论文部分内容阅读
例1:女,6岁。因乏力、苍白一年入院。体检:贫血貌,心肺(-),肝肋下2cm,脾肋下14cm,白细胞240×10~9/L,原始粒+早幼粒10％,中幼粒16％,晚幼粒7％,杆状17％,中性分叶35％,淋巴3％,血色素60g/L,血小板25×10~9/L。骨髓象:原始粒+早幼粒12.2％,中幼粒22.8％,晚幼粒17.6％,杆状核20.8％,红系受抑,淋巴比例偏低。入院诊断:慢性粒细胞白血病(慢粒)。口服马利兰,两周后肝脾无缩小,末梢白细胞达700×10~9/L,原始粒+早幼粒达43％,考虑慢粒急变,再次骨穿,提示原始+早幼粒20％,诊断为慢粒急粒变。改用HOAP治疗六周,肝
Example 1: Female, 6 years old. Due to fatigue, pale year admission. Physical examination: anemia appearance, cardiopulmonary (-), liver ribs 2cm, spleen ribs 14cm, white blood cells 240 × 10 ~ 9 / L, primordium + promyelocytic 10%, 16% 17% of stems, 35% of neutral leaves, 3% of lymphatic vessels, 60g / L of hemoglobin and 25 × 10 ~ 9 / L of platelets. Bone marrow like: primordium + promyelocytic 12.2%, juvenile 22.8%, late juvenile 17.6%, rod 20.8%, erythroid suppression, low lymph ratio. Admission diagnosis: Chronic myeloid leukemia (CML). Oral malitam, two weeks after the liver and spleen did not shrink, peripheral leukocytes 700 × 10 ~ 9 / L, the original particles + promyelocytic up to 43%, consider the CML, again bone wear, suggesting that the original + promyelocytic 20% Diagnosis of CML acute granulopathy. Switch to HOAP for six weeks, liver