成人全血细胞减少症413例临床分析

Clinical analysis of 413 adults with pancytopenia

目的探讨引起成人全血细胞减少的病因学及临床特征。方法对413例在本院血液科就诊的初发全血细胞减少症的成人患者进行回顾性分析。结果由造血系统引起的全血细胞减少症占57.38%(237/413),非造血系统引起的占42.62%(176/413)。造血系统疾病中以缺铁性贫血为主要病因(20.82%);其次为急性白血病(11.14%)。中性粒细胞<0.5×109/L者发热率最高;血小板计数<20×109/L者出血倾向严重;血液系统疾病患者血红蛋白多数在60 g/L^90 g/L。结论引起成人全血细胞减少症的病因复杂,缺铁性贫血、急性白血病、多发性骨髓瘤和巨幼细胞贫血常见,应引起临床医生重视,血红蛋白水平对是否为血液系统疾病有提示意义。

Objective To investigate the etiology and clinical features of pancytopenia in adults. Methods The clinical data of 413 adults with pancytopenia were retrospectively analyzed. Results There were 57. 38%（ 237/413） pancytopenia mainly caused by hematopoietic system and 42. 62%（ 176/413） caused by non-hematopoietic system. Iron deficiency anemia was the main cause of hematopoietic system diseases（ 20. 82%）,followed by acute leukemia（ 11. 14%）. The fever rate of neutrophils 0. 5 × 10^9/L was the highest; the platelet count was 〈20 × 10^9/L; the bleeding tendency was serious; the majority of hemoglobin in patients with hematologic diseases were within 60 g/L-90 g/L. Conclusion The causes of adult pancytopenia are complex.The common causes were iron deficiency anemia,acute leukemia,multiple myeloma and megaloblastic anemia,which should be paid attention to by clinical doctors. Hemoglobin levels have implications for hematologic disorders.