|本期目录/Table of Contents|

[1]刘萨日娜.骨髓增生异常综合征与巨幼细胞性贫血形态学分析[J].慢性病学杂志,2020,21(04):501-505.
　LIUSa-rina.Morphological analysis of myelodysplastic syndrome and megaloblastic anemia[J].,2020,21(04):501-505.
点击复制

骨髓增生异常综合征与巨幼细胞性贫血形态学分析

《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:
21
期数:
2020年04期
页码:
501-505
栏目:
论　著
出版日期:
2020-04-28

文章信息/Info

Title:
Morphological analysis of myelodysplastic syndrome and megaloblastic anemia
作者:
刘萨日娜
内蒙古自治区人民医院临床医学研究中心，呼和浩特 010017
Author(s):
LIUSa-rina
DepartmentofClinical Medical ResearchCenter，InnerMongoliaPeople’sHospital，Hohhot010017,China Correspondingauthor:LIUSa-rina,E-mail:lsrn520@163.com
关键词:
骨髓增生异常综合征; 巨幼细胞性贫血; 形态学
Keywords:
Myelodysplastic syndrome;  Megaloblastic anemia;  Morphology
分类号:
R552
DOI:
-
摘要:
目的 分析骨髓增生异常综合征（MDS）和巨幼细胞性贫血（MA）在血常规、外周血及骨髓细胞形态 中的相似性与区别点。方法 回顾性分析2018年9月至2019年12月内蒙古自治区人民医院确诊的MDS22例 和MA28例，对比分析血常规检测、外周血形态分析及骨髓形态。结果 MDS组和MA组外周血血细胞减少 相比，差异无统计学意义（P>0.05）；平均红细胞体积（MCV）相比，差异有统计学意义（P<0.05）。MDS组 与MA组在外周血幼稚粒细胞、有核红细胞相比，差异无统计学意义（P>0.05）；MDS组与MA组在增生程 度、粒红二系巨幼样变、粒系分叶过多、红系花瓣核、核出芽、双核红、多核红（不包括奇数核）、嗜碱性点彩 红细胞以及Howell-Jolly小体、多圆核及多分叶巨核细胞等改变相比，差异无统计学意义（P>0.05）。MDS组与 MA组在核质发育不平衡、胞质颗粒较少或缺如、核分叶过少（假性Pelger-Huet畸形）、奇数核红细胞、原始细 胞比例、单圆核巨核细胞及小巨核细胞、尤其淋巴样小巨核等改变相比，差异有统计学意义（P<0.05）。结论 MDS和MA都表现外周血细胞减少、外周血及骨髓病态造血，相比之下MDS病态造血比MA更加显著，且有其 特征性表现包括原始细胞数量、假性Pelger-Huet畸形及淋巴样小巨核细胞等。MA形态主要表现在巨幼样改 变。掌握好这些特点有助于临床上对两种疾病进行鉴别与诊断。
Abstract:
Objective To analyze the similarities and differences of myelodysplastic syndrome（MDS）and megaloblastic anemia（MA）in blood routine, peripheral blood and bone marrow cell morphology. Methods Totally22 cases of MDS and 28 cases of MA diagnosed in Inner Mongolia People’s Hospi-tal from September 2018 to December 2019 were retrospectively analyzed, and blood routine examina-tion, peripheral blood morphology analysis and bone marrow morphology were compared. Results There was no statistically significant difference in peripheral blood hemocytopenia（P>0.05）, but the difference in mean red blood cell volume （MCV）was statistically significant between MDS group and MA group （P<0.05）. There was no statistically significant difference between the MDS group and the MA group in the peripheral blood of naive granulocytes and immature erythrocyte（P>0.05）. There was no statisti-cally significant difference between the MDS group and the MA group in the degree of proliferation, granulocyte-erythroid megaloblastic, hypersegmented granulocyte, petaline nucleus, nuclear budding, binu-clear red blood cell, polykaryocyte（excluding odd number nucleus red blood cell）, basophilic stippling erythrocytes and Howell-Jolly body, multinucleate megakaryocyte, multilobed megakaryocyte（P>0.05）. There were statistically significant differences between MDS group and the MA group in the development imbalance of granulocyte nucleus and cytoplasm, reduction or absence of intracellular granules, few nucle-ar lobes（pseudo Pelger-Huet anomaly）, odd number of nuclear red cells, proportion of primitive cells, mononuclear megakaryocytes and small megakaryocytes, especially lymphoid megakaryocytes, etc.（P<0.05）. Conclusion MDS and MA are all presented as peripheral blood cytopenia and abnormal periph-eral blood and bone marrow development. The dysplasia of MDS is more significant than that of MA. The significant characteristic of MDS are primitive cell number, pseudo Pelger-Huet deformity, and lym-phoid megakaryocytes. Megaloblastic changes is mainly found in MA. Mastering these above mentioned characteristics is helpful for clinical differentiation and diagnosis of the two diseases.

参考文献/References:

[1] 沈悌,赵永强.血液病诊断及疗效标准[M].4版.北京:科学出版社, 2018. [2] 肖志坚.骨髓增生异常综合征的诊断[J].诊断学理论与实践, 2016,15(6) :545-549. [3] Arber DA, Orazi A, Hasserjian R,et al. The 2016 revi-sion to the World Health Organization classification of my-eloid neoplasms and acute leukemia [J]. Blood, 2016,127 (20):2391-2405. [4] 胡然,梁艳丽.平均红细胞体积和红细胞体积变异系数在血液疾 病鉴别诊断中的意义[J].检验医学与临床,2012,9(10):1183-1185. [5] 黄锐,向伟,刘丽.巨幼细胞贫血与骨髓增生异常综合征鉴别浅析 [J].医学理论与实践,2019,32(14):2175-2177. [6] Rosangela I, Federica Q, Matteo GDP. Importance of classical morphology in the diagnosis of myelodysplastic syndrome [J]. Mediterr J Hematol Infect Dis, 2015,7(1): e2015035. [7] 钱小鸿,吴佳洛.骨髓增生异常综合征与巨幼细胞性贫血、再生障 碍性贫血的细胞形态学对比分析[J].中国卫生检验杂志,2019,29 (6):740-743. [8] 陈雷.特异性病态造血在骨髓增生异常综合征诊断中的应用价值 [J].现代医用影像学,2016,25(6):1035-1039.

备注/Memo

备注/Memo:
作者简介：刘萨日娜，硕士，主治医师，研究方向：血液系统疾病的外周血形态及骨髓形态分析 通信作者：刘萨日娜，E-mail：lsrn520@163.com
更新日期/Last Update: 2020-04-28