摘要
目的 :探讨骨髓增生异常综合征的难治性贫血 (MDS的 RA)与慢性再生障碍性贫血 (CAA)临床表现和血液学改变的鉴别。方法 :对 10 6例 MDS的 RA(MDS组 )和 142例 CAA(AA组 )住院患者的初诊资料进行回顾性比较研究。结果 :MDS组患者的发病年龄和体检有肝、脾、淋巴结肿大的病例高于 AA组 (P<0 .0 0 5 ;P=0 .0 0 0 )。骨髓涂片检查表现为二系以上造血细胞 DNA复制紊乱的病态造血 ;骨髓增生活跃以上的病例高于 AA组 ,P<0 .0 0 5。MDS组中性粒细胞碱性磷酸酶 (NAP)积分降低、有核红细胞糖原染色 (PAS)阳性的病例均高于 AA组 ,P均等于 0 .0 0 0 0。骨髓病理检查 MDS组的造血细胞容积和网硬蛋白纤维阳性的病例均高于 AA组 (P<0 .0 0 5 ;P=0 .0 0 0 )。骨髓粒—单祖细胞 (GM- CFU)培养集落、集丛、丛 /落比和急性非淋巴细胞白血病祖细胞 (L-CFU)培养集落数均高于 AA组 ,P均 <0 .0 0 1。结论 :骨髓涂片和骨髓病理检查以及骨髓 GM- CFU和 L- CFU培养是鉴别 MDS的 RA与
Objective:To explore the identification of clinical manifestations and hematologic changes between myelodysplastic syndrome refractory anemia (MDS-RA) and chronic aplastic anemia (CAA).Methods:The diagnostic data of 106 cases of MDS-RA(MDS group) and 142 cases of CAA(CAA group) were compared retrospectively.Results:Both the average mean age at onset and cases of hepatomegaly,splenomegaly,lymphadenovarix in MDS group are higher than those in CAA group(P<0.005;P=0.000).Bone marrow smears of MDS-RA patients show morbid hematopoiesis of above two lineages of hematopoietic cells for DNA copying confusion.Data of myeloid hyperplasia,neutrophil alkaline phosphatase(NAP) reduction ,erythroblast periodic acid-shiffs reaction (PAS) positive in MDS group are higher than that of AA group.respectively,(P<0.005;P=0.000;P=0.000).Bone marrow biopsy shows that the percentage of hematopoietic tissue volume and cases of reticulin fibres positive are higher in MDS group than those in AA group.respectively,(P<0.005;P=0.000).The colonies,clumps,and clump/colony of bone marrow GM-CFU,and the colonies of acute non-lymphocytic leukemia CFU(L-CFU) are higher in MDS group than those in AA group.respectively,P<0.001;P<0.001;P<0.001;P<0.001)Conclusion:Bone marrow smear,bone marrow biopsy,the culture of GM-CFU and L-CFU are significant laboratory tests in distinguishing MDS-RA from CAA.
出处
《白血病．淋巴瘤》
CAS
2001年第2期89-91,共3页
Journal of Leukemia & Lymphoma
