237例骨髓纤维化患者临床特征及骨髓活检分析

Clinical features and bone marrow biopsy of 237 patients with myelofibrosis

目的分析骨髓纤维化患者的临床特征和骨髓活检结果,探讨原发性骨髓纤维化与继发性骨髓纤维化之间的差异。方法选取我院2015年4月至2020年3月收治的237例经骨髓活检切片网状纤维染色(Gomori染色)确诊的骨髓纤维化病例,分为原发性骨髓纤维化(PMF)和继发性骨髓纤维化(SMF)两组,对两组临床特征及骨髓活检结果进行分析。结果237患者中诊断为原发性易髓纤维化81例(37%),网状纤维染色结果以MF-2级为主;继发性骨髓纤维化组患者初诊年龄显著低于原发性易髓纤维化组患者(P<0.05),两组患者骨髓增生程度及网状纤维染色分级差异有统计学意义(P<0.05),外周血白细胞数量、血红蛋白含量及血小板数量无显著差异。结论(1)继发性骨髓纤维化患者骨髓中纤维组织增生情况与原发病密切相关;(2)对于疑诊骨髓纤维化患者应行骨髓活检检查以判断患者是否出现骨髓纤维化,并在后续的治疗过程中定期监测骨髓活检,可为患者的治疗和预后判断提供帮助。

Objective To analyze the clinical features and bone marrow biopsy results of patients with myelofibrosis,and to explore the difference between primary myelofibrosis and secondary myelofibrosis.Methods A total of 237 cases of myelofibrosis diagnosed by mitochondrial fiber staining(Gomori staining)of bone marrow biopsy sections from April 2015 to March 2020 were divided into primary myelofibrosis(PMF)and secondary bone marrow fibrosis(SMF)two groups,the clinical characteristics and bone marrow biopsy results were analyzed.Results 237 patients were mainly diagnosed as PMF(37%),reticular fiber staining results were mainly MF-2;The age of SMF patients were significantly lower than PMF patients(P<0.05);There were statistically significant differences in fiber staining grading and degree of myeloproliferation between PMF and SMF groups(P<0.05).There was no significant difference in peripheral blood leukocyte count,hemoglobin content and platelet count between two groups.Conclusion①The fibrous hyperplasia in the bone marrow of patients with secondary myelofibrosis is closely related to the primary disease.②For patients with suspected myelofibrosis,bone marrow biopsy should be performed to determine whether the patient has myelofibrosis and follow-up treatment.Regular monitoring of bone marrow biopsy can help patients with treatment and prognosis.