成人全血细胞减少150例临床剖析.docVIP

成人全血细胞减少150例临床剖析 　　【摘要】 目的：探讨成人全血细胞减少性疾病的病因及临床特点，外周血、骨髓涂片及骨髓活检的意义。方法：对初诊150例全血细胞减少患者予血细胞形态、骨髓、铁蛋白、叶酸、维生素B12测定等进行分析。结果：150例患者中血液系统疾病占73.3%，巨幼细胞性贫血占16.6%，骨髓增生异常综合征占15.3%，急性白血病占14.6%，再生障碍性贫血占12.6%，多发性骨髓瘤占2.7%，淋巴瘤占4.0%，阵发性睡眠性血红蛋白尿占1.3%，EVENS综合征占0.6%，缺铁性贫血占5.3%。非血液系统疾病占26.7%，其中风湿系统疾病12.0%，脾功能亢进6.6%，感染3.3%，内分泌疾病2.0%，药物性占1.3%，肿瘤骨髓转移占1.3%。血细胞形态可对近一半血液系统疾病初步诊断，骨髓检查进一步明确。结论：全血细胞减少病因复杂，多为血液系统疾病，血涂片结合骨髓检查对诊断全血细胞减少有重要意义。 　　【关键词】 全血细胞减少； 外周血涂片； 骨髓检查 　　中图分类号 R446 文献标识码 B 文章编号 1674-6805（2014）24-0107-03 　　Clinical Analysis of 150 Adult Patients with Pancytopenia/ZHAI Li-jia，MIN Feng-ling，ZHOU Wei，et al.//Chinese and Foreign Medical Research，2014，12（24）：107-109 　　【Abstract】 Objective：To probe the causes of pancytopenia in adults and their clinical characteristics， and the significance of peripheral blood， bone marrow smear and bone marrow biopsy as well.Method： In the article， 150 first-time patients with pancytopenia were analyzed for the determination of blood cell forms， bone marrow， ferritin， folic acid and vitamin B12.Result： Of the 150 relapsed cases， hematological systemic diseases account for 73.3%， including 16.6% with megaloblastic anemia， 14.6% with acute leukemia， 15.3% with myelodysplastic syndrome（MDS）， 12.6% with aplastic anemia， 2.7% with multiple myeloma， 4.0% with lymphoma， 1.3% with paroxysmal nocturnal hemoglobinuria（PHN）， 0.6% with EVENS syndrome， 5.3% with iron deficiency anemia， while non-blood systemic diseases account for 26.7%， including hypersplenism（6.6%）， infection（3.3%）， rheumatic disease（12.0%）， endocrine disease（2.0%）， drug-induced disease（1.3%） and tumors with bone marrow metastasis（1.3%）. Nearly half of the hematological systemic diseases can be diagnosed preliminarily through blood cell forms and bone marrow be further defined.Conclusion： There are many complicated causes to induce pancytopenia， most of which are from hematological systemic diseases. Blood smear with bone marrow examination has important significance for the diagnosis of pancy