da Silva Mauro Roberto B, Stewart Jay M, Costa Carlos Henrique N
Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Teresina, Piauí, Brazil.
Am J Trop Med Hyg. 2005 Jun;72(6):811-4.
Bone marrow aspirates are believed to provide a safer but less sensitive method in the diagnosis of visceral leishmaniasis (VL) compared with splenic aspirates. We examined the effect of the number of fields and the time of observation on bone marrow smear sensitivity and compared it to our experience with spleen aspiration. Bone marrow smears of 98 patients and splenic aspirates from 120 patients were examined. Among 87 patients with VL, the sensitivity of bone marrow aspirates was 40.2%, 65.5%, 89.7%, 92%, and 95.4% at 1, 5, 20, 30, and 60 minutes, respectively. The sensitivity of spleen aspirate examination was 93% for 114 patients. One patient died of shock after spleen aspiration. A bone marrow smear is very sensitive if examined thoroughly, reaching a sensitivity similar to that of spleen aspirate. We propose that a bone marrow smear be established as the technique of choice for the parasitologic diagnosis of VL.
与脾脏穿刺相比，骨髓穿刺被认为是诊断内脏利什曼病（VL）的一种更安全但敏感性较低的方法。我们研究了视野数量和观察时间对骨髓涂片敏感性的影响，并将其与我们脾脏穿刺的经验进行了比较。对98例患者的骨髓涂片和120例患者的脾脏穿刺样本进行了检查。在87例VL患者中，骨髓穿刺在1、5、20、30和60分钟时的敏感性分别为40.2%、65.5%、89.7%、92%和95.4%。114例患者的脾脏穿刺检查敏感性为93%。1例患者在脾脏穿刺后死于休克。如果彻底检查，骨髓涂片非常敏感，其敏感性与脾脏穿刺相似。我们建议将骨髓涂片确立为VL寄生虫学诊断的首选技术。
