骨髓细胞形态检验在难治性贫血和巨幼细胞性贫血鉴别中的应用价值  

Value of Bone Marrow Cell Morphology Test in Differentiating Refractory Anemia From Megaloblastic Anemia

作　　者：王春霞 WANG Chunxia(Department of Laboratory Medicine,Liangshan County People’s Hospital,Jining 272000,China)

机构地区：[1]山东省梁山县人民医院检验科,山东济宁272000

出　　处：《中国伤残医学》2024年第19期122-125,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探究骨髓细胞形态检验在难治性贫血和巨幼细胞性贫血鉴别中的应用价值。方法:回顾性分析2021年1月-2023年10月梁山县人民医院收治的83例贫血患者资料,根据不同的疾病类型,将其分为难治性贫血组(n=41)和巨幼细胞性贫血组(n=42)。收集对比两组骨髓细胞形态检验资料,采用Logistic回归分析骨髓细胞形态检验结果与难治性贫血的关系;绘制受试者操作特征(ROC)曲线,检验骨髓细胞形态检验在难治性贫血中的诊断价值。结果:难治性贫血组粒系病态、淋巴样小巨核、红系病态发生率分别为68.29%、90.24%、51.22%,均高于巨幼细胞性贫血组的21.43%、11.90%、9.52%,差异均有统计学意义(P<0.05)。难治性贫血组粒系巨幼变、多样小巨核、红系巨幼变发生率分别为90.24%、85.37%、87.80%,与巨幼细胞性贫血组的85.71%、80.95%、78.57%比较,差异均无统计学意义(P>0.05)。Logistic回归分析显示,骨髓细胞形态检验结果中粒系病态、淋巴样小巨核、红系病态与难治性贫血有关(P<0.05)。ROC结果显示,粒系病态、淋巴样小巨核、红系病态的曲线下面积分别为0.734、0.892、0.708,均有一定诊断价值。结论:骨髓细胞形态检验在难治性贫血、巨幼细胞性贫血的鉴别中具有一定的应用价值,粒系病态、淋巴样小巨核和红系病态与难治性贫血具有相关性,其中淋巴样小巨核在难治性贫血中的诊断价值较高。Objective:To explore the value of bone marrow cell morphology test in differentiating refractory anemia and megaloblastic anemia.Methods:The data of 83 anemia patients admitted to Liangshan County People’s Hospital from January 2021 to October 2023 were retrospectively analyzed.According to the different disease type,they were divided into a refractory anemia group(n=41)and a megaloblastic anemia group(n=42).The data of bone marrow cell morphology were collected and compared.Logistic regression was used to analyze the relationship between bone marrow cell morphology and refractory anemia;receiver operating characteristic curve(ROC)was plotted to test the diagnostic value of bone marrow cell morphology in refractory anemia.Result:The incidence rates of granulopathy,lymphoid micromegakaryon and erythropathy in the refractory anemia group were 68.29%,90.24%and 51.22%,respectively,which were higher than 21.43%,11.90%and 9.52%in the megaloblastic anemia group,with statistical significance(P<0.05).The incidence rates of granulomegaloblastic,multiple micromegakaryon and red megaloblastic in the refractory anemia group were 90.24%,85.37%and 87.80%,respectively,and there were no significant differences compared with 85.71%,80.95%and 78.57%in the megaloblastic anemia group(P>0.05).Logistic regression analysis showed that the results of bone marrow cell morphology test showed that the middle granulosis,lymphoid megakaryon and red system were related to refractory anemia(P<0.05).ROC results showed that the areas under the curve of granulopathy,lymphoid megakaryus and erythropathy were 0.734,0.892 and 0.708,respectively,all of which had certain diagnostic value.Conclusion:Bone marrow cell morphology test is valuable in the differentiation of refractory anemia and megaloblastic anemia.Granulopathy,lymphoid micromegakaryon and erythroid pathology are correlated with refractory anemia,and lymphoid micromegakaryon has a higher diagnostic value in refractory anemia.

关 键 词：难治性贫血 巨幼细胞性贫血 骨髓细胞形态 粒系病态 淋巴样小巨核 红系病态 鉴别 诊断价值 

分 类 号：R556[医药卫生—血液循环系统疾病]