骨髓病理学、外周血涂片、骨髓细胞学联合检查在Hypo-MDS与再生障碍性贫血鉴别诊断中的应用效果

摘要

目的：探讨骨髓病理学、外周血涂片及骨髓细胞学联合检查在低增生性骨髓增生异常综合征（ Hypo -MD）与再生障碍性贫血（AA）中的鉴别诊断效果。方法回顾性分析2010年1月至2015年5月收治的29例 AA 患者（AA 组）、14例 Hypo - MD 患者（Hypo - MD 组）的骨髓病理学、外周血涂片、骨髓细胞学检查结果。结果 Hypo - MD组 PLT、Ret、RDW、MCV 水平及成熟红细胞形态异常比率均高于 AA 组（ P ﹤0.05）；Hypo - MD 组巨核系、粒系、红系三系细胞减少程度均低于 AA 组（ P ﹤0.05），Hypo - MD 组三系细胞形态异常比率均高于 AA 组（ P ﹤0.05）；Hypo - MD组小巨核细胞、核浆发育不平衡、原粒细胞﹥5℅、巨幼改变、成熟红细胞形态异常比率高于 AA 组（ P ﹤0.05）；Hypo -MD 组三系细胞形态异常比率均高于 AA 组（ P ﹤0.05）。结论骨髓病理学、外周血涂片及骨髓细胞学检查等实验室特点有助于 Hypo - MD 与 AA 的鉴别诊断，值得临床重视。%Objective To investigate the effect of bone marrow pathology,peripheral blood smear and bone marrow cytology in the differ-ential diagnosis of patients with low proliferative(Hypo - MD group)and aplastic anemia(AA group),and provide reference for clinical diagno-sis. To provide reference for clinical diagnosis. Methods From January 2010 to May 2015,29 patients with AA,14 patients with Hypo - MD, the results of bone marrow pathology,peripheral blood smear,bone marrow cytology test results were retrospectively analyzed. Results Hypo -MD PLT group,RET,RDW and MCV levels and mature red cell morphology abnormal rate were higher than that in AA group( P ﹤ 0. 05). Hypo- MD group of the megakaryocyte and myeloid,erythroid cells of the three line to reduce the degree were lower than those of AA group( P ﹤ 0. 05). Hypo - MD group the proportion of abnormal cell morphology were higher than those of AA group( P ﹤ 0. 05). Hypo - MD group small huge nucleus cell nucleus and cytoplasm of unbalanced development,raw granulocyte ﹥ 5℅ ,megaloblastic change,mature red blood cell morphol-ogy and the abnormal rate were higher than that of AA group( P ﹤ 0. 05). Hypo - MD group the proportion of abnormal cell morphology were higher than those of AA group( P ﹤ 0. 05). Conclusion The laboratory characteristics of bone marrow pathology,peripheral blood smear and bone marrow examination,etc. ,are helpful for the differential diagnosis between AA and Hypo - MD,it is worthy of clinical attention.