慢性苯中毒患者34例骨髓象的临床观察

目的　通过对慢性苯中毒患者骨髓象分析,了解其临床类型特点。方法　按诊断标准对患者进行分组诊断,３４ 例患者均进行骨髓穿刺,选取材、涂片、染色好的骨髓片计数有核细胞２００ 个,进行分类并观察细胞形态。结果　除２ 例再生障碍性贫血（ 简称再障） 患者外,其他患者均表现骨髓增生活跃或明显活跃,但各组患者粒红比值均数低于正常值均数。骨髓增生异常综合征（ Ｍ Ｄ Ｓ） 患者骨髓中原粒和早幼粒细胞百分率高于正常,分别为５ ．０８ 和７ ．８５（ 正常参考值分别为０ ．６４ 和１ ．５９） ,粒细胞和红细胞有细胞形态异常和核畸形。结论　慢性苯中毒可以导致 Ｍ Ｄ Ｓ,慢性重度苯中毒患者 Ｍ Ｄ Ｓ 发病率高于再障,应考虑将骨髓象检查列为苯中毒诊断的必要项目。

The clinical analysis of bone marrow features of 34 patients with chronic benzene poisoning

Objective To learn the characteristics of clinical classification by analysis of the bone mar row( B M) sm ears of 34 patients with chronic benzene poisoning . Methods Bone marrow smears were exam ined and classified according to the diagnostic criteria . Eligible sm ears were selected to classify 200 nucleatedcells and to observe the cell m orphology . Results All cases showed active or obviously active proliferation ofthe bone marro w except two patients with aplastic anemia ,however ,the mean ratios of granulocytes to ery throcytes were lower than that in controls . The percentage of m yeloblasts and prom yelocytes of the patientswith myelodysplastic syndro me( M D S) increased when com pared with that of controls . Morphological changesincluding nuclear abnormalities were also observed in granulocytic and erythrocyticlines . Conclusion Chronicbenzene poisoning may resultin M D S. Of 34 patients ,m ore suffered fro m M D Sthan aplastic anemia . Examina tion of bone marrow should be considered as a necessary item in the diagnosis of benzene poisoning .