骨髓细胞学和外周血常规检查在再生障碍性贫血和低增生性骨髓增生异常综合征鉴别诊断中的应用价值  

Bone marrow cytology and peripheral blood routine examination in aplastic anemia

作　　者：徐慧良 XU Huiliang(Department of Clinical Laboratory of Lankao Guyang Hospital,Kaifeng 475312 Henan,China)

机构地区：[1]兰考固阳医院检验科,河南开封475312

出　　处：《中国民康医学》2023年第2期137-139,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:观察骨髓细胞学和外周血常规检查在再生障碍性贫血和低增生性骨髓增生异常综合征鉴别诊断中的应用价值。方法:回顾性分析2017年2月至2020年2月该院收治的88例疑似再生障碍性贫血患者的临床资料,其中56例确诊为再生障碍性贫血,32例确诊为低增生性骨髓增生异常综合征,以临床既定诊断结果为金标准,比较骨髓细胞学和外周血常规单项及联合检查鉴别诊断再生障碍性贫血的效能。采用Kappa检验骨髓细胞学和外周血常规单项及联合检查鉴别诊断再生障碍性贫血与金标准的一致性。结果:骨髓细胞学单项和联合检查鉴别诊断再生障碍性贫血患者的准确度、特异度、灵敏度、阳性预测值、阴性预测值均高于外周血常规单项检查,差异有统计学意义(P<0.05);Kappa检验结果显示,骨髓细胞学检查与金标准鉴别诊断再生障碍性贫血结果具有较好的一致性(Kappa值=0.876,P<0.05);外周血常规检查与金标准鉴别诊断再生障碍性贫血结果具有较差的一致性(Kappa值=0.390,P<0.05);联合检查与金标准鉴别诊断再生障碍性贫血结果具有较好的一致性(Kappa值=0.926,P<0.05);骨髓细胞学单项与联合检查鉴别诊断再生障碍性贫血患者的准确度、特异度、灵敏度、阳性预测值、阴性预测值比较,差异均无统计学意义(P>0.05)。结论:骨髓细胞学单项和联合外周血常规检查与金标准鉴别诊断再生障碍性贫血的一致性较好,且诊断准确度、特异度、灵敏度、阳性预测值、阴性预测值均高于外周血常规单项检查。Objective:To observe the differentiation of bone marrow cytology and peripheral blood routine examination in aplastic anemia and hypoplastic myelodysplastic syndrome.Methods:The clinical data of 88 patients with suspected aplastic anemia admitted to the hospital from February 2017 to February 2020 were retrospectively analyzed.Among them,56 cases were diagnosed as aplastic anemia and 32 cases were diagnosed as hypoplastic myelodysplastic syndrome.With the established diagnostic results as the gold standard,the efficacy of single and combined examination of bone marrow cytology and peripheral blood routine in the differential diagnosis of aplastic anemia was compared.Kappa test was used to test the consistency of bone marrow cytology and peripheral blood routine single and combined examination in the differential diagnosis of aplastic anemia with the gold standard.Results:The accuracy,specificity,sensitivity,positive predictive value and negative predictive value of bone marrow cytology and combined examination in the differential diagnosis of patients with aplastic anemia were higher than those of peripheral blood routine single examination,and the difference was statistically significant(P<0.05).The results of kappa test showed that the results of bone marrow cytology and gold standard differential diagnosis of aplastic anemia had good consistency(Kappa value=0.876,P<0.05).The results of peripheral blood routine examination and gold standard in differential diagnosis of aplastic anemia had poor consistency(Kappa value=0.390,P<0.05).The results of combined examination and gold standard differential diagnosis of aplastic anemia had good consistency(Kappa value=0.926,P<0.05).There was no significant difference in accuracy,specificity,sensitivity,positive predictive value and negative predictive value between single and combined examination of bone marrow cytology in the differential diagnosis of aplastic anemia(P>0.05).Conclusions:The consistency of bone marrow cytology single and combined peripheral blood routine

关 键 词：再生障碍性贫血 血常规 检查 诊断 效能 

分 类 号：R556.5[医药卫生—血液循环系统疾病]