González Aza C, Grilo Reina A, López Martín J C, Torre Sabariego A, Martínez Estéfano E, López Lacomba D, Herrera Díaz A, Moreno Garrido D
Servicio de Hematología, Hospital Universitario de Valme. Sevilla.
Med Clin (Barc). 1995 Jan 28;104(3):89-91.
The aim of the present was to study the cytohistology of the bone marrow in intravenous drug addicts (IVDA) and to analyze the possible differences according to the period of drug addiction.
A prospective study was performed in 60 IVDA patients previously untreated and distributed into three groups: 20 seronegative for the human immunodeficiency virus (HIV), 20 patients in a phase of generalized adenopathic infection (GAI) and 20 patients with AIDS.
Cytohistologic examination of the bone marrow aspirates showed plasmocytosis and eosinophilia in all the groups. Selective changes were seen in the red series in 20% of the HIV negative patients and in 25% of the GAI group. The prevalence of cytologic changes was greater in those with AIDS, with hypocellular bone marrow being observed in 65% of the patients with coexistent dismyelopoietic changes in 15%. Pathologic structure showed granulomatous lesions of tuberculous etiology in 30% of the patients with AIDS while in the HIV negative and GAI groups these were found in 10% and 5%, respectively. A greater presence of fibrosis and bone marrow hypoplasia was also found in the group with AIDS, than in the other two groups.
An increased number of bone marrow changes and progressive bone marrow hypocellularity may be observed on advancement of the clinical stages in intravenous drug addict patients. The incidence of tuberculous granulomas is higher in the AIDS group.
本研究旨在探讨静脉吸毒者骨髓的细胞组织学,并分析根据吸毒时间可能存在的差异。
对60例未经治疗的静脉吸毒者进行前瞻性研究,将其分为三组:20例人类免疫缺陷病毒(HIV)血清阴性者,20例处于全身性淋巴结感染(GAI)阶段的患者,以及20例艾滋病患者。
骨髓穿刺液的细胞组织学检查显示,所有组均有浆细胞增多和嗜酸性粒细胞增多。20%的HIV阴性患者和25%的GAI组在红系中出现选择性改变。艾滋病患者的细胞学改变发生率更高,65%的患者出现骨髓细胞减少,15%的患者同时存在骨髓造血异常。病理结构显示,30%的艾滋病患者有结核病因的肉芽肿病变,而HIV阴性和GAI组的这一比例分别为10%和5%。与其他两组相比,艾滋病组的纤维化和骨髓发育不全也更为明显。
静脉吸毒患者临床分期进展时,可观察到骨髓改变数量增加和骨髓细胞逐渐减少。艾滋病组结核肉芽肿的发生率更高。