表现为大细胞性贫血的再生障碍性贫血病人临床分析

APLASTIC ANEMIA MANIFESTS AS MACROCYTIC ANEMIA:CLINICAL ANALYSIS

目的探讨表现为大细胞性贫血的再生障碍性贫血(MAA)病人的临床特点。方法回顾性分析55例MAA病人的临床资料,并以同期表现为正细胞性贫血的再生障碍性贫血(NAA)病人127例作为对照。结果MAA组病人的年龄明显高于对照组,差异有显著性(t=3.60,P<0.05);MAA组中非重型再生障碍性贫血(NSAA)病人比例明显偏高,差异有显著性(χ2=52.47,P<0.05);MAA组重型再生障碍性贫血(SAA)病人网织红细胞计数(Ret)显著高于NAA组,差异有显著性(t=2.68,P<0.05);MAA组SAA病人骨髓红系比例高于NAA组,差异有显著性(t′=2.33,P<0.05)。治疗6个月后,MAA组SAA、NSAA病人有效率与NAA组比较差异无显著性(P>0.05)。随访29(1~72)个月,MAA组SAA、NSAA病人生存率与NAA组比较,差异无显著性(P>0.05)。结论与NAA病人比较,MAA病人发病年龄较大,NSAA比例、Ret、骨髓红系比例偏高。

Objective To discuss the clinical features of aplastic anemia （AA） that manifests as macrocytic anemia （MA）. Methods Clinical data of 55 patients with MA were reviewed retrospectively, and 127 patients with normocytic anemia （NA） of corresponding time period served as controls. Results The age of patients with MA was markedly older than that of the controls （t=3.60,P〈0.05）,in MA, the proportion of non-severe AA patients was higher （gz =52.47,P（0.05） ; the reticulocyte count （Ret） was significantly higher in severe AA than in non-severe AA （t =2.68,P^0.05）. In MA, the proportion of erythroid cells in bone marrow was also higher （t＇= 2.33, P d0.05）. After 6 months of treatment, the difference in effective rate of severe AA and non-severe AA between MA group and NA group was not significant （P〉0.05）. A follow-up of 29 （1--72） months showed the difference in survival rate between MA and NA groups was not significant （P〉0.05）. Conclusion Compared with normocytic anemia patients, the age of onset in patients with macrocytic anemia is comparatively older, and the proportion of non- severe aplastic anemia, Ret and proportion of erythroid ceils are high.