骨髓涂片联合骨髓活检在骨髓增生异常综合征诊断中的临床意义

目的：探讨骨髓涂片联合骨髓活检在骨髓增生异常综合征（ MDS）诊断中的临床意义。方法采用骨髓抽吸、染色对58例MDS进行骨髓穿刺涂片及骨髓活检切片检查。结果骨髓活检中的细胞增生程度显著高于骨髓涂片的核细胞增生程度，骨髓涂片中原始细胞的发现比例显著优于骨髓活检，P＜0.05；粒系病态造血骨髓涂片与骨髓活检切片的发现比例分别为（46.6％与67.2％），红系病态造血发现比例分别为（79.3％与53.4％），巨核系病态造血发现比例分别为（39.7％与69.0％），两两比较，均P＜0.05；58例MDS患者骨髓活检的结果幼稚前体细胞异常定位（ALIP）39例，占比67.2％，单圆核病态造血28例，占比48.3％，多圆核病态造血32例，占比55.2％，网状纤维染色阳性患者26例，占比44.8％，骨髓呈现纤维化15例，占比25.9％，铁染色呈现阳性患者34例，占比58.6％。结论骨髓涂片与骨髓活检在诊断MDS中各有优缺点，通过两者的联合诊断可有效发现巨核系列的病态造血，对于提升诊断的准确性有重要的作用。

Clinical Significance of Bone Marrow Smear Joint Bone Marrow Biopsy in Diagnosis of Myeloproliferative Abnormalities Syn-drome

Objective To explore the value of bone marrow smear joint bone marrow biopsy in diagnosis of myeloproliferative abnormalities syndrome.Methods Through bone marrow aspirate and dye , 58 cases with myelodysplastic syndrome （ MDS） were checked by bone marrow needle smear and bone marrow biopsy.Results The degree of cell proliferation in bone marrow biopsy was significantly higher than bone marrow smears nuclear proliferation.The proportion of original cells in the bone marrow smears was significantly higher than bone marrow biopsy , P〈0.05.The myeloid dysplasia of bone marrow smears and bone marrow biopsy rate was 46.6%vs 67.2%, the proportion of Erythroid dysplasia of bone marrow smears and bone marrow biopsy rate was 79.3% vs 53.4%, Megakaryocytic dysplasia of bone marrow smears and bone marrow biopsy rate was 39.7%vs 69.0%, P〈0.05.The number of ALIP was 39（67.2%） cases, a single round of nuclear dysplasia was 28（48.3%） cases, more round of nuclear dysplasia was 32（55.2%） cases, reticular fiber staining was 26 （44.8%） cases, and iron staining positive was 34（58.6%） cases.Conclusion There are some advantages and disadvantages of marrow smears and bone marrow biopsy in the diagnosis of MDS.Megakaryocytes series dysplasia can be effectively found through joint diagnosis , and it has an important role for enhancing the accuracy of the diagnosis.