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目的 探讨特发性血小板减少性紫癜(ITP)儿童骨髓巨核细胞(MK)形态学变化。方法 选取许昌市中心医院2010年10月—2016年5月收治的43例ITP患儿作为观察组,并选取同期收治健康儿童34例作为对照组。分析两组MK计数及形态学,两组MK分类结果及定量积分结果。结果 观察组标化MK计数为5~746个/(1.5 cm×3 cm),对照组为6~43个/(1.5 cm×3 cm)。两组裸核型MK计数差异无统计学意义(P>0.05);与对照组相比,观察组原幼型、颗粒型MK计数较高,产板型MK计数较低,差异有统计学意义(P<0.05);与对照组相比,观察组MK细胞浆量及退行性变积分均较高,颗粒量积分较低,差异有统计学意义(P<0.05)。结论骨髓MK形态学可作为临床诊断ITP重要指标之一,骨髓细胞学检查在ITP确诊中具有重要意义。
Objective To investigate the morphological changes of bone marrow megakaryocytes (MK) in children with idiopathic thrombocytopenic purpura (ITP). Methods 43 cases of ITP children admitted from October 2010 to May 2016 in Central Hospital of Xuchang were selected as the observation group and 34 healthy children were selected as the control group. MK count and morphology of the two groups were analyzed, MK classification results and quantitative integral results of two groups were analyzed. Results The standardized MK counts in the observation group ranged from 5 to 746 / (1.5 cm × 3 cm) and in the control group 6 to 43 / (1.5 cm × 3 cm). There was no significant difference in the counts of bare karyotype MK between the two groups (P> 0.05). Compared with the control group, the counts of primordial and granulocytic MK in the observation group were higher and the MK count of platelet production was lower, with significant difference (P <0.05). Compared with the control group, the scores of MK cytoplasm and degeneration of MK in observation group were higher than those in the control group, and the difference was statistically significant (P <0.05). Conclusion The morphology of bone marrow MK can be used as one of the important indicators in the clinical diagnosis of ITP. Bone marrow cytology is of great significance in the diagnosis of ITP.