摘要
目的探讨骨髓细胞形态、细胞化学染色及骨髓活检切片三联检测法对低原始细胞骨髓增生异常综合征与溶血性贫血的鉴别诊断价值。方法将2015年1月～2018年1月我院接诊的77例确诊为骨髓髓系原始细胞<5%的MDS患者纳入本研究,作为MDS组。选取溶血性贫血(HA)患者50例作为HA组。进行骨髓细胞形态、细胞化学染色、骨髓活检细胞化学染色检测。观察核型异常及分子生物学异常检测结果、骨髓原始细胞计数、红系比例、粒系病态造血、红系病态造血、巨核系病态造血情况、内铁阳性水平、铁颗粒数、环铁粒幼红细胞阳性率、骨髓活检切片检测结果,并对结果进行联合分析。结果 MDS组核型异常、分子生物学异常检出率高于HA组(P<0.05);MDS组、HA组骨髓原始细胞计数、红系比例对比,P>0.05;MDS组、HA组粒系病态造血、红系病态造血异常检出率对比,P>0.05;MDS组巨核系病态造血异常检出率高于HA组(P<0.05)。MDS组、HA组内铁阳性水平、铁颗粒数对比,P>0.05。MDS组环铁粒幼红细胞阳性检出率高于HA组(χ～2=19.659,P<0.05)。MDS组幼稚前体细胞异常定位(abnormal localization of immature precursors,ALIP)、巨核病态造血检出率高于HA组(P<0.05)。联合检测检出率为89.61%。结论骨髓细胞形态、细胞化学染色及骨髓活检切片三联检测法能够提高低原始细胞骨髓增生异常综合征检出率,辅助临床诊治。
Objective To investigate the differential diagnosis value of bone marrow cell morphology, cytochemical staining and bone marrow biopsy slice for low myogenic myelodysplastic syndrome and hemolytic anemia. Methods 77 MDS patients with bone marrow myeloid blasts 〈5% admitted in our hospital from January 2015 to January 2018 were enrolled in this study as the MDS group. 50 patients with hemolytic anemia（HA） were selected as the HA group. The bone marrow cell morphology, cytochemical staining, and bone marrow biopsy cytochemical staining were performed. The test results of karyotypic abnormalities and molecular biological abnormalities, bone marrow blast count,erythroid ratio,granulocyte pathogenic hematopoiesis, erythroid pathological hematopoiesis,megakaryocytic hematopoiesis, intra-iron positive level, iron particles, and ring iron red blood cell positive rate, and the results of bone marrow biopsy slide were observed. And the results were analyzed jointly. Results The abnormality rate of karyotype and molecular biological abnormality in MDS group was higher than that in HA group（P〈0.05）. There was no significant difference in the ratio of bone marrow blast cell count and red line ratio in MDS group and HA group（P〉0.05）.There was no significant difference in detection rate of morbid hematopoiesis and erythroid pathological hematopoietic abnormalities between MDS group and HA group（P〉0.05）. The detection rate of morbid hematopoietic abnormalities in MDS group was higher than that in HA group（P〈0.05）. There was no significant difference in iron positive level and the number of iron particles between the MDS group and the HA group（P〉0.05）. The positive rate of ring iron red blood cells in the MDS group was higher than that in the HA group （χ2=19.659, P〈0.05）. The detection rates of abnormal localization of immature precursors （ALIP） and megakaryocytic hematopoiesis were higher in the MDS group than those in the HA group（P〈0.05）. The combined detection rate was 89.61%. Conclusion The triple detection of bone marrow cell morphology, cytochemical staining and bone marrow biopsy can improve the detection rate of low-primary myelodysplastic syndrome and assist clinical diagnosis and treatment.
作者
蒋比芬
JIANG Bifen(Department of Clinical Laboratory,Zhaotong First People＇s Hospital in Yunnan Province,Zhaotong 657000,China)
出处
《中国现代医生》
2018年第26期116-119,共4页
China Modern Doctor
关键词
骨髓细胞形态
细胞化学染色
骨髓活检切片
低原始细胞骨髓增生异常综合征
溶血性贫血
鉴别
Bone marrow cell morphology
Cytochemical staining
Bone marrow biopsy slice
Low primordial myelodysplastic syndrome
Hemolytic anemia
Identification
