急、慢性白血病患者全血细胞计数检测分析

Analysis of complete blood cell count in patients with acute and chronic leukemia

目的通过全血细胞计数对白血病进行初步筛查。方法对52例骨髓检查确诊为白血病（急性白血病46例，慢性白血病6例）患者行静脉采血，用KX-21N全血细胞仪进行全血细胞计数，观察红细胞（RBC）、白细胞（WBC）和血小板（PLT）各参数检测结果和白细胞直方图分布变化。结果急性白血病患者白细胞总数多增高，WBC〉10×10^9／L达91．3％，其中23．9％的患者白细胞总数异常增高（〉100×10^9／L），白细胞直方图呈单峰分布达84．8％。急性淋巴细胞白血病，白细胞直方图均表现为小细胞峰极度增高，呈单峰分布并向中间细胞区扩展变宽；急性髓系细胞白血病，81．1％白细胞直方图呈单峰分布（其中54．1％表现为中间细胞单峰增高并向小细胞区和大细胞区扩展，27．0％以大细胞单峰极度增高），18．9％呈双峰分布。红细胞、血红蛋白和血小板均明显减低。慢性粒细胞白血病患者白细胞总数均〉45×10^9／L，其中83．3％的患者白细胞总数异常增高（〉100×10^9／L），白细胞直方图均呈形状单一而分布广泛（100-450fl）的大细胞峰图形。结论作为一种筛查工具，全血细胞计数极大的减少了传统手工检测所需劳动和取样误差，提供大量的信息有助于血液系统等疾病的诊断和疗效评判，对急、慢性白血病的诊断有良好的过筛作用。

Objective To screen initially the patients with leukemia by complete blood count （CBC）. Methods By the SYSMEX KX-21N blood counter, to analyze all parameters including erythrocyte, leukocyte and platelet in 52 specimens of the patients with leukemia diagnosed by stained film microscopy of bone marrow and to observe their changes of leukocyte histogram. Results In 46 patients with acute leukemia, 91.3% of the cases presented with hyperleukocytosis （〉 10 ×10^9/L）, among them 23.9% cases were extremely higher （〉 100 ×10^9/L）, and the leukocyte histogram in 84.8% cases showed unimodal distribution. In 9 patients with acute lymphocytic leukemia, all leukocyte histogram showed small cell unimodal distribution and expanded from small to middle cell areas. In 37 patients with acute myelogenous leukemia, the leukocyte histogram in 81.1% cases showed unimodal distribution （among them 54. 1% cases indicated middle cell unimodal distribution and expanded from middle to small as well as large cell areas, and 27.0% cases indicated abnormally large cell unimodal distribution） while remaining 18.9% cases showed bimodal distribution. All patients＇ parameters of red blood cell count, hemoglobin and platelet count were significantly reduced. In 6 patients with chronic myeloid leukemia （CML）, all of them presented very high white blood cell counts （〉45 × 10^9/L） and represented completely wider and larger unimodal distribution of leukocyte histogram （100- 450 fl）, among them 83.3 % cases were extremely higher （〉 100 × 10^9/L）. Conclusion As a screening tool, the complete blood count can reduce the number of traditional manual differential cell counts and affection of sampling error and provide a lot of information conducive to diagnosis and monitoring treatments for hematologic disorders and other medical problems. There is certain significance in screening the patients with acute and chronic leukemia.