骨髓细胞学联合WBC、NAP在全血细胞减少性疾病诊断中的意义

Effect of Bone Marrow Cytology Combined with WBC and NAP in the Diagnosis of Pancytopenia

目的骨髓细胞学联合WBC、NAP在全血细胞减少性疾病诊断中的作用和意义。方法选取2015年1月至2017年6月本院收治的80例全血细胞减少症患者,分为非造血系统疾病组(n=40)和造血系统疾病组(n=40),给予全部患者行骨髓细胞形态学和外周血常规的检查,同时选取40例健康体检者行外周血常规的检查。结果与对照组相比,非造血系统疾病组和造血系统疾病组患者血小板(PLT)、红细胞(RBC)、白细胞(WBC)和血红蛋白(Hb)水平明显下降,差异具有统计学意义(P<0.05)。与非造血系统疾病组相比,造血系统疾病组患者血小板(PLT)、红细胞(RBC)、白细胞(WBC)和血红蛋白(Hb)水平明显下降,差异具有统计学意义(P<0.05)。与对照组相比,非造血系统疾病组脾功能亢进患者和骨髓增生异常综合征患者NAP积分明显降低,多发性骨髓瘤NAP积分明显升高;造血系统疾病组再生障碍性贫血患者和急性白血病患者NAP积分明显升高,巨幼红细胞性贫血患者NAP积分明显降低,差异具有统计学意义(P<0.05)。结论骨髓细胞学联合外周血常规WBC、NAP检查可作为临床诊断全血细胞减少性疾病的重要指标,具有较高的临床应用价值,值得推广应用。

Objective To investigate the role of bone marrow cytology in combination with WBC and NAP in the diagnosis of pancytopenia. Methods A total of 80 patients with pancytopenia treated in our hospital from January 2015 to January 2017 were enrolled in this study. The patients were divided into nonhematopoietic disease group （n = 40） and hematopoietic system group （n = 40）. All patients were given bone marrow cell morphology and peripheral blood routine examinations. At the same time we selected 40 cases of healthy people from routine examination of peripheral blood as control. Results Compared with the control group, PLT,RBC, WBC and Hb in patients with non-hematopoietic and hematopoietic diseases were significantly decreased （P 〈 0.05 ）. Compared with non-hematopoietic system group, PLT, RBC, WBC and Hb were significantly decreased in hematopoietic system group, （ P 〈 0.05 ）. Compared with the control group, NAP scores of patients with hypersplenism and myelodysplastic syndrome were significantly lower in nonhematopoietic system disease group and NAP scores of multiple myeloma were significantly increased; NAP scores were significantly higher in patients with hematopoietic disorders and patients with acute leukemia, and NAP scores were significantly lower in patients with megaloblastic anemia （ P 〈 0.05 ）. Conclusion Bone marrow cytology combined with routine WBC and NAP in peripheral blood can be used as an important index in the clinical diagnosis of pancytopenia. It has