909例骨髓缺铁及其血液学异常探讨

Investigation on 909 cases of iron deficiency in bone marrow smear and their change in hematologic examination

目的 了解骨髓检查病例的缺铁 (ID)率及其血液学异常的若干特点。方法 每例骨髓检查的初诊患者除了常规外 ,均作骨髓可染铁染色 ,判断骨髓ID并按标准进行缺铁性贫血 (IDA)和血液病伴ID等的诊断。结果 近 7年中诊为骨髓ID 90 9例 ,占同期检查病例的 14 .7%。其中单独诊断为IDA 5 13例 ,占ID的 5 6 .4 % ;血液病伴ID(主要见于特发性血小板减少症和脾功能亢进 ) 2 82例 ,占ID的 31.0 % ;其他疾病ID 114例 ,占12 .5 %。分析血液学检查 ,IDA、血液病伴ID和其他疾病ID的患者 ,在贫血率、血红蛋白浓度、红细胞指数(MCV、MCH、MCHC和RDW )及红系细胞形态学方面各有不同程度的变化。结论 了解骨髓ID及其血液学异常 ,有助于提高ID病理的认识 ,以及IDA与血液病伴随ID的主次诊断。

Objective To investigate some characteristics of iron deficiency(ID) rate in bone marrow and change in hematologic examination. Methods Besides routine, every bone marrow smear in first visit was examined by marrow stainable iron, then bone marrow was determined ID. Iron deficiency anemia(IDA) and blood disease with ID were diagnosed according to relative standards. Results In 7 years, 909 cases were diagnosed as bone marrow ID, which accounted for 14.7% of examined cases in the same period, in which IDA 513 cases(56.4%), hematological disease(idiophatic thrombocytopenic purpura and hypersplenism were in the majority) with ID 282 cases (31.0%), and other disease with ID 114 cases(12.5%). Analysing hematologic examination, the range of anemia rate, hemoglobin concentration, erythrocyte index(MCV,MCH,MCHC and RDW) and erythrocyte morphology had obviously different characteristics. Conclusions The analysis of ID in bone marrow smear and change in hematologic examination, may be helpful to improve recognition of ID pathology and make the minor or majoy diagnosis for IDA and blood diseases with ID.