摘要
目的:分析儿童原发性免疫性血小板减少症(Primary Immune Thrombocytopenia, ITP)、再生障碍性贫血(Aplastic Anemia, AA)、急性B系淋巴细胞白血病(B-cell Acute Lymphoblastic Leukemia, B-ALL)的临床特点,探讨骨髓CD34^(+)、血清自身免疫抗体在ITP、AA、B-ALL中的临床诊断价值。方法:对ITP、AA、B-ALL的外周血细胞、血清自身免疫抗体进行比较分析;以同期就诊的长期发热和/或白细胞增高,最终排除血液病的患儿为对照组,分析比较骨髓CD34+的表达水平。结果:(1)ITP组外周血红蛋白、中性粒细胞计数大于AA组与B-ALL组;AA组血小板计数最低,其次为ITP组,B-ALL组最高;B-ALL组白细胞计数与淋巴细胞计数最高,AA组最低。(2)血清自身免疫抗体15项中抗SS-A/Ro60k D抗体、抗Ro/SS-A(52)抗体仅在ITP组有阳性表达。(3)B-ALL组骨髓CD34^(+)表达水平高于对照组、ITP组、AA组,AA组低于对照组,ITP组与对照组比较差异无统计学意义。结论:外周血细胞、血清自身免疫抗体、骨髓CD34^(+)表达水平可辅助ITP、AA与B-ALL的初步鉴别诊断,为进一步优化选择精准检查提供方向及转诊提供参考依据。
Objective:To analyze the clinical characteristics of primary immune thrombocytopenia(ITP),aplastic anemia(AA),and B-cell acute lymphoblastic leukemia(B-ALL)in children,and explore the clinical value of bone marrow CD34^(+) and serum autoimmune antibodies in the diagnosis of ITP,AA and B-ALL.Methods:The peripheral blood cells and serum autoimmune antibodies of ITP,AA,and B-ALL were analyzed comparatively.The expression levels of bone marrow CD34^(+) were analyzed and compared with that in children who had prolonged fever and/or white blood cells elevation and ultimately excluded hematological disorders at the same time.Results:(1)The peripheral hemoglobin and neutrophil counts in the ITP group were higher than those in the AA group and B-ALL group,The AA group had the lowest platelet count,followed by the ITP group,and the B-ALL group had the highest platelet count.the B-ALL group had the highest white blood cell and lymphocyte counts,while the AA group had the lowest.(2)Among the 15 serum autoimmune antibodies,SS-A/Ro60kD antibody and Ro/SS-A(52)antibody were only positively expressed in the ITP group.(3)The expression level of CD34^(+) in the bone marrow of the B-ALL group was higher than that of the control group,ITP group,and AA group,while the AA group was lower than that of the control group.There was no statistically significant difference between the ITP group and the control group.Conclusions:Peripheral blood cell count,serum autoimmune antibodies,and the percentage of bone marrow CD34^(+) in the total number of nuclear cells can assist in the preliminary differential diagnosis of ITP,AA,and B-ALL providing direction and reference for further optimization and selection of precise examinations.
作者
周文连
宁建英
ZHOU Wenlian;NING Jianying(Department of Pediatrics,the First Affiliated Hospital of Shihezi University,Shihezi,Xinjiang 832008,China)
出处
《农垦医学》
2025年第3期218-221,243,共5页
Journal of Nongken Medicine
