小儿再生障碍性贫血合并骨髓细胞病态造血现象的临床分析

Clinical analysis on pediatric aplastic anemia combined with morbid hematopoiesis of bone marrow cells

目的分析小儿再生障碍性贫血合并骨髓细胞病态造血现象。方法选取资阳市第一人民医院2014年3月至2017年3月收治的40例再生障碍性贫血患儿作为A组,骨髓增生异常综合征患儿38例作为B组,再生障碍性贫血合并骨髓细胞病态造血患儿30例为C组,另选择同时期收治的来院体检的35例健康儿作为对照组,A组、B组及C组患儿采用对应的治疗方法,测定并比较治疗前后CD34+、叶酸及维生素B12的水平。结果治疗前,A组、B组、C组与对照组相比CD34+、叶酸及维生素B12的水平均较低,C组与A组、B组相比CD34+降低更加显著,A组与B组相比CD34+降低更加显著,差异具有统计学意义(t=2.34~6.57,均P<0.05),A组、B组及C组叶酸及维生素B12的水平分别相比无明显差异(t=0.87~1.01,均P>0.05);治疗后,A组、B组及C组CD34+、叶酸及维生素B12水平均有所升高,但低于对照组,差异具有统计学意义(t=4.90~6.38,均P<0.05)。A组、B组及C组治疗后CD34+、叶酸及维生素B12的水平相比无明显差异(t=0.56~0.88,均P>0.05)。结论小儿再生障碍性贫血合并骨髓细胞病态造血的血清学指标具有特殊,建议对患儿的血清叶酸及维生素B12的水平进行合理的检测和针对性治疗。

Objective To explore pediatric aplastic anemia combined with morbid hematopoiesis of bone marrow cells.Methods Forty cases of aplastic anemia children admitted in Ziyang First People＇s Hospital from March 2014 to March 2017 were selected in group A,38 cases of myelodysplastic syndromes（MDS）were selected in group B,and 30 children with aplastic anemia combined with morbid hematopoiesis of bone marrow cells in group C.At the same period,35 healthy children receiving physical check in the hospital were selected in control group.Patients in group A,B and C were treated with corresponding treatment.Levels of CD34＋,folic acid and vitamin B12 in three groups were detected and compared before and after the treatment.Results Levels of CD34＋,folic acid and vitamin B12 in group A,B and C were lower than those in the control group before treatment,level of CD34＋in group C was lower than that in group A and B,and level of CD34＋in group A was lower than that in group B with significant differences（t value ranged 2.34-6.57,all P〈0.05）.Folic acid and vitamin B12 levels had no significant differences among group A,B and C（t value ranged 0.87-1.01,all P〈0.05）.Levels of CD34＋,folic acid and vitamin B12 in group A,B and C were all increased after treatment but still lower than those in the control group,and differences were statistically significant（t value ranged 4.90-6.38,all P〈0.05）.Levels of CD34＋,folic acid and vitamin B12 in group A,B and C after treatment had no significant difference（t value ranged 0.56-0.88,all P〈0.05）.Conclusion Serological indicators of patients with pediatric aplastic anemia combined with morbid hematopoiesis of marrow cells are specific.Detection of patient＇s serum levels of folic acid and vitamin B12 and targeted therapy are suggested.