骨髓细胞形态学检查对肝移植后贫血的诊断价值

Diagnostic value of bone marrow cytomorphology in anemia patients after liver transplantation

【目的】探讨骨髓细胞形态学检查对肝移植后贫血的诊断价值。【方法】收集我院2012年1月至2016年1月共41例肝移植后贫血患者的骨髓细胞形态学检查结果,按贫血程度分为轻度贫血组、中度贫血组和重度贫血组,并对数据进行汇总统计分析总结。【结果】通过骨髓细胞形态学检查,28例明确贫血原因,约占68.3%,其他13例骨髓象无特殊改变。导致肝移植后贫血的主要原因依次是感染、缺铁性贫血、嗜血细胞综合征,分别占17.1%、12.2%、9.8%,其他原因包括:急性白血病、骨髓增生异常综合征、铁粒幼细胞贫血、脾功能亢进、骨髓转移癌、移植物抗宿主病。骨髓细胞形态发生特异性改变情况在不同组别病例中存在差异,且有统计学意义(P<0.05)。【结论】骨髓细胞形态学检查对明确肝移植后贫血原因有重要的诊断价值。

【Objective】To investigate the diagnostic value of bone marrow cytomorphology in anemia patients after liver transplantation.【Methods】The results of bone marrow cytomorphology in 41 anemia patients after liver transplantation were collected in our hospital from January 2012 to January 2016. The patients were divided into mild anemia group, moderate anemia group and severe anemia group according to anemia degree. The data were analyzed and summarized.【Results】According to bone marrow cytomorphology, the anemia causes of 28 cases（68.3%） were clear, while the other 13 patients had no significant changes in the examination. The main causes of anemia after liver transplantation were infection（17.1%）, iron deficiency anemia（IDA,12.2%） and hemophagocytic syndrome（HPS,9.8%）. The other causes included acute leukemia（AL）, myelodysplastic syndrome（MDS）, sideroblastic anemia（SA）, hypersplenism,metastatic carcinoma of bone marrow and graft versus host disease（GVHD）. The specific changes of bone marrow cytomorphology in different groups were significantly different（P0.05）.【Conclusion】Bone marrow cytomorphology is of important value in the diagnosis of anemia after liver transplantation.