九例骨髓坏死患者的实验室检查结果分析

Laboratory tests and result analysis of 9 cases of bone marrow necrosis

目的了解骨髓坏死(BMN)患者的实验室检查结果与原发病的关系。方法分析1997-2012年本院收治的9例骨髓坏死患者实验室检查结果,对其临床表现及原发病进行比较。结果实验室检查显示9例患者血清乳酸脱氢酶活性都明显增高,7例碱性磷酸酶活性升高;9例患者血红蛋白都明显减低(其中6例<50g/L);骨髓涂片中细胞形态模糊不清、大片融合、破碎、溶解;以骨痛、发热和进行性贫血为主要表现,且原发病多数为恶性疾病。结论骨髓坏死与恶性肿瘤密切相关,是一种少见的临床综合征,但实验室检查尤其是骨髓涂片细胞形态学检查仍是目前诊断骨髓坏死的主要手段,对于疑似患者应及时行骨髓穿刺检查。

Objective To understand the relationship of laboratory tests and primary disease in patients with bone marrow necrosis （BMN）. Methods The laboratory test results of 9 patients with bone marrow necrosis treated in our hospital from1997 to 2012 were analyzecL The clinical manifestations and the primary disease were comparecL Results I_aborato- ry tests showed that the 9 patients＇ serum lactate dehydrogenase activity were all significantly higher than normal, 7 of the patients＇alkaline phosphatase were more active than normal, and the 9 patients＇ hemoglobin were all significantly reduced （〈50 g/L in 6 cases）. The bone marrow smears showed that the cells were blurred, broken or dissolving, or with blockbuster fusion. The main clinical manifestations were bone pain, fever and anemia, and the primary diseases were the most malignant disease. Condusion Bone marrow necrosis is mostly related to malignancies and is recognized as a rarely clinical syndrome. However, laboratory tests, especially morphological examination of bone marrow smears, is still the primary means of diagnosis of bone marrow necrosis. Suspected patients of BMN should be checked bone marrow promptly.