836例全血细胞减少患者临床特征分析  

Analysis of the clinical characteristics of 836 patients with pancytopenia

作　　者：王欢 叶芳[1] 李宁宁 舒亚南 童春 王玲 张立男 WANG Huan;YE Fang;LI Ningning;SHU Ya'nan;TONG Chun;WANG Ling;ZHANG Linan(Department of Hematology,Beijing Chuiyangliu Hospital,Beijing 100021,China)

机构地区：[1]北京市垂杨柳医院血液科,北京100021

出　　处：《中国当代医药》2022年第8期42-46,共5页China Modern Medicine

基　　金：北京市朝阳区科技计划项目(CYSF1812);北京市科委计划项目(Z191100006619054)。

摘　　要：目的探讨北京市三级综合医院全血细胞减少患者的临床特征。方法选取2016年1月至2020年10月北京市垂杨柳医院的836例全血细胞减少患者作为研究对象,根据病因分成造血系统疾病组(n=287)和非造血系统疾病组(n=488),比较两组血细胞减少程度,并分析和总结全部患者科室分布及病因。结果836例患者中,全血细胞减少程度整体以轻、中度为主。轻、中度贫血患者785例(93.9%),521例(62.32%)患者血小板计数为(75~<125)×10^(9)/L,763例(91.15%)患者白细胞计数为(2.0~<3.5)×10^(9)/L。全血细胞减少患者主要分布在血液科、急诊科、呼吸内科、普通外科、消化内科、心内科等科室。836例患者根据病因分为造血系统疾病287例(34.33%)、非造血系统疾病488例(58.37%)。造血系统疾病以巨幼细胞性贫血为主要病因(35.19%),其次为骨髓增生异常综合征(19.16%)。非造血系统疾病以感染性疾病为主要病因(34.06%),其次为转移性肿瘤(21.31%)。造血系统疾病组白细胞、血红蛋白及血小板计数减少程度均高于非造血系统疾病组,差异有统计学意义(P<0.05)。结论各专业临床医生应重视寻找全血细胞减少的病因,提高对全血细胞减少的认识和诊疗水平。除造血系统疾病外,由非造血系统疾病引起的全血细胞减少也占相当比例,对于这样的患者应积极行骨髓细胞学和相关实验室检查明确诊断,避免漏诊及误诊。Objective To investigate the clinical characteristics of patients with pancytopenia in the third-class comprehensive hospital preliminarily.Methods A total of 836 patients with pancytopenia in our hospital from January 2016 to October 2020 were selected as the subjects,and divided into hemotopathy group(287 cases)and non-hemotopathy group(488 cases).The blood cell reduction degree were compared between the two groups.The distribution and cause of all patients were analyzed and summarized.Results Among the 836 patients,the degree of pancytopenia was mainly mild or moderate.There were 785 cases(93.9%)of mild and moderate anemia,Pations of platelet count([75-<125]×10^(9)/L)was 21 cases(62.32%),WBC count([2.0-<3.5]×10^(9)/L)was 763 cases(91.15%).Patients with pancytopenia were mainly distributed in Department of Haematology,Department of Emergency,Department of Respiratory Medicine,Department of General Surgery,Department of Gastroenterology,Department of Cardiology and other departments.According to the etiology,the 836 patients were divided into 287 cases(34.33%)of hemotopathy and 488 cases(58.37%)of non-hemotopathy.In hematopoietic system,megaloblastic anemia mainly accounted for 35.19%,followed by myelodysplastic syndrome(19.16%).In non-hematopoietic system,infection disease accounted for 34.06%,followed by metastatic tumor(18.5%).The decrease degree of leukocyte,hemoglobin and platelet in hemotopathy was higher than that in non-hemotopathy,the difference was statistically significant(P<0.05).Conclusion Clinicians of all specialties should pay attention to finding the etiology of pancytopenia,and improve the level of diagnosis and treatment.Pancytopenia is mainly caused by hematopoietic disorders,non-hematopoietic diseases also accounts for a certain percentage.Bone marrow cytology and laboratory tests should be actively performed to confirm the diagnosis and avoid missed diagnosis and misdiagnosis.

关 键 词：全血细胞减少 造血系统疾病 非造血系统疾病 病因分析 

分 类 号：R552[医药卫生—血液循环系统疾病]