再生障碍性贫血骨髓小粒细胞成分分析

Analysis of bone marrow parvule cell in aplastic anemia

目的通过对病人骨髓小粒细胞进行分类计数,从而为再生障碍性贫血(简称再障)的诊断提供依据。方法分别对65例再障病例、36例增生性贫血(简称增贫)病例、22例原发性血小板减少性紫癜(ITP)病例以及10例正常人对照组进行骨髓细胞涂片,每个病例各选取2张髓片在油镜下分类计数,将每组骨髓小粒出现率、每个骨髓小粒平均所含细胞数以及所含细胞种类进行比较。结果 4组病例骨髓小粒出现率差异无统计学意义,再障组每个骨髓小粒的平均细胞数明显低于增贫组及ITP组。再障组小粒非造血细胞比例显著高于其他3组(P<0.01),从细胞分类来看,组织嗜碱细胞、淋巴细胞和脂肪细胞增高尤为突出。结论再障病人骨髓小粒以非造血细胞为主,这可以作为不典型再障的诊断依据,同时对再障病人骨髓小粒细胞成分的分析,可以为后续治疗方案的确定提供一定的参考。

Objective By differential count of bone marrow parvule cell in patients,the study aims to provide the basis for diagnosis of aplastic anemia（ AA）. Methods 65 cases of AA,36 cases of hyperplastic anemia,22 cases of idiopathic thrombocytopenic purpura（ ITP） and 10 control cases were divided into four groups. And then two pieces of each case,marrow cell smear were selected for differential count. The occurrence rate of the bone marrow parvule and the cell numbers and types of each parvule were compared. Results The results shows that the occurrence rates of the bone marrow parvule are not significantly different among the four groups. The average cell number of each parvule in AA group are much lower than that in hyperplastic anemia group and ITP group. The proportion of non-hematopoietic cell in AA group is significantly higher than other three groups（ P 〈0. 01）. From the point of cell classification,tissue basophilic cells,lymphocytes and especially fat cells increase dramatically. Conclusion The fact that non-hematopoietic cells making up the majority in the bone marrow parvule of AA patients the can be used as a basis in diagnosis of atypical aplastic anemia. Meanwhile,the analysis of the composition of parvule cell in bone marrow of AA patients can be taken as a reference in subsequent treatment.