骨髓增生异常综合征难治性贫血与慢性再生障碍性贫血临床表现和血液学改变的比较研究

目的：探讨骨髓增生异常综合征的难治性贫血（MDS的RA）与慢性再生障碍性贫血（CAA）临床表现和血液学改变的鉴别，方法：对106例MDS的RA（MDS组）和142例CAA（AA组）住院患者的初诊资料进行回顾性比较研究，结果：MDS组患者的发病年龄和休检有肝，脾，淋巴结肿大的病例高于AA组（P＜0．005，P＝0．000），骨髓涂片检查表现为二系以上造血细胞DNA复制紊乱的病态造血，骨髓增生活跃以上的病例高于AA组，P＜0．005，MDS组中性粒细胞碱性磷酸酶（NAP）积分降低，有核红细胞糖原染色（PAS）阳性的病例均高于AA组，P均等于0．0000，骨髓病理检查MDS组的造血细胞容积和网硬蛋白纤维阳性的病例均高于AA组（P＜0．005，P＝0．000），骨髓粒一单祖细胞（GM－CFU）培养集落，集丛，丛／落比和急性非淋巴细胞白血病祖细胞（L－CFU）培养集落数均高于AA组，P均＜0．001，结论：骨髓涂片和骨髓病理检查以及骨髓GM－CFU和L－CFU培养是鉴别MDS的RA与CAA重要的实验室检查。

THE COMPARATIVE STUDY OF CLINICAL MANIFESTATIONS AND HEMATOLOGIC CHANGES IN MYELODYSPLASTIC SYNDROME REFRACTORY ANEMIA AND CHRONIC APLASTIC ANEMIA

Objective:To explore the identification of clinical manifestations and hematologic changes between myelodysplastic syndrome refractory anemia (MDS-RA) and chronic aplastic anemia (CAA).Methods:The diagnostic data of 106 cases of MDS-RA(MDS group) and 142 cases of CAA(CAA group) were compared retrospectively.Results:Both the average mean age at onset and cases of hepatomegaly,splenomegaly,lymphadenovarix in MDS group are higher than those in CAA group(P<0.005;P=0.000).Bone marrow smears of MDS-RA patients show morbid hematopoiesis of above two lineages of hematopoietic cells for DNA copying confusion.Data of myeloid hyperplasia,neutrophil alkaline phosphatase(NAP) reduction ,erythroblast periodic acid-shiffs reaction (PAS) positive in MDS group are higher than that of AA group.respectively,(P<0.005;P=0.000;P=0.000).Bone marrow biopsy shows that the percentage of hematopoietic tissue volume and cases of reticulin fibres positive are higher in MDS group than those in AA group.respectively,(P<0.005;P=0.000).The colonies,clumps,and clump/colony of bone marrow GM-CFU,and the colonies of acute non-lymphocytic leukemia CFU(L-CFU) are higher in MDS group than those in AA group.respectively,P<0.001;P<0.001;P<0.001;P<0.001)Conclusion:Bone marrow smear,bone marrow biopsy,the culture of GM-CFU and L-CFU are significant laboratory tests in distinguishing MDS-RA from CAA.