摘要
本研究旨在探索骨髓增生异常综合症患者贫血和外周血中性粒细胞减少与骨髓幼红细胞和中性幼粒细胞超微结构异常的相关性。采用全自动血细胞分析仪检测74例MDS患者贫血指标和中性粒细胞数,根据贫血程度和外周血中性粒细胞减少程度将MDS患者分别分为正常范围、轻度、中度和重度4组,用透射电子显微镜分析所有患者骨髓中性幼粒细胞和幼红细胞病态及凋亡细胞百分率。结果表明,74例MDS患者中68例贫血(92%),68例患者中51例外周血中性粒细胞减少(75%);电子显微镜下所有MDS患者骨髓幼红细胞和中性幼粒细胞不同程度结构异常;血红蛋白正常组和轻度、中度及重度贫血4组患者骨髓幼红细胞病态率分别为(37±14.7)%、(24±9)%、(32±16)%和(34±21)%,凋亡率分别为(2.25±1.03)%、(4.43±2.60)%、(8.78±4.04)%和(11.67±4.57)%,病态和凋亡率分别与血红蛋白及红细胞比容呈负相关(p<0.05);外周血中性粒细胞正常、轻度、中度和重度减少4组患者骨髓中性幼粒细胞凋亡率分别为(6.00±2.67)%、(9.50±4.42)%、(13.00±3.54)%和(17.00±2.39)%,与外周血中性粒细胞呈负相关(p<0.01);骨髓中性幼粒细胞病态率分别为(12.25±16.31)%、(13.5±10.01)%、(23±8.59)%和(51.67±19.67)%,病态率与凋亡率呈正相关(p<0.01)。结论:MDS患者骨髓幼红细胞和中性幼粒细胞的凋亡和病态发育与贫血、外周血中性粒细胞减少相关,二者可能是MDS无效造血重要成因。
The aim of study was to investigate the relationship of anemia and neutropenia with ultrastructural abnormalities of erythroblasts and young neutrophils in bone marrow of patients with myelodysplastic syndrome（MDS）.Anemia parameters and peripheral neutrophil amount of 74 patients with MDS were measured by automatic hemocyte analyzer.According to Hb value and neutropenia degree,MDS patients were divided into 4 groups： normal,mild,middle and severe anemia or neutropenia.The morbid rate and apoptosis rate of erythroblasts and young neutrophils in bone marrow were measured by transmission electron microscopy（TEM）.The results indicated that 68 out of 74 patients were consistent with anemia diagnostic criteria,and 51 out of 68 patients were with neutrocytopenia.TEM showed different abnormal features of erythroblasts and young neutrophils in all patients.The morbid rates of erythroblasts in normal,mild,middle and severe anemia groups were 37±14.7%,24±9%,32±16% and 34±21% respectively,while apoptotic rates of erythroblasts in normal,mild,middle and severe anemia groups were 2.25±1.03%,4.43±2.60%,8.78±4.04% and 11.67±4.57% respectively.The morbid rate and apoptotic rate of erythroblasts were correlated negatively with Hb and HCT value（p0.05）.The apoptotic rates of bone marrow young neutrophils in 4 groups with different degree of neutropenia were 6.00±2.67%,9.50±4.42%,13.00±3.54% and 17.00±2.39%,which correlated negatively with peripheral neutrophil quantity（p0.01）.Morbid rates of neutrophils in normal,mild,middle and severe anemia groups were 12.25±16.31%,13.5±10.01%,23±8.59% and 51.67±19.67% respectively,which positively correlated with its apoptotic rates（p0.01）.It is concluded that anemia and neutropenia in patient with MDS are correlated with apoptosis and morbid rate of erythroblasts and young neutrophils in bone marrow,which may result in ineffective hematopoiesis.
出处
《中国实验血液学杂志》
CAS
CSCD
2011年第1期81-84,共4页
Journal of Experimental Hematology
基金
2007年教育部博士点新教师项目基金资助
编号20070023085
关键词
骨髓增生异常综合征
造血细胞
贫血
粒系减少
无效造血
myelodysplastic syndrome
hematopoietic cell
anemia
neutrophil depletion
ineffective hematopoiesis
