骨髓细胞形态检验在难治性贫血与巨幼细胞性贫血鉴别中的临床价值

Clinical value of morphological examination of bone marrow cells in the identification of refractory anemia and megaloblastic anemia

目的对比分析骨髓细胞形态检验在难治性贫血与巨幼细胞性贫血鉴别中的临床价值。方法选取2013年10月~2016年10月在我院治疗的64例贫血患者作为研究对象,其中难治性贫血组占32例,巨幼细胞性贫血组占32例。两组患者均进行骨髓细胞形态的临床检验,并将检验结果进行分析对比。结果难治性贫血组的有核红细胞PAS阳性率为71.88%,红系病态占比为65.63%,粒系病态占比为75.00%,淋巴样小巨核占比为100.00%,与巨幼细胞性贫血组的3.13%、15.63%、6.25%、0.00%比较,差异有统计学意义(P<0.05)。难治性贫血组的巨幼变原始红细胞直径为(18.64±4.23)μm,巨幼变早幼红细胞直径为(17.64±2.84)μm,显著短于巨幼细胞性贫血组的(23.84±6.49)μm、(20.87±4.69)μm,差异有统计学意义(P<0.05)。巨幼细胞性贫血组的红细胞分布宽度为(16.35±3.47)%,低于难治性贫血组的(28.94±7.22)%,差异有统计学意义(P<0.05)。两组的血红蛋白、血小板以及白细胞水平比较,差异无统计学意义(P>0.05)。结论骨髓细胞形态检验在难治性贫血与巨幼细胞性贫血中的临床检验价值可观,值得进一步推广。

Objective To compare and analyze the clinical value of morphological examination of bone marrow cells in the identification of refractory anemia and megaloblastic anemia.Methods 64 anemia patients treated in our hospital from October 2013 to October 2016 were selected as observation objects,and 32 cases were refractory anemia,32 cases were megaloblastic anemia.Participants in the two groups were all provided with the clinical test of morphological examination of bone marrow cells,and test results were analyzed and compared.Results In the refractory anemia group,the posi- tivity rate of PAS was 71.88%,the proportion rates of erythroid pathosis,granulocytic pathosis,and lymphoid megakaryo-cytes was 65.63%,75.00%,and 100.00%;while in the megaloblastic anemia group,they were 3.13%,15.63%,6.25%,and 0.00% respectively,which were displayed great differences after comparisons （P〈0.05）.In the refractory anemia group,the diameters of megaloblastic pronormoblast and normoblast were （18.64±4.23）μm and （17.84±2.84）μm,which was shorter than （23.84±6.49）μm and （20.87±4.69）μm in the megaloblastic anemia group,with significant difference （P〈0.05）.Meanwhile, the red cell distribution width in the megaloblastic anemia group was （16.35±3.47）%,which was much lower than （28.94±7.22）% in the refractory anemia group,with significant difference （P〈0.05）.There was no significant difference in the level of hemoglobin,platelet and white blood cells between the two groups （P〉0.05）.Conclusion The clinical value of morpho- logical examination of bone marrow ceils in refractory anemia and megaloblastic anemia is substantial,and is worthy of further promotion.