同步对比骨髓活检与涂片在全血细胞减少症鉴别诊断中的作用

为了解骨髓涂片及活检在全血细胞减少症鉴别诊断中的地位及其对疗效判断的价值 ,分析了 71例在我院住院的全血细胞减少症病人 ,所有骨髓活检标本经处理后塑料包埋 ,切成 3μm厚切片 ,HGF染色。骨髓涂片经瑞氏染色后进行了常规检查。结果表明 :骨髓活检增生度高于涂片 (u =3.0 96 6 ,P <0 .0 5 ) ;误诊率 ( 4 .76 % )低于涂片 ( 35 .71% ) ( χ2 =7.0 791,P <0 .0 5 ) ;9例治疗好转的再生障碍性贫血 (AA) ,其骨髓活检恢复正常的时间平均比涂片正常时间早约 4周 ;而白血病的病人骨髓涂片提示缓解的时间要早于活检 ,多数第一次缓解的病人骨髓活检中仍可见到成堆或小片状分布的幼稚细胞。结论 :骨髓活检更能正确地反映骨髓组织的真实情况 ,在全血细胞减少症鉴别诊断、疗效判断方面的价值优于涂片

Evaluation of Bone Marrow Biopsy and Smear Examinations in Differential Diagnosis for Patients with Pancytopenia by Simultaneously Compartive Study

To simultaneously compare and evaluate the examinations of bone marrow smear and trephine biopsy in differential diagnosis and therapeutical effect of pancytopenia patients, the differences between bone marrow smear and trephine biopsy in degree of cellularity, misdiagnosis rate and therapeutical effect for 71 patients with pancytopenia were analyzed. The results showed that the degree of cellularity in bone marrow biopsy for cytologic morphology was higher than that from the smear, but misdiagnosis rate in the biopsy was lower than that in the smear. In conclusion, bone marrow biopsy is necessary to the diffrerential diagnosis and more valuable for evaluation of therapeutical effect and progrosis of pancytopenia patients.