骨髓细胞学与外周血常规检查在再生障碍性贫血诊断中的应用

Application of Bone Marrow Cytology and Peripheral Blood Routine Examination in the Diagnosis of Aplastic Anemia

目的:研究骨髓细胞学与外周血常规检查在诊断低增生骨髓异常综合症(Hypo-MDS)与再生性贫血(AA)中的应用价值。方法:回顾性分析医院2014年1月至2018年12月收治的20例Hypo-MDS患者及26例AA者实验室检查资料,统计并比较两组骨髓细胞学及外周血常规检查结果,评估两种检查方式在鉴别两疾病中的应用价值。结果:外周血化验结果提示,AA组患者血小板(PLT)、网织红细胞(Ret)、红细胞体积分布宽度(RDW)、平均红细胞体积(MCV)水平显著低于Hypo-MDS组(P<0.05);外周血细细胞形态学检查结果提示Hypo-MDS患者成熟红细胞形态异常比例显著高于AA组患者(P<0.05);Hypo-MDS患者红系统病态造血、巨核系统病态造血及三系病态造血频率均显著高于AA患者(P<0.05),两组粒系统病态造血频率无显著性差异(P>0.05)。结论:单一的实验室检查难以区分Hypo-MDS与AA,而合理综合骨髓细胞学与外周血常规检查结果可为两疾病的鉴别提供一定的参考,但对于不可鉴别者,应建议患者进行染色体检查。

Objective: To study the application value of bone marrow cytology combined with peripheral blood routine examination in the diagnosis of hypo-myelodysplastic syndrome (Hypo-MDS) and aplastic anemia (AA). Methods: The laboratory data of 20 patients with Hypo-MDS and 26 patients with AA admitted to our hospital from January 2014 to December 2018 were retrospectively analyzed. The results of bone marrow cytology and peripheral blood routine examination were compared between the two groups,and the application value of the two methods in identifying the two diseases was evaluated. Results: The results of peripheral blood test showed that the levels of platelet (PLT),reticulocyte (Ret),erythrocyte volume distribution width (RDW) and mean corpuscular volume (MCV) in AA group were significantly lower than those in Hypo-MDS group (P < 0.05). The morphological examination of peripheral blood microcells showed that the proportion of abnormal mature red blood cells in Hypo-MDS patients was significantly lower than that in Hypo-MDS group (P < 0.05). The frequencies of erythropoiesis,megakaryocyte hematopoiesis and trilineage hematopoiesis in Hypo-MDS patients were significantly higher than those in AA patients (P < 0.05). There was no significant difference in the frequencies of granulocyte hematopoiesis between the two groups (P > 0.05). Conclusions: It is difficult to distinguish Hypo-MDS from AA by a single laboratory examination,and a reasonable combination of bone marrow cytology and peripheral blood routine examination results can provide some reference for the identification of the two diseases,but for those who can not be identified,chromosome examination should be recommended for patients.