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一家三级护理教学医院全血细胞减少成年患者的临床血液学特征

Clinico-hematological profile of pancytopenic adult patients in a tertiary care teaching hospital.

作者信息

Jain Anil, Garg Ravinder, Kaur Rupinderjeet, Nibhoria Sarita, Chawla Sumit Pal Singh, Kaur Sarabjot

机构信息

Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.

Department of Pathology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.

出版信息

Tzu Chi Med J. 2021 Aug 23;34(1):95-101. doi: 10.4103/tcmj.tcmj_17_21. eCollection 2022 Jan-Mar.

Abstract

OBJECTIVE

The causes of pancytopenia vary in different populations depending on age, gender, nutrition, geographic location, standard of living, and exposure to certain infections and drugs. As the severity of pancytopenia and its underlying etiology determine the management and prognosis, identifying the correct etiology in a given case is crucial and helps in implementing timely and appropriate treatment. The objectives of this study were to study the clinical profile and hematological parameters of pancytopenic adults and to identify different etiologies of pancytopenia. This observational study was conducted in the Medicine department of a tertiary care teaching hospital.

MATERIALS AND METHODS

The study was conducted on 100 adult patients aged 18-65 years presenting with pancytopenia. All the participants were subjected to detailed clinical examination and relevant investigations including bone marrow (BM) examination. Categorical variables were presented in number and percentage (%). Qualitative variables were correlated using the Chi-square test. A =0.05 was considered statistically significant.

RESULTS

A female preponderance was observed, and the majority of patients were aged between 18 and 40 years. The most common clinical features were generalized weakness, fever, and pallor. Seventy-four percent of patients were vegetarians; 58% had vitamin B12 deficiency, 25% had folic acid deficiency and 19% had a deficiency of both. The most common cause of pancytopenia was megaloblastic anemia (MA) (37%), followed by dimorphic anemia (DA) (26%), aplastic anemia (AA) (20%), and hematological malignancies (11%).

CONCLUSION

MA, DA, and AA are the most prevalent etiologies of pancytopenia. BM examination is of utmost importance in the definitive diagnosis of pancytopenia and is useful in initiating timely treatment as a significant number of causes of pancytopenia are potentially curable.

摘要

目的

全血细胞减少的病因在不同人群中因年龄、性别、营养状况、地理位置、生活水平以及接触某些感染源和药物的情况而有所不同。由于全血细胞减少的严重程度及其潜在病因决定了治疗方法和预后,因此在特定病例中确定正确的病因至关重要,有助于实施及时且恰当的治疗。本研究的目的是研究全血细胞减少成年患者的临床特征和血液学参数,并确定全血细胞减少的不同病因。这项观察性研究在一家三级护理教学医院的内科进行。

材料与方法

本研究对100名年龄在18 - 65岁、患有全血细胞减少的成年患者进行。所有参与者均接受了详细的临床检查和包括骨髓检查在内的相关检查。分类变量以数量和百分比(%)呈现。定性变量使用卡方检验进行相关性分析。α = 0.05被认为具有统计学意义。

结果

观察到女性占优势,大多数患者年龄在18至40岁之间。最常见的临床特征是全身无力、发热和面色苍白。74%的患者为素食者;58%的患者维生素B12缺乏,25%的患者叶酸缺乏,19%的患者两者均缺乏。全血细胞减少最常见的病因是巨幼细胞贫血(MA)(37%),其次是双相性贫血(DA)(26%)、再生障碍性贫血(AA)(20%)和血液系统恶性肿瘤(11%)。

结论

MA、DA和AA是全血细胞减少最常见的病因。骨髓检查在全血细胞减少的明确诊断中至关重要,并且由于大量全血细胞减少的病因具有潜在可治愈性,所以对及时开始治疗很有帮助。

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本文引用的文献

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Pancytopenia: a clinico hematological study.全血细胞减少症:一项临床血液学研究。
J Lab Physicians. 2011 Jan;3(1):15-20. doi: 10.4103/0974-2727.78555.

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