摘要
目的分析以血细胞减少首发的免疫疾病骨髓形态学特点及临床价值。方法回顾性分析25例风湿免疫疾病患者血象变化、造血系统增生程度,统计骨髓活检及涂片中造血细胞增生情况,分析不同血白蛋白及白细胞水平改变与骨髓各系增生程度关系,比较不同风湿免疫疾病者红系比值、粒系比值与细胞形态特征,分析不同风湿免疫疾病者血小板变化与巨核细胞相关特征。结果风湿免疫疾病合并多种血液学异常,其中贫血最常见17例,白细胞减少15例,血小板减少12例,全血细胞减少8例。血小板减少多分布在SS与SLE患者,SS更多见。贫血患者为增生性贫血的表现,粒系以增生活跃或明显活跃为主,巨核数目常常不低,有少部分血小板重度减少的病人伴有巨核产板成熟功能障碍。结论骨髓形态学检查为风湿免疫病的诊断、疗效监测及与血液疾病的诊断与鉴别提供依据,临床应用价值广泛。
Objective To analyze morphological characteristics and clinical value of bone marrow for immune diseases with initial onset of hematopenia.Methods The paper reviewed and analyzed changes in blood count and degree of hematopoietic system proliferation of 25 patients with rheumatic and immune diseases,counted proliferation of hematopoietic cells in bone marrow biopsies and smears,and analyzed relationship between different changes in blood albumin and white blood cell levels and bone marrow proliferation degree in various lineages.Red blood cell ratio,granulocyte ratio,and cell morphology characteristics were compared of different rheumatic and immune disease patients.Platelet changes and megakaryocyte related characteristics were analyzed of different rheumatic and immune disease patients.Results showed rheumatic immune diseases were complicated by various hematological abnormalities,with anemia being most common in 17 cases,leukopenia in 15 cases,thrombocytopenia in 12 cases,and pancytopenia in 8 cases.Thrombocytopenia was mostly distributed for patients with SS and SLE,with SS being more common.Anemia patients were manifested with proliferative anemia,with active or significantly active granulosa,high number of megakaryocytes.Small number of patients with severe thrombocytopenia were accompanied by mature dysfunction of megakaryocytes.Conclusion Bone marrow morphology examination can provide basis for diagnosis,effect monitoring of rheumatic immune diseases,and diagnosis and differentiation from hematological diseases,which has wide clinical application value.
作者
宁静
朱琳
章大谦
龙珍珠玛
潘歆
NING Jing;ZHU Lin;ZHANG Daqian;LONG Zhenzhuma;PAN Xin(Department of Hematology and Rheumatology,Shihezi University the First Affiliated Hospital,Shihezi,Xinjiang 832000;Department of Hematology,Xinjiang Uygur Autonomous Region People's Hospital,Urumqi,Xinjiang 830001)
出处
《智慧健康》
2023年第26期126-129,共4页
Smart Healthcare
基金
兵团财政科技计划项目《国家血液病临床研究中心兵团分中心》(项目编号:2021CA002)。
关键词
风湿免疫病
贫血
白细胞
血小板
骨髓细胞形态
Rheumatic immune disease
Anemia
White blood cells
Platelets
Bone marrow cell morphology
