98例血小板增多症患者血象、骨髓铁染色及铁代谢分析

Analysis of hemogram,iron staining in bone marrow and iron metabolism in 98 patients with thrombocytosis

目的通过对98例血小板增多症患者血象、骨髓铁染色及铁代谢结果的回顾性分析，了解血小板增多患者在确立诊断时机体的含铁状况，协助鉴别诊断。结果血小板〈800×10^9／L的患者中缺铁性贫血占40．8％；而血小板≥800×10^9／L的患者中原发性血小板增多症占81．5％，其中有2例患者铁蛋白水平低于正常值（占9．1％），而血清铁水平正常。结论对于血小板数在（400～800）×10^9／L的患者，继发性血小板增多的可能性更大；血小板计数≥800×10^9／L的患者中绝大部分可以诊断为原发性血小板增多症，但仍需要排除可伴有血小板增多的其他骨髓增殖性疾病（如慢性粒细胞白血病、真性红细胞增多症等）以及同时合并反应性血小板增多的情况。

Objective To estimate the iron level in the patients with thrombocytosis for differential diagnosis. Methods A retrospective analysis on 98 thrombocytosis patients was performed by studying hemogram, iron staining in bone marrow and serum iron and ferritin level. Results In the patients whose platelet count were between 400 × 10^9 ）/L and 800 × 10^9 ）/L 40.8% were diagnosed as iron-deflcient anemia, while in the patients whose platelet count were higher than 800 × 10 （9）/L 81.5% were diagnosed as essential thrombocytosis （ET）. Of 27 ET cases 2 had lower serum ferritin values but their serum iron levels were in normal range. Conclusion The patients with platelet count between 400 × 10 （9）L and 800 × 10 （9）/L may be secondary thrombocytosis, while the patients with platelet count higher than 800 × 10 （9）/L may be diagnosed as ET, but other conditions such as iron deficiency should be excluded.