慢性肝病血小板减少症与原发免疫性血小板减少症的骨髓细胞形态的鉴别  

Differentiation of bone marrow cell morphology of thrombocytopenia in chronic liver disease and primary immune thrombocytopenia

作　　者：李清 陈雷 余晓红 Li Qing;Chen Lei;Yu Xiaohong(Department of Laboratory,Shenzhen Hospital of Southern Medical University,Shenzhen 518100,China)

机构地区：[1]南方医科大学深圳医院检验科,深圳518100

出　　处：《中国实用医刊》2022年第8期10-12,共3页Chinese Journal of Practical Medicine

基　　金：广东省深圳市宝安区科技计划基础研究项目(2021JD360)。

摘　　要：目的探讨慢性肝病血小板减少症与原发免疫性血小板减少症(ITP)的血常规、外周血及骨髓细胞形态的相似处与区别点。方法抽取南方医科大学深圳医院2020年10月至2021年10月收治的42例慢性肝病血小板减少症患者作为肝病组,另抽取同期收治的34例原发性ITP患者作为ITP组,对比分析两组患者血常规、外周血及骨髓涂片细胞形态。结果两组患者的外周血细胞形态比较差异未见统计学意义(P>0.05)。ITP组血小板计数低于肝病组(P<0.05);肝病组骨髓增生程度Ⅱ级6例(14.3%,6/42)、Ⅲ级18例(42.9%,18/42)、Ⅳ级18例(42.9%,18/42),ITP组骨髓增生程度Ⅱ级23例(71.9%,23/34)、Ⅲ级9例(28.1%,9/34)、Ⅳ级0例(0),两组患者骨髓增生程度比较差异有统计学意义(P<0.05)。ITP组巨核细胞数量高于肝病组(P<0.05)。结论联合血小板计数、外周血及骨髓细胞形态学检查,有利于鉴别诊断慢性肝病血小板减小症与原发ITP。Objective To investigate the similarities and differences of blood routine,peripheral blood and bone marrow cells morphology between thrombocytopenia in chronic liver disease and primary immune thrombocytopenia(ITP).Methods Forty-two patients with thrombocytopenia in chronic liver disease treated in Shenzhen Hospital of Southern Medical University from October 2020 to October 2021 were selected as the liver disease group,and 34 patients with primary ITP at the same period were selected as the ITP group.The blood routine,peripheral blood and bone marrow smear cells morphology of the two groups were compared and analyzed.Results There was no significant difference in the morphology of peripheral blood cells between the two groups(P>0.05).The platelet count in the ITP group was lower than that in the liver disease group(P<0.05).There were 6 cases(14.3%,6/42)of gradeⅡ,18 cases(42.9%,18/42)of gradeⅢ,18 cases(42.9%,18/42)of gradeⅣin the liver disease group,and 23 cases(71.9%,23/34)of grade II,9 cases(28.1%,9/34)of gradeⅢ,and 0 case(0/34)of gradeⅣin the ITP group.The difference in proliferation of bone marrow between the two groups was statistically significant(P<0.05).The number of megakaryocytes in the ITP group was higher than that in the liver disease group(P<0.05).Conclusions Combination of platelet count,peripheral blood and bone marrow cells morphology is conductive to differentiating chronic liver disease thrombocytopenia from primary ITP.

关 键 词：骨髓细胞 形态 慢性肝病血小板减小症 原发免疫性血小板减少症 

分 类 号：R575[医药卫生—消化系统] R558.2[医药卫生—内科学]