某三级医院低社会经济人群贫血临床管理中的骨髓抽吸评价

J. JohnsyMerla, J. SureshDurai, K. Shantaraman
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引用次数: 1

摘要

骨髓穿刺(BMA)是一种相对安全的侵入性手术,通过针吸获得有代表性的骨髓样本进行诊断评估。在研究期间,共记录了331例贫血病例。患者年龄10 ~ 81岁。调查对象以10 ~ 19岁青少年为主(20.54%)。全血细胞计数及外周血涂片检查显示:小细胞性低色素贫血125例(37.76%),二形性贫血116例(35.05%),全血细胞减少症23例(6.95%),白血病23例(6.95%),巨细胞性贫血31例(9.37%),溶血性贫血2例(3.32%),正常细胞性贫血11例(3.32%)。进一步行骨髓检查,骨髓穿刺示红系增生伴微母细胞和巨母细胞成熟88例(26.59%),微母细胞成熟56例(16.92%),巨母细胞成熟38例(11.48%),白血病23例(6.95%),浆细胞骨髓瘤7例(2.11%),淋巴瘤6例(1.81%),骨髓发育不良5例(1.51%),噬血细胞淋巴组织细胞增多症4例(1.21%),骨髓增生异常综合征3例(0.91%),骨髓增生异常综合征3例(0.91%)。特发性血小板减少性紫癜2例(0.60%)。22例(6.65%)患者骨髓有反应。对年龄、性别、外周血涂片检查、骨髓穿刺检查及诊断进行统计分析。只有骨髓评估才能明确诊断浆细胞骨髓瘤、淋巴瘤和骨髓增生异常综合征。在我们的研究中,有77%的病例在骨髓评估后明确诊断出贫血的原因。50%的病例被诊断为巨幼细胞性贫血,表明潜在的B12和叶酸缺乏。
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Bone Marrow Aspiration Evaluation in Clinical Management of Anemia Among Low Socioeconomic Group In A Tertiary Care Hospital.
Bone marrow aspiration (BMA) is a relatively safe invasive procedure by which representative sample of bone marrow is obtained through a needle aspiration for diagnostic evaluations. A total of 331 cases of anemia were profiled during the study period. The age range of patients were from 10 to 81 years. The majority of the subjects was in the adolescent age group of 10 – 19 years(20.54%). A complete blood count and peripheral smear examination in these cases revealed 125(37.76%) microcytic hypochromic anemia followed by 116(35.05%) Dimorphic anemia,23(6.95%)Pancytopenia, 23(6.95%)leukemia,31 cases (9.37%) macrocytic anemia,2 haemolytic anemia and 11(3.32%) were normocytic. These cases were further evaluated with bone marrow examination bone-marrow aspiration revealed 88 (26.59%) erythroid hyperplasia with micronormoblastic and macronormoblastic maturation(Combined deficiency),56 ( 16.92%) micronormoblastic maturation, 38 (11.48%) megaloblastic maturation, 23 ( 6.95%) Leukemia, Plasma cell myeloma 7(2.11%), lymphoma 6 (1.81%), hypoplastic marrow 5 (1.51%), haemophagocytic Lymphohistiocytosis 4 (1.21%),3 (0.91%) myelodysplastic syndrome, 2 (0.60%)cases of idiopathic thrombocytopenic purpura.In 22 (6.65%) cases the marrow was reactive. The age, sex, peripheral smear study, bone marrow aspiration study and diagnosis were collated and statistically analyzed. A definite diagnosis of plasma cell myeloma,lymphoma and myelodysplastic syndrome was possible only with bone marrow evaluation. In our study,in 77 % of cases a definite diagnosis of cause of anemia was arrived after bone marrow evaluation. 50% of cases were diagnosed with megaloblastic anemia indicating an underlying B12 and folate deficiency.
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