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目的分析以血液系统改变为主要首发表现的风湿免疫病患者骨髓形态特点,初步探讨骨髓细胞形态学检查在其诊疗中的意义。方法回顾性分析46例的风湿免疫病患者骨髓表现及血液学改变。结果 46例的风湿免疫病患者临床主要表现为贫血者22例(47.8%)、白细胞减少19例(41.3%)、血小板减少17例(37.0%),仅一系减少者21例(45.7%),同时有两系减少者18例(39.1%),全血细胞减少3例(6.5%)。骨髓红系主要呈增生活跃或减低的慢性病贫血及溶血表现。粒系可见中毒改变。巨核细胞数可正常或减少,伴成熟障碍。部分血小板正常的患者骨髓巨核细胞缺如。结论风湿免疫病常以因血液系统受损导致的各种血液学症状为主要临床表现,骨髓细胞形态检查及特点对以血液学异常为主要首发表现的风湿免疫病与原发造血系统疾病的鉴别具有重要意义。
OBJECTIVE: To analyze the morphological characteristics of bone marrow in rheumatoid patients with rheumatism as the main initial manifestation of hematological system changes, and to explore the significance of bone marrow cell morphology in diagnosis and treatment. Methods The bone marrow manifestations and hematological changes of 46 patients with rheumatic immune disease were retrospectively analyzed. Results Twenty-four patients (47.8%) had anemia, 19 (41.3%) had anemia, 17 (37.0%) had thrombocytopenia and 21 (45.7%) had only a series of decrease. There were 18 cases (39.1%) with two-line reduction and 3 cases (3.5%) with pancytopenia. Bone marrow erythroid hyperplasia was mainly active or reduced anemia and hemolysis of chronic diseases. Myeloid visible poisoning changes. The number of megakaryocytes can be normal or reduced, with a mature disorder. Some patients with normal platelets lack of bone marrow megakaryocytes. Conclusions Rheumatic immune diseases are often characterized by various hematological symptoms caused by the impaired blood system, morphological examination of bone marrow cells, and characteristics of rheumatoid immune diseases and primary hematopoietic system diseases that are characterized by hematological abnormalities It is of great significance.