摘要
目的分析骨髓形态检验在难治性贫血(RA)与巨幼细胞性贫血(MA)中的鉴别诊断价值。方法选取2015年6月至2017年6月收治的45例RA患者和45例MA患者。行髂后上棘穿刺术,获取红色骨髓液进行骨髓形态检验,观察对比检验结果。结果 RA组患者有核红细胞PAS阳性率为64.4%,高于MA组,差异有统计学意义(P<0.001)。RA组患者的红系病态、粒系病态、淋巴样小巨核比例为62.2%、71.1%、100.0%,高于MA组的6.7%、17.8%、8.9%,差异有统计学意义(P<0.001)。MA组患者的巨幼变原始红细胞、早幼红细胞直径大于RA组,差异有统计学意义(P<0.01)。结论骨髓形态检验鉴别诊断RA、MA具有较高价值,其中RA患者应关注病态造血和淋巴样小巨核细胞现象及有核红细胞PAS阳性率,MA患者应关注巨幼变红细胞的直径。
Objective To analyze the diagnostic value of bone marrow morphologic test in refractory anemia(RA)and megaloblastic anemia(MA).Methods 45 patients with RA and 45 patients with MA treated from June,2015 to June,2017 were selected.Then,the puncture of the posterior superior iliac spine was performed to obtain the bone marrow fluid for the bone marrow morphology test,and the examination results were observed and compared.Results The positive rate of PAS in nuclear red cells in the RA group was 64.4%,which was higher than that in the MA group,difference was statistically significant(P<0.001).In the RA group,the proportion of erythroid disease,granular disease and lymphoid megakaryocyte was respectively 62.2%,71.1%and 100.0%,higher than that(respectively 6.7%,17.8%and 8.9%)in the MA group,difference was statistically significant(P<0.001).The diameter of primary erythrocyte and early erythrocyte in the MA group was larger than that in the RA group,difference was statistically significant(P<0.01).Conclusion Bone marrow morphologic examination is of high value in differential diagnosis of RA and MA.RA patients should pay attention to pathological hematopoiesis,lymphoid megakaryocyte phenomenon and the positive rate of PAS in nuclear red cells,and MA patients should pay attention to the diameter of megaloblastic erythrocytes.
作者
关瑞霞
孙长娟
GUAN Ruixia;GUAN Ruixia(Department of Clinical Laboratory,No.155 Central Hospital of the PLA,Kaifeng 475003,China)
出处
《右江医学》
2018年第1期64-66,共3页
Chinese Youjiang Medical Journal
