【摘要】 目的探讨骨髓涂片和活检同步检查在全血细胞减少中的诊断价值,并对比分析不同年龄组引起全血细胞减少的疾病及发病情况。方法对345例全血细胞减少患者按年龄分组,采用骨髓穿刺涂片、骨髓活检同步取材,对比分析各组病例发病情况的不同。结果青壮年组引起全血细胞减少最常见的前三位疾病分别为再生障碍性贫血67例(36.0%),骨髓增生异常综合征30例(16.1%),急性白血病14例(7.5%);老年组最常见的前三位疾病分别为骨髓增生异常综合征22例(13.8%),巨幼细胞性贫血17例(10.6%),急性白血病16例(10.1%)。非造血系统疾病主要是肿瘤、肝炎、结核及各种其他感染、结缔组织病等。结论再生障碍性贫血引起的全血细胞减少青壮年组比老年组明显增多,巨幼细胞性贫血引起的全血细胞减少老年组比青壮年组明显增多。造血系统疾病发生全血细胞减少最多见,但也不能忽视非造血系统疾病对患者血象的影响。骨髓活检与骨髓穿刺两者结合更能反映骨髓细胞造血情况、及早确诊、指导临床治疗。更多还原

【Abstract】 Objective To comparatively analyze the different causes that lead to the pancytopenia in different age groups and discuss the diagnostic value of marrow aspirate and biopsy in pancytopenia. Methods Patients were divided into two groups according to age. Bone marrow biopsy and aspiration were simultaneously performmed in 345 clinical pancytopenia cases. The results of each group were analyzed under microscope. Results In young group,three top causes were 67 cases of aplastic anemia( 36%), 30 cases of myelodysplastic syndrome( 16. 1%),and 14 cases of acute leukemia( 7. 5%). In aged group,the most common cause was 22 cases of myelodysplastic syndrome( 13. 8%),followed by 17 cases of megaloblastic anemia( 10. 6%) and 16 cases of acute leukemia( 10. 0%). Non hematopoietic system diseases include tumors,hepatitis,tuberculosis and other infection diseases,connective tissue diseases,etc. Conclusion Pancytopenia caused by aplastic anemia in young group is significantly more than aged group,while megaloblastic anemia is more common in aged group. Hematopoietic system diseases are the common causes of pancytopenia,but other system disorders should also be taken into account. The combination of bone marrow smear and biopsy could elevate the diagnostic rate of the pancytopenia.更多还原