骨髓增生异常综合征-难治性贫血与巨幼细胞贫血的临床研究

Clinical Study of Myelodysplastic Syndronre-refractory Anemia with Megaloblastic Anemia

目的:通过探讨骨髓增生异常综合征-难治性贫血(MDS-RA)和巨幼细胞贫血(MA)的临床特点、细胞形态学特征及治疗性诊断,提高其诊断与鉴别诊断水平。方法:对24例MDS-RA与78例MA患者的临床特点、细胞形态学特征及治疗性诊断进行回顾性分析。结果:MDS-RA和MA在临床、实验室检查、骨髓细胞形态学有相似之处,但MDS-RA三系血细胞的病态造血明显,并且呈多相性,治疗效果差。MA三系血细胞巨变程度明显,且核染色质疏松呈网状变化,治疗效果好。结论:对于MDS-RA和MA鉴别困难的病例,要通过其临床特点、细胞形态学特征及治疗性诊断综合分析,提高其诊断与鉴别诊断水平。

Objective： To myelodysplastic syndrome-refractory anemia（MDS-RA） and megaloblastic anemia（MA） of the clinical features,morphological features,and treatment of diagnosis,improve the diagnosis and differential diagnosis.Methods： 24 cases of MDS-RA and 78 patients with clinical features of MA,morphological features,and treatment of diagnosis were reviewed.Results： MDS-RA and MA in clinical,laboratory,bone marrow cell morphology are similar,but the MDS-RA three lines marked dysplasia of blood cells,and showed heterogeneous nature of poor prognosis.MA degree three lines marked changes of blood cells,and showed a loose network of nuclear chromatin changes,the treatment effect is good.Conclusion： MDS-RA and MA is difficult to distinguish the cases,through its clinical features,morphological features and comprehensive analysis of therapeutic diagnosis,improve the diagnosis and differential diagnosis.