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[儿童慢性再生障碍性贫血与骨髓增生异常综合征临床特征比较]

[Comparisons of clinical features of chronic aplastic anemia and myelodysplastic syndrome in children].

作者信息

Hao Jin-Jin, Qiu Yi-Ning, Zhou Dong-Feng, Xiao Yan, Liu Qin, Jin Run-Ming

机构信息

Department of Pediatrics, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2011 Nov;13(11):867-9.

Abstract

OBJECTIVE

This study compared the differences in clinical features between chronic aplastic anemia (CAA) and myelodysplastic syndrome (MDS) in children in order to provide a basis for the differential diagnosis of the two diseases.

METHODS

A retrospective study of 23 cases of CAA and 9 cases of MDS from September 2007 to September 2010 was performed. The clinical data including routine blood test results, reticulocyte counts, serum lactate dehydrogenase level, serum ferritin level, cytological examination of bone marrow, bone marrow CD34+ cell counts, bone marrow chromosome and FISH test results were compared between the CAA and MDS groups.

RESULTS

Neutrophils, reticulocytes, and serum ferritin and lactate dehydrogenase levels increased in the MDS group compared with those in the CAA group. There were significant differences in bone marrow blast cell counts and dyshematopoiesis phenomena of three lines blood cells between the CAA and MDS groups. The bone marrow CD34+ cell counts and the rate of chromosomal abnormalities detected in bone marrow cytogenetic analysis in the MDS group were significantly higher than those in the CAA group.

CONCLUSIONS

There are differences in the results of laboratory examinations and morphological and cytogenetic examinations of bone marrow between the children with CAA and MDS. The differences are useful to the differential diagnosis of the two diseases.

摘要

目的

本研究比较儿童慢性再生障碍性贫血(CAA)和骨髓增生异常综合征(MDS)的临床特征差异,以便为这两种疾病的鉴别诊断提供依据。

方法

对2007年9月至2010年9月期间的23例CAA患儿和9例MDS患儿进行回顾性研究。比较CAA组和MDS组的临床资料,包括血常规检查结果、网织红细胞计数、血清乳酸脱氢酶水平、血清铁蛋白水平、骨髓细胞学检查、骨髓CD34+细胞计数、骨髓染色体及荧光原位杂交(FISH)检测结果。

结果

与CAA组相比,MDS组中性粒细胞、网织红细胞、血清铁蛋白及乳酸脱氢酶水平升高。CAA组和MDS组在骨髓原始细胞计数及三系血细胞造血异常现象方面存在显著差异。MDS组骨髓CD34+细胞计数及骨髓细胞遗传学分析中检测到的染色体异常率显著高于CAA组。

结论

CAA患儿和MDS患儿在实验室检查结果以及骨髓形态学和细胞遗传学检查方面存在差异。这些差异有助于这两种疾病的鉴别诊断。

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