中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2011年
1期
64-67
,共4页
苯%中毒%骨髓检查%贫血,再生障碍性%白血病
苯%中毒%骨髓檢查%貧血,再生障礙性%白血病
분%중독%골수검사%빈혈,재생장애성%백혈병
Benzene%Poisoning%Bone marrow examination%Anemia,aplastic%Leukemia
目的 通过对56例苯中毒患者骨髓象进行分析,探讨苯对造血系统损害的骨髓象的特点.方法 按GBZ 68-2008<职业性苯中毒诊断标准>将苯中毒患者分为轻度中毒组、中度中毒组、再生障碍性贫血及全血细胞减少症组(再障组)、白血病组,均进行骨穿、涂片、以瑞氏-姬姆萨染色的骨髓片计数100个有核细胞,进行分类并观察细胞形态.结果 骨髓增生程度和巨核细胞增殖按轻度中毒、中度中毒、再障依次递减.轻度、中度中毒患者的原始和幼稚细胞增殖有受抑制的趋势,出现中毒相关的细胞形态异常.与其余各组及正常参考值比较,再障组的骨髓细胞占有核细胞百分率(早幼粒0.17%、中幼粒3.11%,早幼红0.06%、中幼红3.16%)降低,差异有统计学意义(P＜0.01,P＜0.05).白血病表现为粒系、红系幼稚细胞单克隆性增殖伴成熟障碍,巨核细胞增殖分化受明显抑制,与其余各组及正常参考值比较,白血病组的骨髓细胞占有核细胞百分率(原幼粒21.25%、早幼粒4.88%)升高、差异有统计学意义(P＜0.01).再障组、白血病组的粒细胞、红细胞出现细胞形态异常和核畸形比例增高,以白血病组尤为明显.结论 慢性苯中毒轻度、中度病例的骨髓象可见骨髓原始和幼稚细胞增殖已出现受抑制的趋势,且出现部分细胞形态异常.重度中毒骨髓象表现出与临床分型相对应的异常改变.
目的 通過對56例苯中毒患者骨髓象進行分析,探討苯對造血繫統損害的骨髓象的特點.方法 按GBZ 68-2008<職業性苯中毒診斷標準>將苯中毒患者分為輕度中毒組、中度中毒組、再生障礙性貧血及全血細胞減少癥組(再障組)、白血病組,均進行骨穿、塗片、以瑞氏-姬姆薩染色的骨髓片計數100箇有覈細胞,進行分類併觀察細胞形態.結果 骨髓增生程度和巨覈細胞增殖按輕度中毒、中度中毒、再障依次遞減.輕度、中度中毒患者的原始和幼稚細胞增殖有受抑製的趨勢,齣現中毒相關的細胞形態異常.與其餘各組及正常參攷值比較,再障組的骨髓細胞佔有覈細胞百分率(早幼粒0.17%、中幼粒3.11%,早幼紅0.06%、中幼紅3.16%)降低,差異有統計學意義(P＜0.01,P＜0.05).白血病錶現為粒繫、紅繫幼稚細胞單剋隆性增殖伴成熟障礙,巨覈細胞增殖分化受明顯抑製,與其餘各組及正常參攷值比較,白血病組的骨髓細胞佔有覈細胞百分率(原幼粒21.25%、早幼粒4.88%)升高、差異有統計學意義(P＜0.01).再障組、白血病組的粒細胞、紅細胞齣現細胞形態異常和覈畸形比例增高,以白血病組尤為明顯.結論 慢性苯中毒輕度、中度病例的骨髓象可見骨髓原始和幼稚細胞增殖已齣現受抑製的趨勢,且齣現部分細胞形態異常.重度中毒骨髓象錶現齣與臨床分型相對應的異常改變.
목적 통과대56례분중독환자골수상진행분석,탐토분대조혈계통손해적골수상적특점.방법 안GBZ 68-2008<직업성분중독진단표준>장분중독환자분위경도중독조、중도중독조、재생장애성빈혈급전혈세포감소증조(재장조)、백혈병조,균진행골천、도편、이서씨-희모살염색적골수편계수100개유핵세포,진행분류병관찰세포형태.결과 골수증생정도화거핵세포증식안경도중독、중도중독、재장의차체감.경도、중도중독환자적원시화유치세포증식유수억제적추세,출현중독상관적세포형태이상.여기여각조급정상삼고치비교,재장조적골수세포점유핵세포백분솔(조유립0.17%、중유립3.11%,조유홍0.06%、중유홍3.16%)강저,차이유통계학의의(P＜0.01,P＜0.05).백혈병표현위립계、홍계유치세포단극륭성증식반성숙장애,거핵세포증식분화수명현억제,여기여각조급정상삼고치비교,백혈병조적골수세포점유핵세포백분솔(원유립21.25%、조유립4.88%)승고、차이유통계학의의(P＜0.01).재장조、백혈병조적립세포、홍세포출현세포형태이상화핵기형비례증고,이백혈병조우위명현.결론 만성분중독경도、중도병례적골수상가견골수원시화유치세포증식이출현수억제적추세,차출현부분세포형태이상.중도중독골수상표현출여림상분형상대응적이상개변.
Objective To explore the bone marrow feature of hemopoietic system injured by benzene through analyzing 56 benzolism cases. Methods The 56 benzolism cases were divided into mild poisoning group, midrange poisoning group, aplastic anemia group, pancytopenia group and leukemia group. All cases progressed bone marrow aspiration and smear, and counted hundred karyocytes by Wright-Giemsa tinct bone marrow smear to classification and observe the cells' feature. Results The megakaryocytes and the extent of bone marrow hyperplasia were decreased by turns of mild poisoning group, midrange poisoning group and aplastic anemia group. The archaeocytes and juvenile cells proliferation in mild poisoning group and midrange poisoning group were inhibited and occured cell paramorphia which related to intoxication. Comparing with the other groups and mormal reference value, the pancytopenia group' s percentage of bone marrow cells in karyotes was significantly decreased (P＜0.01. P＜0.05) and the leukemia group's pecentage of bone marrow cells in karyotes was significantly increased (P＜0.01). The proportion of cell paramorphia and nucleus malformation of granulocytes and red blood cells in pancytopenia group and leukemia group were increased, expecially in leukemia group. Conclusion We saw the inhibition of archaeocytes and juvenile cells proliferation and somecell paramorphia appearances in mild poisoning and midrange poisoning cases of chronic benzolism. The abnormality changes which can be seen in bone marrow of severe benzolism cases were corresponding with the clinical classification.
