CAJ | 학술논문

目的探讨细菌和真菌感染患者骨髓巨核细胞的形态学改变.方法选择浙江大学医学院附属第二医院微生物培养阳性并行骨髓检查的细菌感染患者56例,真菌感染患者20例;随机选择30例排除感染,血液系统疾病和其他严重疾病者作为对照.回顾性分析细菌感染患者血小板、巨核细胞数量、功能,并对巨核细胞胞体、细胞核分叶、空泡变性、逸核进行半定量分析比较.结果细菌感染组巨核细胞胞体、核分叶、空泡变性、逸核积分分别为2.20±0.21、2.11±0.23、0.51±0.11和0.74±0.11;真菌感染组分别为2.21±0.16、2.10±0.19、0.52±0.10、0.79±0.10;对照组分别为1.40 ±0.10、1.36±0.12、0.28±0.06和0.54±0.09,细菌感染组和对照组间比较差异有统计学意义(t值分别为14.52、12.19、9.33和6.61,P值均＜0.05),真菌感染组和对照组间比较差异有统计学意义(t值分别为16.27、12.34、7.85、6.49,P值均＜0.05).革兰阴性(G-)菌感染组巨核细胞体积、核分叶、空泡积分分别为2.29±0.20、2.22±0.26和0.57±0.10;革兰阳性(G+)菌感染组分别为2.13±0.20、2.04±0.18和0.46±0.09,两组间比较差异亦有统计学意义(t值分别为2.07、3.03和3.56,P值均＜0.05).细菌感染组巨核细胞产板功能为31.4±7.6,真菌感染组为32.4±6.4,对照组为41.3 ±5.5,细菌感染组和真菌感染组与对照组比较差异均有统计学意义(t分别为4.78和3.98,P值均＜0.05);G-菌感染组巨核细胞产板功能为28.0 ±6.7,G+菌感染组为34.4±7.2,两组间比较差异亦有统计学意义(t=2.41,P＜0.05).结论细菌和真菌感染患者骨髓巨核细胞胞体增大、核分叶增多、空泡变性明显、逸核增多,产板功能减低,其中G-菌感染组巨核细胞的上述表现较G+菌感染组明显.
목적 탐토세균화진균감염환자골수거핵세포적형태학개변.방법 선택절강대학의학원부속제이의원미생물배양양성병행골수검사적세균감염환자56례,진균감염환자20례;수궤선택30례배제감염,혈액계통질병화기타엄중질병자작위대조.회고성분석세균감염환자혈소판、거핵세포수량、공능,병대거핵세포포체、세포핵분협、공포변성、일핵진행반정량분석비교.결과 세균감염조거핵세포포체、핵분협、공포변성、일핵적분분별위2.20±0.21、2.11±0.23、0.51±0.11화0.74±0.11;진균감염조분별위2.21±0.16、2.10±0.19、0.52±0.10、0.79±0.10;대조조분별위1.40 ±0.10、1.36±0.12、0.28±0.06화0.54±0.09,세균감염조화대조조간비교차이유통계학의의(t치분별위14.52、12.19、9.33화6.61,P치균＜0.05),진균감염조화대조조간비교차이유통계학의의(t치분별위16.27、12.34、7.85、6.49,P치균＜0.05).혁란음성(G-)균감염조거핵세포체적、핵분협、공포적분분별위2.29±0.20、2.22±0.26화0.57±0.10;혁란양성(G+)균감염조분별위2.13±0.20、2.04±0.18화0.46±0.09,량조간비교차이역유통계학의의(t치분별위2.07、3.03화3.56,P치균＜0.05).세균감염조거핵세포산판공능위31.4±7.6,진균감염조위32.4±6.4,대조조위41.3 ±5.5,세균감염조화진균감염조여대조조비교차이균유통계학의의(t분별위4.78화3.98,P치균＜0.05);G-균감염조거핵세포산판공능위28.0 ±6.7,G+균감염조위34.4±7.2,량조간비교차이역유통계학의의(t=2.41,P＜0.05).결론 세균화진균감염환자골수거핵세포포체증대、핵분협증다、공포변성명현、일핵증다,산판공능감저,기중G-균감염조거핵세포적상술표현교G+균감염조명현.
Objective To investigate the morphological changes of bone marrow megakaryocytes in patients with bacterial and fungal infection.Methods Totally 76 patients with microorganism infection from the Second Affiliated Hospital,Zhejiang University School of Medicine from January 2008 to August 2009 were enrolled,including 56 bacteria infected patients and 20 fungal infected patients.All patients received bone marrow examinations,and were positive in microorganism culture.Thirty subjects without infection,hematological disease and other severe diseases were randomly selected as controls.The number and function of megakaryocytes were examined retrospectively, and the size, nuclear lobulation, and vacuolar degeneration of megakaryocytes were quantitative analyzed and compared among the groups.Results The size,nuclear lobulation,vacuolar degeneration,and Yat nuclear of megakaryocytes in bacterial infected group were 2.20 ±0.21,2.11 ±0.23,0.51 ±0.11 and 0.74 ±0.11 respectively,those in fungal infected group were 2.21 ±0.16,2.10 ±0.19,0.52 ±0.10 and 0.79 ±0.10 respectively;while those in control group were 1.40 ±0.10,1.36 ±0.12,0.28 ±0.06 and 0.54 ±0.09 respectively.The differences between bacterial infected group and control were of statistical significance(t values were 14.52,12.19,9.33 and 6.61 respectively,P ＜ 0.05),and the differences between fungal infected group and control were of statistical significance(t values were 16.27,12.34,7.85 and 6.49 respectively,P ＜ 0.05).The size,nuclear lobulation,and vacuoles of megakaryocytes in gram-negative(G-)bacteria group were 2.29 ±0.20,2.22 ±0.26 and 0.57 ±0.10,while those in the gram-positive(G+)bacteria group were 2.13 ±0.20,2.04 ±0.18 and 0.46 ±0.09,and the differences were also significant(t values were 2.07,3.03and 3.56 respectively,P ＜ 0.05).The production of platelet by megakaryocytes in bacterial infected group,in fungal infected and the control were 31.4 ±7.6,32.4 ±6.4 and 41.3 ±5.5,and the differences between bacterial infected group and control,fungal infected group and control were significant(t values were 4.78and 3.98 respectively,P ＜ 0.05).The production of platelet in G-bacteria group was 28.0 ± 6.7,while that in G + bacteria group was 34.4 ± 7.2,and the difference was also of statistical significance(t = 2.41,P ＜0.05). Conclusion Bacterial infected patients have increased megakaryocytes cell body,nuclear lobulation,obvious vacuolar degeneration,Yat nuclear and decreased platelet production function,which are more significant in G- bacteria infected group.