摘要
目的:研究小巨核细胞(SMK)碱性磷酸酶抗碱性磷酸酶(APAAP)染色在贫血、骨髓增生异常综合征(MDS)中的鉴别诊断意义。方法:应用抗血小板膜糖蛋白ⅡbⅢa(CD41a)单克隆抗体对238例血液病的骨髓片进行APAAP染色并镜检。结果:分别用瑞氏和APAAP两种染色方法计数全片的巨核细胞,两者差异有显著性(P<0.01),后者明显优于前者。各疾病组SMK阳性率由高到低依次为MDS>特发性血小板减少性紫癜(ITP)>原发性血小板增多症(ET)>巨幼细胞贫血(MgA)>肿瘤转移>巨核细胞生成血小板不良>骨髓纤维化症(MF)>混合性贫血>继发性贫血>溶血性贫血(HA)>缺铁性贫血(IDA),再生障碍性贫血未见SMK;MDS组、MgA组和ITP组在SMK类型方面有显著性差异(P<0.05)。结论:APAAP染色有助于识别SMK;SMK的数量及类型变化对贫血的分类、MDS的诊断有一定的鉴别诊断意义,为早期治疗提供了可靠的依据。
Objective:To study the significance of small megakaryocyte(SMK) by APAAP staining in differential diagnosis of anemias and MDS. Methods:The bone marrow smear of 238 patients were stained by APAAP technique and using anti-platelet membrane glycoprotein Ⅱb-Ⅲa (CD41a) monoclonal antibody.The SMK of each marrow smear were counted and classified according to morphologic characteristic. Results:Compared with Wright’s staining, APAAP staining of SMK in all bone marrow smears had a significant difference(P<0.01). The positive rate in turn of SMK of every disease group was MDS>ITP>ET>MgA>Metastatic carcinoma in bone marrow>The platelet production of megakaryocytes is lack>MF>mixed anemia>secondary anemia> HA>IDA. There was a significant difference in the type of SMK among the group of MDS,MgA and ITP(P<0.05). Conclusion:APAAP staining is contributed to identify SMK. Variety of the quantities and types will provide a reliable evidence for differential diagnosis of anemias and MDS.
出处
《江苏大学学报（医学版）》
CAS
2005年第2期142-144,共3页
Journal of Jiangsu University：Medicine Edition
