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目的:探讨骨髓增生异常综合征RA型(MDS-RA)的血液、骨髓涂片、骨髓病理组织学等的改变,为其疑难病例提供诊断价值。方法:将近几年的MDS资料中筛选MDS-RA被诊断时的资料,进行相关指标统计分析。结果:外周血:以二系或三系减少者为多见;49%的患者可见幼红细胞,44%的患者可见白细胞异常改变;骨髓涂片:以增生活跃和增生低下多见,病态造血者占83%(66/79)例,骨髓病理:以增生活跃为多见;粒系前体细胞增多者32例(41%),可见或偶见“幼稚前体细胞异常定位”(ALIP)者56例(71%);幼红细胞发育滞停,可见原红细胞岛、同一发育阶段的幼红细胞岛占58(73%)例,有异型巨核细胞者56(71%)例,纤维组织增多占72(91%)。结论:骨髓活组织检查对MDS-RA必不可少的联合诊断方法。
Objective: To investigate the changes of blood, bone marrow smear, histopathology and histopathology of myelodysplastic syndrome type MD (MDS-RA) and provide the diagnostic value for its difficult cases. Methods: MDS data in recent years were screened MDS-RA data, the relevant indicators of statistical analysis. RESULTS: Peripheral blood was more common in patients with secondary or tertiary degeneration; in 49% of patients, erythrocytes were visible and in 44% of patients, abnormal changes in leukocytes were seen; in bone marrow smears: active hyperplasia and hyperplasia were more common in those with pathological hematopoiesis Accounting for 83% (66/79) cases. Myelopathies were more common in hyperplasia; 32 cases (41%) had increased myelomonocytic precursors, with or “occasional” abnormalities of ALIP ) Were 56 (71%). The development of erythrocytes was stasis. The number of erythrocyte island in the same developmental stage was 58 (73%) in the same developmental stage, and 56 (71%) was shaped megakaryocyte. The number of fibrous tissues was increased Accounting for 72 (91%). CONCLUSION: Bone marrow biopsy is an essential diagnostic method for MDS-RA.