伴血细胞减少系统性红斑狼疮34例骨髓细胞形态学分析

摘要

目的 了解伴血细胞减少的系统性红斑狼疮(SLE)骨髓细胞形态学变化.方法 对34例外周血细胞减少的SLE患者(WBC<4×109/L, 或Hb<100 g/L, 或Pt<100×109/L)的骨髓涂片进行回顾性细胞形态学检查,并与26例特发性血小板减少性紫癜(ITP)、18例骨髓增生异常综合征的难治性贫血(MDS-RA)患者以及14例健康对照者综合分析.结果 34例SLE患者中24例(70.6%)骨髓发育不良,包括红系多核(三核或更多)10例(29.4%),巨幼样变8例(23.5%), Pelger-Hüet样畸形12例(35.3%),多核巨核细胞8例(23.5%),小型巨核细胞10例(29.4%). 结论在伴血细胞减少的SLE患者中能观察到骨髓多系细胞发育不良,这些改变说明骨髓可能是SLE侵犯的靶器官之一.%Objective To 1earn bone marrow morphocytology in systemic lupus erythematosus(SLE) patients with peripheral cytopenia.Methods The smears of bone marrow aspirates obtained from 34 SLE patients who had bone marrow aspiration due to peripheral cytopenia (WBC<4×109/L, or Hb<100 g/L, or platelet count<100×109/L) were examined retrospectively.And the smears of the bone marrow aspirates obtained from 14 healthy controls,18 patients with MDS (refractory anemia), and 26 patients with idiopathic thrombocytopenic purpura (ITP) were inserted randomly among those obtained from the SLE patients.Results Of the 34 SLE patients, 24(70.6%) had dysplasias, including: erythroid cell multinuclearity (trinuclear or more) 10(29.4%), megaloblastoid changes 8(23.5%), pseudo Pelger-Hüet abnormalities 12(35.3%),separated nuclear megakaryocytes 8(23.5%), and micromegakaryocytes 10(29.4%).Conclusion This study found that bone marrow dysplasia can be observed in all lineage cells of SLE patients, We conclude that the bone marrow may be a target organ in SLE with cytopenia.