均可见病态造血,淋巴细胞均明显减少。铁染色结果显示,细胞内铁大致正常,细胞外铁均减少,SS组减少最严重。结论SLE、RA和SS可有相似的血液学异常,但又各具特点。加强自身免疫性疾病患者的外周及骨髓监测,可加深对疾病发病机制的探讨。Objective To explore characteristics of peripheral blood routine,bone marrow and iron staining in systemic lupus erythematosus(SLE)patients,rheumatoid arthritis(RA)and sjogren’s syndrome(SS),and to provide reliable laboratory evidence for clinical practice.Methods From January 2017 to April 2019,clinical data of 461 patients with autoimmune diseases diagnosed in our hospital(173 cases of SLE,154 cases of RA,134 cases of SS)were retrospectively analyzed,including peripheral blood routine,bone marrow findings,and iron staining results.Results Among three groups,there were significant differences in onset age,WBC,RBC,HGB,and PLT(P<0.05).In SLE group,WBC and HGB were the lowest.In SS group,had the lowest PLT was the lowest.SLE group was most prone to anemia(78.47%)and WBC reduction(62.03%).SS group was the most prone to PLT reduction(52.94%)with statistically significant diffference(χ~2=12.00,P=0.017).Bone marrow analysis showed that three groups were mainly hyperplasia or activewith pathological hematopoiesis and lymphocytes decreased significantly.Iron staining results showed that intracellular iron was roughly normal,while extracellular iron was reduced.And SS group had the most severe reduction.Conclusion SLE,RA and SS may have similar hematological abnormalities,but each has its own characteristics.For autoimmune diseases,to strengthen peripheral and bone marrow monitoring could deeply explore disease pathogenesis.

关 键 词：自身免疫性疾病 系统性红斑狼疮 类风湿关节炎 干燥综合征 外周血常规 骨髓分析 

分 类 号：R446.11[医药卫生—诊断学]