摘要
目的探讨病毒性肝炎血小板减少症的发病机制。方法对41例病毒性肝炎并血小板减少症患者,23例病毒性肝炎血小板正常患者和10例对照者进行骨髓穿刺和骨髓细胞学检查。结果74例研究对象骨髓象结果显示骨髓有核细胞增生活跃者67例(90.54%),骨髓有核细胞增生低下者4例(5.41%),系粒系、红系及巨核细胞系均增生低下,且均为病毒性肝炎并血小板减少症患者。全片巨核细胞数正常者46例(62.16%),全片巨核细胞数<7个有23例(31.08%),全片巨核细胞数≤3个有10例,均为病毒性肝炎并血小板减少症患者。41例病毒性肝炎并血小板减少症患者骨髓巨核细胞内胞浆颗粒减少9例,核内、胞浆内空泡变性19例,胞浆内可见圆形或椭圆形嗜酸性包涵体3例,病毒性肝炎血小板正常患者和对照者无1例有上述改变。结论初步发现部分病毒性肝炎患者有骨髓抑制现象,这可能成为引起病毒性肝炎血小板减少的因素之一。
Objective:To explore the pathogenesis of thrombocytopenia in viral hepatitis.Methods:The bone marrow punctures and bone marrow cell tests were carried out in41viral hepatitis with thrombocytope-nia,23viral hepatitis with normal platelet count and10controls.Results:In myelogram of74subjects,the active proliferation of bone marrow baryocyte was observed in67subjects(90.54%),while the hypoplasia of bone marrow baryocyte was observed in4subjects(5.41%)which showed the hypoplasia of erythrocytic series,granulocyte series and megakaryocytic series.The4subjects of hypoplasia of bone marrow baryocyte were patients with thrombocytopenia in viral hepatitis.The normal megakaryocyte count was observed in46subjects(62.16%),and megakaryocyte count<7was observed in23subjects(31.08%),but the megakaryocyte count≤3was observed in10subjects with thrombocytopenia in viral hepatitis.There were9patients with decrease of megakaryocyte intracytoplasmic granule,19patients with intranuclear and intracytoplasmic vacuolar degener-ation,and3patients with intracytoplasmic circular or oval eosinophilic inclusion in41viral hepatitis withthrombocytopenia.But The above changes in23viral hepatitis with normal platelet count and10controls could be found in no case.Conclusions:The preliminary study indicates that some patients in chronic liver disease has bone marrow depression,which may become one factor inducing thrombocytopenia in the viral hepatitis.
出处
《中国现代医学杂志》
CAS
CSCD
2004年第11期106-108,111,共4页
China Journal of Modern Medicine
基金
湖南省卫生厅科研基金资助项目(编号:2001-Y14)
关键词
病毒性肝炎
血小板减少
骨髓抑制
viral hepatitis
thrombocytopenia
bone marrow depression
