不同病因脾功能亢进患者骨髓造血容积的比较分析

Difference of haematogenesis volume between patients with hypersplenism of different etiopathogenisis

目的:比较乙肝后肝硬化和血吸虫肝纤维化脾功能亢进患者骨髓容积的差异,探讨骨髓代偿性增生在不同原因脾功能亢进诊断中的意义。方法:对乙肝后肝硬化和血吸虫肝纤维化脾功能亢进患者行骨髓穿刺及活检,记录每高倍视野下有核细胞数。活检组织石蜡包埋制作切片,网形测微器计数法计算骨髓造血容积比例。结果:乙肝后肝硬化组患者骨髓细胞涂片每高倍视野下有核细胞数为(43.32±22.51)个,骨髓活检造血容积为(38.44±21.45)%,均显著低于血吸虫肝纤维化组的(72.59±17.90)个和(58.73±12.21)%(P<0.01)。结论:乙肝后肝硬化脾功能亢进患者骨髓造血容积可能低下,不能作为诊断重要标准。

Objective： To compare the difference of haematogenesis volume in bone marrow between hypersplenism patients with hepatic cirrhosis caused by HB virus or hepatic fibrosis caused by schistosome respectively,and to investigate the meaning of bone marrow compensatory hyperplasia in the diagnosis of hypersplenism. Methods：Bone marrow aspiration and biopsy were performed in the patients,nucleated cells per highpower field were counted. Bone marrow tissue was sliced after paraffin imbedding, Haematogenesis volume was calculated by using a netshape micrometer. Resutls： The mean age of patients with post-HB liver cirrhosis was younger than that with postschistosome hepatic fibrosis,and howerer,the number of nucleated cells per high-power field of patients with post-HB hepatic cirrhosis was 43.32±22.51,and bone marrow haematogenesis volume was（38.44±21.45）% ,with both lower than patients with post - schistosome hepatic fibrosis significantly （72. 59 ±17. 90） and （58. 73±12. 21） %, respectively （P 〈0.01）. Conclusion： Lower haematogenesis volume in the bone marrow may occur in patients with hypersplenism caused by post-HB liver cirrhosis,which,as a major criterion,is improper in the diagnosis.