难治性贫血与巨幼细胞性贫血的临床鉴别与诊断

目的]观察骨髓增生异常综合征难治性贫血(MDS-RA)和巨幼细胞性贫血(MA)的临床特点、血液学特征和细胞形态学特征,提高其诊断与鉴别诊断水平。方法]回顾性分析22例MDS-RA与36例MA患者的临床特点、血象和骨髓象。结果]RA与MA血象均表现不同程度的血细胞减少;RA骨髓象中红系以中晚幼红细胞增生为主,MA骨髓象中红系以巨早、中幼红细胞为主;RA病态造血表现比MA明显,骨髓象除巨幼样变外,还有形态的异常,以淋巴样小巨核细胞最具有诊断意义。MA三系血细胞的巨幼变程度比RA明显,分多个小核的巨核细胞是MA的形态学特征。结论]MDS-RA与MA的临床表现、血液学及细胞形态学既具有相似性,又具有各自不同特征,需要综合分析进行治疗性诊断,以免误诊。

CLINICAL DIFFERENTIAL DIAGNOSIS OF MMYELODYSPLASTIC SYNDROME REFRACTORY ANEMIA AND MEGALOBLASTIC ANEMIA

Objective]To observe the clinical features,hematological features and cell morphological features of Mmyelodysplastic syndrome refractory anemia(MDS-RA)and Megaloblastic anemia(MA),and to improve the diagnosis and differential diagnosis.Methods]A retrospectively analysis was taken to analyze the the clinical features,hematological features and cell morphological features of 22 patients with MA and 36 patients with RA.Results]The blood cells counts of RA and MA showed different degrees of reduction.Late e...