芥子气中毒致外周血细胞和骨髓细胞形态学损伤的研究

Morphological study of injuries to cells of peripheral blood and bone marrow as a result of mustard gas poisoning

目的 观察血细胞及骨髓细胞形态学指标在芥子气中毒人员的治疗过程中的变化与中毒严重程度的相关性。方法 对芥子气中毒人员进行外周血及骨髓细胞形态学分析。结果 4 4名芥子气中毒患者白细胞总数均进行性降低 ,有 10名患者出现中性粒细胞减少症或中性粒细胞缺乏症 ,芥子气中毒早期嗜酸性粒细胞损伤较严重 ,淋巴细胞百分比及绝对值在早期显著降低 ,芥子气中毒对外周血的血小板总数影响不大 ,红细胞和血红蛋白在最初因血液浓缩而升高。血细胞及骨髓细胞形态改变明显 ,白细胞胞体肿大 ,胞质可见中毒颗粒、空泡等 ,所有中毒者均出现异型淋巴细胞 ,以幼稚型异型淋巴细胞为主 ,血小板形态改变不明显。芥子气中毒早期骨髓造血细胞损害严重。结论 检查血象和骨髓象是判断芥子气中毒患者中毒程度及预后的一项重要指标 ,淋巴细胞绝对值减少程度和恢复正常值的时间长短及骨髓细胞增生受抑制的程度与中毒严重程度有关。

Objective To study the morphological changes in peripheral blood cells and bone marrow cells of the patients suffering from mustard gas poisoning and their relationship with the degree of poisoning. Method The peripheral blood cells and marrow cells were examined morphologically after mustard gas poisoning. Results The total WBC count was reduced progressively in 44 patients, among them 10 patients showed granulocytopenia or agranulocytosis. Severe injury to eosinophils was seen also in the early period, and the percentage and absolute value of lymphocytes were significantly lowered too. However, platelets were not significantly influenced. The red cell count and hemoglobin level were elevated because of hemoconcentration. Blood marrow cells showed marked morphological changes. WBC became swollen with appearance of poisonous granules and vacuoles in their cytoplasm. Deformed lymphocytes (LY) could be found in the marrow cells of all the patients, mainly in the form of immature lymphocytes. It was shown that mustard gas produced serious damage to the hematopoitic cells of the bone marrow in the early period. Conclusions The examination of pheripheral blood and bone marrow cells is an important measure to determine the degree of mustard gas poisoning. The decrease in the absolute value of lymophocyte count and the time of its recovery, and degree of inhibition of hematopoiesis are closely related to the degree of mustard gas poisoning.