骨髓增生异常综合症骨髓细胞结构异常与贫血和粒细胞减少相关性研究

本研究旨在探索骨髓增生异常综合症患者贫血和外周血中性粒细胞减少与骨髓幼红细胞和中性幼粒细胞超微结构异常的相关性。采用全自动血细胞分析仪检测74例MDS患者贫血指标和中性粒细胞数,根据贫血程度和外周血中性粒细胞减少程度将MDS患者分别分为正常范围、轻度、中度和重度4组,用透射电子显微镜分析所有患者骨髓中性幼粒细胞和幼红细胞病态及凋亡细胞百分率。结果表明,74例MDS患者中68例贫血(92%),68例患者中51例外周血中性粒细胞减少(75%);电子显微镜下所有MDS患者骨髓幼红细胞和中性幼粒细胞不同程度结构异常;血红蛋白正常组和轻度、中度及重度贫血4组患者骨髓幼红细胞病态率分别为(37±14.7)%、(24±9)%、(32±16)%和(34±21)%,凋亡率分别为(2.25±1.03)%、(4.43±2.60)%、(8.78±4.04)%和(11.67±4.57)%,病态和凋亡率分别与血红蛋白及红细胞比容呈负相关(p<0.05);外周血中性粒细胞正常、轻度、中度和重度减少4组患者骨髓中性幼粒细胞凋亡率分别为(6.00±2.67)%、(9.50±4.42)%、(13.00±3.54)%和(17.00±2.39)%,与外周血中性粒细胞呈负相关(p<0.01);骨髓中性幼粒细胞病态率分别为(12.25±16.31)%、(13.5±10.01)%、(23±8.59)%和(51.67±19.67)%,病态率与凋亡率呈正相关(p<0.01)。结论:MDS患者骨髓幼红细胞和中性幼粒细胞的凋亡和病态发育与贫血、外周血中性粒细胞减少相关,二者可能是MDS无效造血重要成因。

Correlation between Ultrastructural Abnormality of Bone Marrow Cells and Anemia and Neutropenia in Myelodysplastic Syndrome

The aim of study was to investigate the relationship of anemia and neutropenia with ultrastructural abnormalities of erythroblasts and young neutrophils in bone marrow of patients with myelodysplastic syndrome(MDS).Anemia parameters and peripheral neutrophil amount of 74 patients with MDS were measured by automatic hemocyte analyzer.According to Hb value and neutropenia degree,MDS patients were divided into 4 groups: normal,mild,middle and severe anemia or neutropenia.The morbid rate and apoptosis rate of e...