肿瘤患者化疗过程中网织红细胞动态变化的观察

Dynamic Observation of Reticulocyte Counts and Immature Reticulocyte Fraction during Chemotherapy in Patients with Neoplasm

目的 了解肿瘤化疗时骨髓受抑和恢复期网织红细胞 (网红 )各参数变化的情况 ,以便确定骨髓造血功能开始恢复的早期指标。方法 用ADVIA 12 0全自动血细胞分析仪对 18例肿瘤患者在化疗过程中的白细胞、血小板、中性粒细胞绝对数 (ANC)和网红计数与分类进行了动态观察。结果 化疗后骨髓造血功能明显受抑 ,白细胞、网红及血小板极度降低 ,其中中性粒细胞绝对数降至 0 .0 2×10 9 L以下、网红绝对数降至 10× 10 9 L以下 ,高荧光强度网红百分率和中荧光强度网红百分率 (HFR % +MFR % )逐步降至最低水平或 0 ,网红分类几乎全部由低荧光强度网红 (LFR)组成。造血功能开始恢复时高荧光强度网红和中荧光强度网红的出现或升高较中性粒细胞绝对数达到 0 .2× 10 9 L早 4 .5d(中位数 )、达到 0 .5× 10 9 L早 7.5d(中位数 ) ,较网红绝对数 (RET # )达到正常范围低限早 15d(中位数 )。结论 HFR +MFR可作为评价肿瘤病人化疗过程中骨髓造血功能开始恢复的较敏感指标。

Objective To obtain a premature indicator of bone marrow recovery. Methods Reticulocyte counts,immature reticulocyte fraction(HFR+MFR),white blood cell(WBC),platelet(PLT)and absolute neutrophil count(ANC)were observed by a Bayer ADVIA 120 automated hematology analyzer during follow-up of chemotherapy in 18 patients with tumour. Results Bone marrow function was obviously suppressed after chemotherapy. WBC, reticulocyte and PLT were extremely decreased.The time for occurrence or rise of HFR+MFR was 4.5 days(median)earlier than that for ANC passed the lowest limit of 0.2×10 9/L,was 7.5 days(median)earlier than that for ANC passed the critical limit of 0.5×10 9/L, but was 15 days(median)earlier than that for the absolute reticulocyte count (RET#)risen to the normal range. Conclusion HFR+MFR may act as an early indicator of bone marrow recovery after chemotherapy proving to be a more sensitive parameter than ANC and RET#.