RA型骨髓增生异常综合征79例相关资料分析

Chinical features,bone marrow smears and bone marrow biopsy of 79 patients with myelodysplastic syndrome-RA

目的:探讨骨髓增生异常综合征RA型(MDS-RA)的血液、骨髓涂片、骨髓病理组织学等的改变,为其疑难病例提供诊断价值。方法:将近几年的MDS资料中筛选MDS-RA被诊断时的资料,进行相关指标统计分析。结果:外周血:以二系或三系减少者为多见;49%的患者可见幼红细胞,44%的患者可见白细胞异常改变;骨髓涂片:以增生活跃和增生低下多见,病态造血者占83%(66/79)例,骨髓病理:以增生活跃为多见;粒系前体细胞增多者32例(41%),可见或偶见"幼稚前体细胞异常定位"(ALIP)者56例(71%);幼红细胞发育滞停,可见原红细胞岛、同一发育阶段的幼红细胞岛占58(73%)例,有异型巨核细胞者56(71%)例,纤维组织增多占72(91%)。结论:骨髓活组织检查对MDS-RA必不可少的联合诊断方法。

Objective：To study the changes of clinical features, bone marrow smears and bone marrow biopsy of Myelodysplastic Syndrome RA（MDS-RA） in order to provide value for the diagnosis of questionable cases. Method：The MDS-RA data were selected from the mylodysplastic syndrome data in the last few years and statistical analysed. Result：In clinical features, we found that there were more patients with two or three lineage cytopenia; 49% of patients had normoblast and 44% of patients had leucocyte abnormal changes. In bone marrow smears, we found that there were more patients with active hyperplasia and hypoplasia, and dyshaematopoiesis accounted for 83 % （66/79）. In bone marrow biopsy, we found that there were more patients with active hyperplasia; there were 32 patients（41%） with increased granulocyte precursor cells, 56 patients（71%） with abnormal location of immature precursor （ALIP）; and development of normoblasts was stopped, so there were 58 patients （73 %） with proerythroblast and normoblast island, 56 patients（71%） with abnormal megakaryocytes, and 72 patients（91%） with increased fibrous tissues. Conclusion： Bono marrow biopsy is an essential method for the diagnosis of MDS-RA.