骨髓涂片与骨髓活检对血液病的诊断价值

Diagnostic Value of Bone Marrow Smear and Bone Marrow Biopsy in Hematological Diseases

目的评估血液病患者应用骨髓涂片与骨髓活检的诊断价值。方法选择2022年3—9月期间河西学院附属张掖人民医院接诊的290例疑似血液病患者,全部均接受骨髓涂片与骨髓活检诊断,以血培养作为诊断金标准,分析诊断效果。结果骨髓活检在血液疾病中的诊断总符合率71.38%高于骨髓涂片检查的63.10%,差异有统计学意义(χ^(2)=22.042,P<0.001)。骨髓涂片检查在急性淋巴细胞白血病、急性髓系细胞白血病、慢性粒细胞白血病中的诊断符合率均高于骨髓活检,差异有统计学意义(P<0.05)。骨髓活检在骨髓纤维化、骨髓异常综合征中的诊断符合率均高于骨髓涂片检查,差异有统计学意义(P<0.05)。骨髓涂片检查、骨髓活检在再生障碍性贫血、多发性骨髓瘤、巨幼细胞性贫血、骨髓转移瘤、血小板减少性紫癫、霍奇金淋巴瘤中的诊断符合率对比,差异无统计学意义(P>0.05)。骨髓活检总符合率95.86%,高于骨髓涂片检查的,84.83%,差异有统计学意义(P<0.05)。结论骨髓活检更便于诊断出血液病,可为临床治疗提供参考依据。

Objective To evaluate the diagnostic value of bone marrow smear and bone marrow biopsy in patients with hematological diseases.Methods A total of two hundred and ninety suspected hematological patients admitted to Zhangye People's Hospital Affiliated to Hexi University from March to September 2022 were selected,all of whom received bone marrow smear and bone marrow biopsy diagnosis.Blood culture was used as the diagnostic gold standard to analyze the diagnostic effect.Results The total coincidence rate of bone marrow biopsy in the diagnosis of blood diseases was 71.38%higher than that of bone marrow smear examination 63.10%,the difference was statistically significant(χ^(2)=22.042,P<0.001).The diagnostic coincidence rate of bone marrow smear in acute lymphocytic leukemia,acute myeloid leukemia and chronic myeloid leukemia were higher than those of bone marrow biopsy,and the difference was statistically significant(P<0.05).The coincidence rate of bone marrow biopsy in diagnosis of myelofibrosis and myelodysplastic syndrome were higher than those of bone marrow smear,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the diagnostic accuracy of bone marrow smear and bone marrow biopsy in aplastic anemia,multiple myeloma,megaloblastic anemia,bone marrow metastasis thrombocytopenic purpura,and Hodgkin's lymphoma(P>0.05).The total coincidence rate of bone marrow biopsy was 95.86%higher than that of bone marrow smear examination(84.83%),and the difference was statistically significant(P<0.05).Conclusion Bone marrow biopsy is more convenient for diagnosing hematological diseases and can provide a reference basis for clinical treatment.