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骨髓增生综合征包括骨髓各种成分不同程度增生,肝、脾肿大,各种血细胞不同程度增多或减少,出血倾向及血栓形成等恶性或潜在恶性的疾病。近年来,我们单用马利兰治疗2例,取得较好疗效。现报告如下: 例1 苏××,女,62岁,因头晕、头痛、颜面发红,右踝关节疼痛而就诊。病人在61岁时,因左股动脉栓塞行截肢,术后因切口感染时间长而输血,次日出现左上肢瘫痪。检查:BP140/90,颜面紫红,以额、颧、鼻、唇、耳垂为明显。颞静脉充盈,结膜充血,舌红、无苔,颈静脉较充盈。心尖部可闻Ⅱ/Ⅵ收缩期杂音,肝上界在右锁骨中线6肋间,下界肋下3cm,质中。指(趾)端紫红,左上肢不完全性瘫痪,肌力Ⅲ级。血象:Hb 18.2g%,RBC650万,PC12万,WBC20,000,ESR0/h,RBC压积60%。中性粒细胞硷性磷酸酶染色阳性率98%,积分290分,骨髓象:粒、红、巨三系增生活跃。眼底动脉硬化改变。诊断:骨髓增生综合征(考虑真性红细胞增多征)。
Myeloproliferative syndromes include various degrees of bone marrow hyperplasia, liver and splenomegaly, various blood cells increased or decreased to varying degrees, bleeding tendency and thrombosis and other malignant or potentially malignant diseases. In recent years, we treated only 2 cases of Maryland, achieved good results. Now report as follows: Example 1 Su × ×, female, 62 years old, due to dizziness, headache, facial redness, right ankle pain and treatment. At 61 years of age, the patient was amputated due to left femoral artery embolization. Blood transfusions occurred after a long period of incision infection and paralysis of the left upper limbs occurred the next day. Check: BP140 / 90, face purplish red, with forehead, zygomatic, nose, lips, earlobe as obvious. Temporal vein filling, conjunctival congestion, red tongue, no moss, jugular filling more. Apex hypersensitus Ⅱ / Ⅵ systolic murmur, the upper liver in the right intercostal midline 6 intercostal, the lower boundary ribs 3cm, quality. Finger (toe) side purple, incomplete upper left limb paralysis, muscle strength Ⅲ grade. Blood: Hb 18.2g%, RBC6500000, PC120000, WBC20,000, ESR0 / h, RBC 60%. Neutrophil alkaline phosphatase staining positive rate of 98%, points 290 points, bone marrow like: grain, red, giant three hyperplasia active. Fundus arteriosclerosis changes. Diagnosis: Myeloproliferative syndrome (consider signs of polycythemia vera).