活动期系统性红斑狼疮骨髓形态学分析

Bone marrow morphological analysis of active systemic lupus erythematosus

目的 对系统性红斑狼疮(SLE)骨髓形态进行分析,探讨其在SLE诊断中的意义。方法 回顾性分析73例活动期SLE患者骨髓象、外周血象及自身抗体结果。结果 患者血液系统受累表现明显,73例患者中67例患者(91.8%)骨髓增生明显活跃或活跃,70例患者(95.9%)粒系增生活跃,35例患者(47.9%)淋巴细胞相对减少,63例患者(86.3%)红系增生活跃或明显活跃,42例患者(57.5%)巨核细胞增多。在外周血象中,20例患者(27.4%)白细胞减少,47例患者(64.4%)有不同程度的贫血,21例患者(28.8%)血小板减少。血小板减少组的骨髓巨核细胞数显著低于血小板正常组,差异有统计学意义(P=0.028)。结论 SLE累及多器官,骨髓可能为SLE的靶器官之一;血液系统受累较为普遍,骨髓形态学检查对SLE有十分重要的诊断意义。

Objective To discuss the bone marrow morphology of active systemic lupus erythematosus (SLE),and to study the clinical significance in the diagnosis of SLE. Methods A total of 73 subjects with active SLE were included.Bone marrow image,peripheral blood and autoantibody were tested. Results A total of 67 patients (91.8%) had hyper-to active cellularity.And 70 patients (95.9%) displayed active myeloid cellularity while 35 of them (47.9%) showed lymphocytopenia.Totally 63 patients (86.3%) were associated with hyperplasia of erythron series.Increased megakaryocytes were found in bone marrow smears of 42 patients (57.5%).In peripheral blood detection,20 patients (27.4%) showed leukopenia,47 patients (64.4%) showed anemia of varying degrees.And 21 patients (28.8%) were demonstrated to show sparse thrombocytes.Number of megakaryocytes in bone marrow of thrombocytopenia group were significantly lower than that of normal platelet group ( P =0.028). Conclusion Multiple organs are involved in the disease progression of SLE.Bone marrow may be a target organ in patients diseased with SLE.Hematological complications are common and examination of bone marrow aspirates is of great significance in the diagnosis.