中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
Chinese Journal of Woman and Child Health Research
2015年
4期
735-737
,共3页
王玲%杨长虹%尹春燕%肖延风
王玲%楊長虹%尹春燕%肖延風
왕령%양장홍%윤춘연%초연풍
儿童%不典型再障%外周血象%骨髓涂片%骨髓活检
兒童%不典型再障%外週血象%骨髓塗片%骨髓活檢
인동%불전형재장%외주혈상%골수도편%골수활검
children%atypical aplastic anemia%peripheral blood hemogram%bone marrow smear%bone marrow biopsy
目的 比较并分析不典型再障与典型再障患儿的临床资料,为再障的临床治疗提供一定的指导,减少误诊和漏诊的发生. 方法 2008年1月至2014年12月西安交通大学医学院第二附属医院儿科收治的再障患儿31例,入院后收集病史,进行体格检查,采集外周血及骨髓进行检查,并进行骨髓活检. 结果 不典型再障组患儿发病到确诊时间明显长于典型再障组,差异具有统计学意义(t=4.79,P<0.05). 不典型再障患儿与典型再障患儿相比,白细胞计数(WBC)、红细胞计数(RBC)及网织红细胞计数(RET)均无显著性差异(t值分别为2.01、1.78、1.98,均P>0.05;而血红蛋白含量(HB),血小板计数(PLT),中性粒细胞计数(ANC)均具有显著性差异(t值分别为2.42、2.53、3.29,均P<0.05). 典型再障患儿骨髓图片结果中,粒系、红系比例及巨核细胞数均明显低于不典型再障患儿,而淋巴细胞及浆细胞比例均明显高于不典型再障患儿( t值分别为6.98、2.28、2.25、4.96、2.57,均P<0.05). 结论 不典型再障患儿初期临床表现较轻,外周血象及骨髓改变不显著,仅靠骨髓涂片不能及时有效地做出准确诊断,因此,骨髓活检在不典型再障诊断中具有重要作用.
目的 比較併分析不典型再障與典型再障患兒的臨床資料,為再障的臨床治療提供一定的指導,減少誤診和漏診的髮生. 方法 2008年1月至2014年12月西安交通大學醫學院第二附屬醫院兒科收治的再障患兒31例,入院後收集病史,進行體格檢查,採集外週血及骨髓進行檢查,併進行骨髓活檢. 結果 不典型再障組患兒髮病到確診時間明顯長于典型再障組,差異具有統計學意義(t=4.79,P<0.05). 不典型再障患兒與典型再障患兒相比,白細胞計數(WBC)、紅細胞計數(RBC)及網織紅細胞計數(RET)均無顯著性差異(t值分彆為2.01、1.78、1.98,均P>0.05;而血紅蛋白含量(HB),血小闆計數(PLT),中性粒細胞計數(ANC)均具有顯著性差異(t值分彆為2.42、2.53、3.29,均P<0.05). 典型再障患兒骨髓圖片結果中,粒繫、紅繫比例及巨覈細胞數均明顯低于不典型再障患兒,而淋巴細胞及漿細胞比例均明顯高于不典型再障患兒( t值分彆為6.98、2.28、2.25、4.96、2.57,均P<0.05). 結論 不典型再障患兒初期臨床錶現較輕,外週血象及骨髓改變不顯著,僅靠骨髓塗片不能及時有效地做齣準確診斷,因此,骨髓活檢在不典型再障診斷中具有重要作用.
목적 비교병분석불전형재장여전형재장환인적림상자료,위재장적림상치료제공일정적지도,감소오진화루진적발생. 방법 2008년1월지2014년12월서안교통대학의학원제이부속의원인과수치적재장환인31례,입원후수집병사,진행체격검사,채집외주혈급골수진행검사,병진행골수활검. 결과 불전형재장조환인발병도학진시간명현장우전형재장조,차이구유통계학의의(t=4.79,P<0.05). 불전형재장환인여전형재장환인상비,백세포계수(WBC)、홍세포계수(RBC)급망직홍세포계수(RET)균무현저성차이(t치분별위2.01、1.78、1.98,균P>0.05;이혈홍단백함량(HB),혈소판계수(PLT),중성립세포계수(ANC)균구유현저성차이(t치분별위2.42、2.53、3.29,균P<0.05). 전형재장환인골수도편결과중,립계、홍계비례급거핵세포수균명현저우불전형재장환인,이림파세포급장세포비례균명현고우불전형재장환인( t치분별위6.98、2.28、2.25、4.96、2.57,균P<0.05). 결론 불전형재장환인초기림상표현교경,외주혈상급골수개변불현저,부고골수도편불능급시유효지주출준학진단,인차,골수활검재불전형재장진단중구유중요작용.
Objective To compare and analyze the clinical data of children with atypical aplastic anemia ( AA) and those with typical AA so as to provide guidance for clinical treatment and reduce misdiagnosis and missed diagnosis.Methods From January 2008 to December 2014 totally 31 cases of AA were admitted in the Second Affiliated Hospital of Xi' an Jiaotong University.After admission, medical history was collected, and physical examination, peripheral blood and bone marrow examination were also conducted.Bone marrow biopsy was performed.Results The duration from onset to diagnosis of atypical AA was significantly longer than that of typical AA ( t=4.79, P<0.05).Comparison of two groups showed that WBC, RBC and RET were not significantly different (t value was 2.01, 1.78 and 1.98, respectively, all P>0.05), but HB, PLT and ANC were significantly different (t value was 2.42, 2.53 and 3.29, respectively, all P<0.01).Myeloid and erythroid proportions and megakaryocyte number of typical AA children were significantly lower than those of atypical AA children, but the proportion of lymphocytes and plasma cells increased (t value was 6.98, 2.28, 2.25, 4.96 and 2.57, respectively, all P<0.05).Conclusion Children with atypical AA have mild early clinical manifestations and their peripheral hemogram and bone marrow slightly change, therefore, accurate diagnosis can not be made only with bone marrow smear.Thus, bone marrow biopsy plays an important role in the diagnosis of atypical AA.
