Tsukada T, Ueyama J, Miyakoshi S, Morinaga S, Mutoh Y, Yamaguchi H, Matsuya S
Division of Hematologic Research, Toranomon Hospital.
Rinsho Ketsueki. 1990 Jul;31(7):903-10.
In 18 patients with decreased platelet production proved by reduced platelet turnover, the numbers of megakaryocytes in clot section of marrow aspirate were counted. Platelet counts ranged from 19,000 to 128,000/microliters. The sternal marrow showed decrease of megakaryocytes only in 3 out of 18 cases while megakaryocytes in the iliac marrow were reduced in 6 out of 11 cases. Only one of 11 cases showed decrease of megakaryocyte in both marrows examined. On the contrary, four cases showed normal number of megakaryocytes at both sites. Of 9 cases with normal or increased number of megakaryocytes in sternal and/or iliac marrow, no case showed morphologically abnormal megakaryocytes and only one case had the reduced number of platelet-forming megakaryocytes. Results suggested that the number of megakaryocytes in bone marrow especially in the sternum was not reliable for establishing the diagnosis of decreased platelet production, and that about 50% of patients with thrombocytopenia due to hypoproduction of platelets could be diagnosed pertinently only after the study of platelet kinetics.
在18例经血小板周转率降低证实血小板生成减少的患者中,对骨髓穿刺凝块切片中的巨核细胞数量进行了计数。血小板计数范围为19,000至128,000/微升。胸骨骨髓仅在18例中的3例显示巨核细胞减少,而髂骨骨髓在11例中的6例巨核细胞减少。11例中只有1例在检查的两个部位均显示巨核细胞减少。相反,4例在两个部位的巨核细胞数量均正常。在胸骨和/或髂骨骨髓中巨核细胞数量正常或增加的9例中,没有病例显示巨核细胞形态异常,只有1例有形成血小板的巨核细胞数量减少。结果表明,骨髓尤其是胸骨中的巨核细胞数量对于确立血小板生成减少的诊断不可靠,并且约50%因血小板生成减少导致血小板减少的患者只有在研究血小板动力学后才能得到准确诊断。