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1.
目的探讨骨髓细胞形态学检查在全血细胞减少症(PCP)患者中的临床应用,以期为PCP患者治疗提供重要依据。方法对云南省普洱市镇沅县人民医院内科在2014年1月至2017年6月送检的88份患者的骨髓涂片标本进行细胞形态学检查,结合临床表现对PCP病因进行诊断。结果 88例患者骨髓细胞形态学检查显示,造成PCP的病因中,造血系统疾病63例(占71.59%),其中再生障碍性贫血33例(37.50%)、骨髓增生异常综合征9例(10.23%)、急性白血病8例(9.09%)、溶血性贫血5例(5.68%)、多发性骨髓瘤2例(2.27%)、缺铁性贫血6例(6.82%);非造血系统疾病23例(占26.14%),其中急慢性肝病14例(15.91%)、恶性肿瘤骨转移4例(4.55%)、感染性疾病5例(5.68%);另外有2例不能确诊;确诊率为97.73%。结论对于PCP患者,除了要考虑造血系统所致的疾病,非造血系统疾病引起的全血细胞减少也应引起临床重视。应用骨髓细胞形态学诊断方法具有快速准确和简便的优点,能明确全血细胞减少病因,协助临床疾病的诊断、疗效观察和预后估计,值得临床推广应用。  相似文献   

2.
刘丽  胡小平 《中国误诊学杂志》2011,11(34):8472-8472
目的探讨外周血白细胞、红细胞和血小板三系同时减少时的骨髓变化及常见病因。方法对168例全血细胞减少症患者的骨髓检查及诊断资料进行回顾分析。结果 134例全血细胞减少的病因以血液系统疾病为主,占79.8%,其中常见的有再生障碍性贫血占39.5%,骨髓增生异常综合征占17.9%,急性白血病占16.4%。非血液系统疾病34例,占20.2%,其中急慢性肝病11例,重度感染8例,结缔组织8例等。7例儿童全血细胞减少症,其中急性白血病3例,再生障碍性贫血2例,重度感染1例,肝病1例。结论全血细胞减少最常见的病因是造血系统疾病,因此骨髓细胞形态学检查是全血细胞减少症病因诊断的主要手段,部分非造血系统疾病的诊断需结合临床。  相似文献   

3.
目的探讨骨髓细胞学检查在全血细胞减少性疾病中的鉴别诊断价值。方法选取2013年10月至2014年12月100例全血细胞减少症患者为研究对象,入选患者均进行骨髓细胞学的检查,观察骨髓的形态、细胞分布和骨髓增生情况。结果 100例患者中,有74例(74.0%)由于造血系统疾病引发,其中恶性血液病有:急性白血病15例,再生障碍性贫血21例,多发性骨髓瘤4例,骨髓增生异常综合征9例。由非造血系统疾病引发的患者有26例(26.0%),其中骨髓增生明显活跃或活跃为主占78.0%,骨髓增生减低者占22.0%。结论全血细胞减少性疾病病因复杂、病种繁多,骨髓细胞学检查能明确显示骨髓的形态及增生情况,对全血细胞减少性疾病有较高的鉴别诊断价值。  相似文献   

4.
目的探究骨髓细胞学检查在全血细胞减少症病因诊断中的应用价值。方法回顾性分析河北省第七人民医院及河北医科大学第二医院2016年12月至2018年12月收治的200例全血细胞减少症患者的临床资料,所有患者均行血常规检查及骨髓细胞学检查,比较不同病因患者骨髓细胞学表现。结果200例患者均明确诊断,因造血系统疾病引起的全血细胞减少192例(96.00%),以再生障碍性贫血、骨髓增生异常综合征、急性早幼粒细胞白血病为主;非造血系统疾病引起全血细胞减少8例(4.00%)。造血系统疾病患者白细胞计数、血小板及血红蛋白水平均显著低于非造血性疾病(P<0.05);造血系统疾病引起的全血细胞减少骨髓象表现为骨髓增生减低或活跃,骨髓形态学多见异常;非造血系统疾病引起全血细胞减少骨髓象特征为骨髓增生活跃,但巨核系细胞无特殊变化,部分骨髓细胞形态呈感染骨髓象特征。结论全血细胞减少疾病病种繁多,主要以造血系统疾病为主,不同病因疾病骨髓细胞学表现存在一定差异,临床需密切结合临床资料及相应的检查进行综合分析,减少疾病的误诊及漏诊。  相似文献   

5.
目的探讨外周血白细胞、红细胞和血小板三系同时减少时的骨髓变化及其常见病因。方法对156例全血细胞减少症患者的临床资料进行回顾性分析。结果 146例成人全血细胞减少的病因以血液系统疾病为主,占83.6%(122/146),其中排在前三位的急性白血病占31.5%(46/146),骨髓增殖异常综合征15.1%(22/146),淋巴瘤10.9%(16/146);非血液系统疾病占16.4%(24/146),其中排在前三位的结缔组织疾病占3.4%(5/146),脾功能亢进占3.4%(5/146),慢性肝病占2.7%(4/146)。10例儿童全血细胞减少,其中急性白血病占6例,再生障碍性贫血占4例。结论全血细胞减少最常见的病因是急性白血病,因此加强对外周血细胞形态学的认识对于三系减少时白血病的初期诊断非常重要。  相似文献   

6.
目的 :探讨骨髓活检与骨髓涂片同步检查对全血细胞减少症病因诊断及骨髓增生程度的意义。方法 :对 2 5 5例首诊全血细胞减少症的住院病人 ,同步做骨髓活检及骨髓涂片 ,行骨髓病理和骨髓细胞形态学检查。结果 :造血系统疾病 196例占 0 77,非造血系统疾病 5 9例占 0 2 3。骨髓切片与涂片增生度相同者 92例 ;骨髓切片增生程度大于骨髓涂片 133例 ( 0 5 2 ) ,骨髓切片增生程度小于骨髓涂片 30例 ( 0 2 8) ;骨髓涂片增生减低和重度减低者 ,骨髓切片显示增生明显活跃和极度活跃有 38例 ( 0 15 )。骨髓切片与骨髓增生程度比较差异有极显著意义 ,P <0 0 1。结论 :骨髓活检对骨髓增生程度的判断优于骨髓涂片 ;骨髓活检与骨髓涂片同步检查有利于提高全血细胞减少症的诊断正确率  相似文献   

7.
目的分析骨髓细胞形态学检查在贫血疾病中所起的作用,了解2007年至2013年7年间贫血疾病的形态学特征对诊断的临床应用价值。方法回顾性分析,对2007年至2013年7年间457例攀钢集团总医院贫血待诊患者进行骨髓穿刺,常规涂片,瑞-姬染色和骨髓铁染色,显微镜油镜下观察细胞形态和铁染色结果,并结合临床,统计分析2007年至2013年间贫血患者的骨髓形态学特征。结果缺铁性贫血、白血病性及骨髓增生异常综合征(MDS)贫血和巨幼细胞性贫血为主要贫血,其中缺铁性贫血占128例(28%),增生性贫血91例(20%),白血病及MDS贫血占82例(18%),巨幼细胞性贫血占64例(14%),感染性贫血29例(6%),其他为描述性诊断骨髓象、骨髓坏死及骨髓转移癌等。结论骨髓细胞形态学检查对查找贫血病因起着重要作用,有助于临床进行针对性治疗。  相似文献   

8.
目的探讨贫血患者的细胞形态学分析在疾病诊断中的应用价值。方法对160例初诊为贫血的患者骨髓和外周血进行细胞形态学检查与组化染色,对疾病做出诊断。结果 160例患者中,造血系统良性疾病共111例,占69.4%,其中缺铁性贫血(IDA)最常见;造血系统恶性疾病37例,占23.1%,最多的是骨髓增生异常综合症(MDS);非造血系统疾病占7.5%。结论外周血及骨髓细胞形态检查是诊断贫血病因最基本也是最重要的方法 ,对血液系统疾病的诊断以及鉴别诊断具有非常重要的价值。  相似文献   

9.
全血细胞减少371例病因分析   总被引:5,自引:0,他引:5  
目的分析引起全血细胞减少的病因,了解全血细胞减少症在各种疾病中的分布,以提高诊断的准确率。方法对371例初诊时全血细胞减少患者的临床资料进行回顾性分析。结果371例患者中,引起全血细胞减少的原因主要为造血系统疾病,共274例(73.9%),其中以再生障碍性贫血最多见,共92例(24.8%);余依次为骨髓增生异常综合征57例(15.4%),其中MDS-RA33例、MDS-RAS3例、MDS-RAEB16例、MDS-RAEB-T5例;急性白血病39例(10.5%),其中急性早幼粒细胞白血病20例;巨幼细胞性贫血22例(5.92%);溶血性贫血16例(4.31%),其中阵发性睡眠性血红蛋白尿9例,自身免疫性溶血性贫血7例;多发性骨髓瘤13例(3.50%);脾功能亢进8例(2.16%);特发性血小板减少性紫癜7例(1.89%);缺铁性贫血6例(1.62%);恶性组织细胞病5例(1.35%);噬血细胞综合征4例(1.08%);淋巴瘤3例(0.81%);原发性骨髓纤维化2例(0.54%)。非造血系统疾病引起的全血细胞减少共97例(26.1%),依次为急、慢性肝病37例(9.97%),感染性疾病22例(5.93%),恶性肿瘤15例(4.04%),其中癌细胞骨髓浸润8例,结缔组织病9例(2.43%),肾脏疾病4例(1.08%),甲状腺机能亢进3例(0.81%),未明原因者7例(1.89%)。结论引起全血细胞减少的原因主要为造血系统疾病,对于全血细胞减少的患者必须进行全面详细的检查,才能提高诊断的准确率。  相似文献   

10.
目的探讨引起大细胞性贫血的病因及骨髓细胞形态学在其诊断中的价值。方法对121例大细胞性贫血患者的临床资料进行回顾性分析。结果一系减少,溶血性贫血(83.3%)明显高于巨幼细胞性贫血(2.2%)、骨髓增生异常综合征(14.3%)、急性髓系白血病(18.2%),差异有统计学意义(P〈0.05)。三系减少发生率依次为巨幼细胞性贫血(88.9%)、骨髓增生异常综合征(77.1%)、急性髓系白血病(63.6%)、溶血性贫血(6.7%),差异有统计学意义(P〈0.05)。结论骨髓细胞形态学检查可观察骨髓细胞发育异常形态学表现,对大细胞性贫血的诊断及鉴别诊断具有重要的临床价值。  相似文献   

11.

Background

Valproic acid is associated with a variety of hematologic abnormalities, most commonly thrombocytopenia. Pancytopenia is much less common and potentially much more serious. Little is known about the natural course of valproate-induced pancytopenia.

Case summary

We present a patient who developed pancytopenia while taking valproic acid for bipolar illness. After failing to respond to several other mood stabilizers, valproic acid was cautiously reintroduced with close hematologic monitoring. The pancytopenia has not recurred in the past 6 months.

Conclusions

Pancytopenia may not represent an absolute contraindication to continuing valproate therapy, although caution is warranted.  相似文献   

12.
We report a sensitive and selective localized surface plasmon resonance (LSPR) nanoprobe for the detection of mercuric ions (Hg2+) using gold/silver core–shell nanorods as an optical nanosubstrate. Sulfide can quickly react with silver atoms to generate Ag2S at room temperature in the presence of oxygen. The transformation from Ag shell to Ag2S on the nanorod surface results in its LSPR absorption band shifting to a longer wavelength, which is attributed to their different refractive indices. Interestingly, the morphology also changed from a rod-like to dumbbell shape. However, in the presence of Hg2+, this morphology transformation is inhibited because the sulfide reacts with free Hg2+ prior to the Ag atoms. The amount of Ag2S reduced with the increasing concentration of Hg2+, and the absorption band shift was also decreased. According to this “rod-like to dumbbell or not” shape change, a sensitive and selective LSPR nanoprobe was established, assisted by UV-Vis absorption spectroscopy. The detection limit of this probe for Hg2+ was as low as 13 nM. The efficiency of this probe in complex samples was evaluated by the detection of Hg2+ in spiked water samples.

Sensitive plasmonic nanoprobes for the sensitive detection of mercury ions based on a “rod-like to dumbbell or not” morphology transition of the Au/Ag core–shell hybrid nanorods.  相似文献   

13.
背景:一氧化氮在脑缺血损伤中起着很重要的作用,而高压氧能改善缺血再灌注引起的神经损伤,高压氧的这种作用与一氧化氮是否有关联?其机制有待探讨。目的:观察一氧化氮合酶阳性细胞在大鼠急性局灶性脑缺血再灌注损伤和高压氧治疗后表达的变化。设计:随机对照动物实验。单位:解放军第四军医大学唐都医院急诊科;西安高新医院检验中心;解放军空军总医院。材料:取健康SD雄性大鼠66只,随机分为5组:假手术组5只,假手术 高压氧组5只,模型组28只,模型 高压氧组28只,后2组又分缺血后5,12,24,72h4个时间点,每个时间点7只。方法:①造模:模型组和模型 高压氧组大鼠参照Koizum方法制备大脑中动脉缺血模型,并于插入栓子造成缺血1h后抽出栓子。其他2组手术,但不插入栓子。②高压氧治疗:假手术 高压氧组和模型 高压氧组大鼠分别在缺血后2,9,21,45,69h共5次将动物置于高压氧舱内,给予高压氧(0.25MPa绝对压)治疗1h。主要观察指标:各组于相应时间点处死取脑,黄递酶-NADPH组织化学方法观察一氧化氮合酶阳性细胞在视交叉平面梗死区皮质、视前区、纹状体外侧区和纹状体内侧区域分布及形态的变化。结果:经补充后66只大鼠进入结果分析。①缺血后一氧化氮合酶阳性细胞发生形态改变,主要变化为突起减少或消失,细胞由椭圆形、三角形变成圆形,细胞皱缩,胞体着色重,胞核和胞浆均染成深蓝色;形态改变的一氧化氮合酶阳性细胞在纹状体外侧区最多,其次是视前区和纹状体内侧区,而皮质区较少。假手术组和假手术 高压氧组未见有形态改变的一氧化氮合酶阳性细胞。②模型组脑内形态有改变的一氧化氮合酶阳性细胞表达随缺血再灌注时间延长而增多,模型 高压氧组各时间点在皮质、视前区和纹状体内侧区其表达均比模型组少,但都于缺血后72h至高峰[皮质:(15.46±3.02),(30.52±4.73)个/视野;视前区:(28.56±4.05),(68.81±7.84)个/视野;纹状体内侧区:(21.09±3.83),(45.71±5.24)个/视野;P均<0.01]。结论:高压氧可明显抑制大鼠急性局灶性脑缺血再灌注损伤区一氧化氮合酶阳性细胞的变性,部位主要在皮质、视前区和纹状体内侧区。  相似文献   

14.
The development of new technologies for securing and recycling water resources are in high demand. A key focus of these technologies is the development of various ion exchangers or adsorbents that are used for the purification of aqueous solutions. Layered sodium titanate is one of the cation exchangers utilised in the removal of heavy metals and radionuclides from wastewater. To enhance the removal efficiency, the precise design of the crystal morphology, structure, and chemical composition is important. Herein, we synthesised a unique seaweed-like sodium titanate mat (SST) using a template-free alkaline hydrothermal process. The Co2+ sorption capacity of SST was investigated by batch testing with cobalt(ii) nitrate. SST, which was synthesised from titanium sulphate in a 10 M NaOH solution at 200 °C, had a seaweed-like structure composed of randomly distributed nanofibres of layered sodium titanate that is approximately 9 nm in diameter. The crystal shape changed from roundish crystals to fibrous crystals as the hydrothermal reaction period increased. The Co2+ sorption isotherm of SST was fitted with the Langmuir isotherm model and the maximum sorption density was 1.85 mmol g−1. The selectivity of the Co2+ sorption on SST was high in comparison to that of Ca2+ and Mg2+. Herein, the Co2+ sorption mechanisms of SST were studied in comparison with commercially available sodium titanate. Results show that controlling the crystal morphology, structure, and Na concentration of the layered titanate that can be ion-exchanged determines the cation sorption properties of sodium titanate.

The seaweed-like sodium titanate mat has a high Co2+ sorption capacity via the ion-exchange reaction due to its crystal structure, low crystallinity, and morphology.  相似文献   

15.
The effect of hexadecyltrimethylammonium bromide (CTAB) addition on the crystal structure, morphology, and magnetic properties of co-precipitated hexagonal barium ferrite was investigated. For a fixed amount of surfactant, different Fe3+ concentrations and Fe3+/Ba2+ ratios were used to optimize the formation of single-phase barium ferrite particles. The results indicated that the obtained ferrite particles exhibited coercivity changes similar to those of superparamagnetic particles with larger than theoretically calculated particle sizes. This results from the softening of the material due to the size reduction of the grains and incorporation of excess barium, localized on the surface of the particles. Therefore, lowering the energy barrier required to reverse the magnetization was observed, while high magnetization saturation was preserved. The precipitation of barium ferrite particles from a surfactant-rich solution allowed control of BaFe12O19 magnetic properties without introducing any modifications inside the crystal structure.

Observed morphology evolution of BaFe12O19 ferrite particles, obtained with different relative amounts of surfactant used.  相似文献   

16.
目的 了解两性霉素B(AMB)、伊曲康唑(ICZ)、伏立康唑(VRC)和卡泊芬净(CBF)对72株丝状真菌的体外抗菌活性,指导临床合理应用抗真菌药物.方法 MIC检测采用美国临床和实验室标准协会(CLSI)制订的用于产丝孢状真菌的体外药敏方案(M38-P)和(M38-A).AMB、VRC、ICZ在单独用药时分别取100%、100%、≥80%的生长抑制为MIC值,CBF在单独用药时取明确改变真菌菌丝形态的最低浓度作为最小有效浓度.分数抑菌浓度(FIC)评价体外联合效果,FIC=MIC<,联合>/MICA单独+MIC联合/MICB单独.结果 AMB、ICZ、CBF、VRC对72株丝状真菌的MIC90分别为8、4、2、8 μg/ml,AMB+ICZ、AMB+VRC、ICZ+VRC联合用药MIC的范围分别为0.125~16.97、0.245 2~1.25、0.062 5~8.25μg/ml.AMB+VRC对丝状真菌产生协同作用为20.0%~88.9%,优于AMB+ICZ的10.0%~62.5%和ICZ+VRC的20.0%~44.4%(P=0.007<0.05).结论 72株丝状真菌对4种常用抗真菌药物的体外抗菌活性有差异,AMB+VRC优于AMB+ICZ与ICZ+VRC,同样可作为直症感染治疗的联合用药.  相似文献   

17.
BACKGROUND: In cardiac resynchronization therapy (CRT), the atrio-ventricular (AV) and interventricular (VV) intervals have to be optimized. For maximal optimization, the paced and sensed AV intervals have to be determined. We hypothesized that the morphology of the paced QRS complex at the optimal paced AV interval (PAV) can be used to determine the optimal sensed AV (SAV) interval in patients with normal AV conduction. PATIENTS AND METHODS: In 16 patients with implanted CRT devices, the optimal PAV and V-V interval were determined by invasive measurement of left ventricle (LV) dP/dt(max). A 12-lead electrocardiogram (ECG) was recorded at the optimum setting. Subsequently, during atrial sensing ventricular pacing, the SAV interval was changed until the QRS morphology was identical to the morphology at the optimal PAV interval. The optimal SAV interval was verified by repeated measurement of LV dP/dt(max). RESULTS: By optimization of the PAV and VV interval, the LV dP/dt(max) increased from 639 +/- 204 to 789 +/- 223 mmHg/s (+23%; P = 0.0000002). The optimized PAV was 149 +/- 19 ms; the optimized SAV was 100 +/- 20 ms and the corresponding LV dP/dt(max) at this interval was 774 +/- 204 ms (+21%; P = 0.000004). LV dP/dt(max) at optimized SAV - 20 ms and optimized SAV + 20 ms was 747 +/- 213 mmHg/s (P = 0.00004) and 751 +/- 203 mmHg/s (P = 0.0000003), respectively. The mean difference in optimized PAV and optimized SAV was 49 +/- 17 ms, ranging from 20 to 80 ms. CONCLUSIONS: The QRS morphology at optimized PAV can be used as a template to determine the optimal SAV, provided that the patient has normal AV conduction.  相似文献   

18.
目的评估流式细胞仪细胞免疫表型检测(FCI)在慢性粒单核细胞白血病(CMML)诊断和监测治疗反应中的临床价值和意义。方法采用多色FCI分析法和形态学观察法对109例CMML患者和39例随访患者的骨髓标本的免疫表型和形态学进行检测和评价,并对结果进行统计学分析。结果采用FCI测得骨髓单核细胞百分比为15%。与形态学分出的单核细胞百分比相关(r=0.35,P=0.000 3)。96%患者单核细胞FCI发生改变;FCI观察到的CMML粒细胞生成障碍为91.7%明显高于形态学方法测得的82.6%(χ~2=4.10,P0.05)。CMML患者FCI CD34+细胞测定结果为中位数0.7%(范围0.15%~11.60%),但其免疫表型改变非常显著改变个数的中位数为7(范围1~11个)。91%患者出现1阶段原始血细胞缺失或明显减少。39例随访患者中35例使用低甲基化剂(HMA)治疗和4例等待治疗患者的骨髓样品CD34+原始细胞均被检测到持续的免疫表型改变,对HMA治疗有应答的13例患者单核细胞CD14表达均正常;而40.9%(9/22)HMA治疗无应答者单核细胞CD14表达发生改变(P=0.030),4例接受造血干细胞移植治疗的患者免疫表型于移植后均正常。结论 CMML患者的CD34+细胞,单核细胞和粒细胞表现出多种FCI异常,FCI能够将恶性增生从反应性单核细胞增多中区分出来,同时也可用于监测CMML患者治疗反应。  相似文献   

19.
5-Ethoxymethylfurfural (EMF) has been identified as a potential biofuel and fuel additive, for which the production from glucose (the most abundant and inexpensive monosaccharide) in a one-step process would be highly desirable. Here, the synthesis of sulfonic acid-functionalized porous coordination polymers (PCPs) and their application as catalysts for EMF synthesis are reported. PCP(Cr)-BA (PCP material with Cr3+ ions and H2BDC-SO3H linkers) and PCP(Cr)-NA (PCP material with Cr3+ ions and H2NDC(SO3H)2 linkers) materials containing both Cr3+ sites and Brønsted-acidic –SO3H sites were prepared. The morphology, pore structure, acidity, chemical composition, and thermal stability of the two functionalized PCP(Cr) catalysts were analyzed by systematic characterization. The catalysts featured a porous morphology and dual Cr3+ and –SO3H sites, which enabled the cascade conversion of glucose to EMF. PCP(Cr)-BA exhibited higher performance than PCP(Cr)-NA with an EMF yield of 23.1% in the conversion of glucose at 140 °C after 22 h in an ethanol/water system. In addition, the as-prepared catalyst exhibited a high stability in the current catalytic system for EMF production from glucose with a constant catalytic activity in a four-run recycling test without an intermediate regeneration step.

The PCP(Cr)-BA catalysts featured porous morphology and dual Cr3+ and –SO3H sites, which enabled the cascade conversion of glucose to EMF. In addition, the as-prepared catalyst exhibited a high stability in the current catalytic system.  相似文献   

20.
In this work, various LiZnPO4:0.5 mol% Ln3+ (Ln = Ho, Er) phosphors with different Yb3+ ion doping concentrations were synthesized by a sol–gel/Pechini method. X-ray diffraction (XRD) and scanning electron microscope (SEM) techniques were used to evaluate the phase and morphology of the samples. The UC process was mentioned as the typical emission peaks of Er3+ and Ho3+. For Er3+ and Ho3+, different optical temperature sensing methods are included. The Boltzmann distribution was accompanied by the fluorescence intensity ratio (FIR) for the two green Er3+ emissions originating from thermally-coupled levels. The effect of pump power on sensor sensitivities was extensively studied. The temperature uncertainty is also evaluated. The red and green emissions generated from non-thermally-coupled levels were used for temperature sensing in the Ho3+-activated LiZnPO4. High sensitivities were obtained in the phosphors, and the LiZnPO4:Yb3+/Ho3+ showed the largest absolute sensitivities. LiZnPO4:Yb3+–Er3+/Ho3+ phosphors may be useful in the development of new luminescent materials for optical temperature sensing.

Novel orthophosphate LiZnPO4:Yb3+–Er3+/Ho3+ with tunable luminescence have been synthesized via sol–gel/Pechini method for optical thermometry.  相似文献   

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