摘要
目的探究分析红系增生明显活跃的骨髓增生异常综合征的临床特点。方法将有核红细胞按照比例1划分,而骨髓成熟的红细胞按照20比例划分,两者之间以≤20:1来进行比例划分,其中非红系的有核细胞比骨髓的初始细胞<20%,同时MDS-E和红系增生水平进行对比≤50%。通过选取郑州大学附属郑州中心医院2014年4月—2018年6月收治的180例骨髓增生异常综合征患者来作为研究对象,并对其红系增生变化以及预后影响进行观察探讨。结果红系增生明显活跃的骨髓增生异常综合征患者的中位年龄在61岁,男患者和女患者的比例为1.62:2,年龄小于61岁的患者占据整体比例的42.5%;其中外周血HB的中位数为69 g/L、RCMD45(45.00%)、PLT 57.6×10^9/L、增生水平中位为58.9%、常见的三系病态造血为35.8%、伴有红系病态造血为92.5%且骨髓的红系增生异常活跃。红系增生明显活跃的骨髓增生异常综合征患者与对照组患者相比较,P>0.05;性别、年龄、Hb、白细胞、PLT、中性粒细胞计数、病态造血、促红细胞生成素、骨髓原始细胞、骨髓红系增生异常活跃、骨髓巨核细胞计数、染色体核型复杂程度、原始细胞以及MDS的回击预后标准评分系对于红系增生明显活跃的骨髓增生异常综合征患者的预后影响,差异无统计学意义(P>0.05)。结论临床研究表明MDS患者的骨髓红系增生水平明显没有骨髓增生异常综合征患者的活跃度高,同时红系增生明显活跃的骨髓增生异常综合征患者1号、+8的染色体以及红系病态造血等更加异常,红系增生明显活跃的骨髓增生异常综合征患者不会受到骨髓红系增生水平的预后影响,而能够明显影响预后的便是通过骨髓移植。
Objective To explore and analyze the clinical characteristics of myelodysplastic syndrome with markedly active ery⁃throid hyperplasia.Methods The nucleated red blood cells were divided according into proportion 1 and the mature red blood cells from bone marrow were divided according into proportion 20.The ratio between them was less than 20:1,in which the non-ery⁃throid nucleated cells were less than 20%of the original cells of bone marrow,the level of MDS-E and erythroid hyperplasia was less than 50%.180 patients with myelodysplastic syndrome who treated in the hospital from April,2014 to June,2018 were select⁃ed as the research objects.Then,the changes of erythroid proliferation and its prognostic influence were observed and discussed.Results The median age of patients with erythropoietic myelodysplastic syndrome with markedly active erythropoiesis was 61 years old,the proportion of male patients and female patients was 1.62:2,and the proportion of patients younger than 61 years old was 42.5%.The median values of HB in peripheral blood were 69g/L,RCMD45(45.00%),PLT 57.6×10^9/L,the median proliferative level was 58.9%,the common trilineage pathological hematopoiesis was 35.8%,the erythropoiesis with erythropoiesis was 92.5%,and the erythropoiesis of bone marrow was abnormal and active.Compared with the control group,the patients with myelodysplastic syndrome with markedly active erythroid proliferation were P>0.05.Here was no significant difference in the prognostic effects of sex,age,Hb,leukocyte,PLT,neutrophil count,pathological hematopoiesis,erythropoietin,bone marrow primordial cells,erythro⁃cyte dysplasia,bone marrow megakaryocyte count,chromosome karyotype complexity,primordial cells and MDS on patients witherythrocytic dysplasia,(P>0.05).Conclusion Clinical research shows that the erythroid proliferation level in MDS patients are significantly lower than that in patients with myelodysplastic syndrome.At the same time,the chromosomes 1,+8 and erythropoie⁃sis of patients with myelodysplastic syndrome with markedly active erythropoiesis are more abnormal,and the patients with myelo⁃dysplastic syndrome with markedly active erythropoiesis are not affected by the prognosis of erythropoietic myelodysplastic levels.The bone marrow transplantation can significantly affect the prognosis.
作者
石丽芳
郭志强
秦福丽
SHI Li-fang;GUO Zhiqiang;QIN Fu-li(Department of Hematology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zheng-zhou,450000,China)
出处
《黑龙江医学》
2020年第12期1646-1648,共3页
Heilongjiang Medical Journal
关键词
红系增生明显活跃
骨髓增生异常综合征
预后
临床分析
Obviously active erythroid hyperplasia
Myelodysplastic syndrome
Prognosis
Clinical analysis
