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目的探讨缺铁性贫血(IDA)和慢性病贫血(ACD)骨髓涂片及骨髓活检的临床效果。方法选取2012年1月至2015年12月56例IDA患者和64例ACD患者作为研究对象,根据病情分为IDA组和ACD组,均行骨髓涂片及骨髓活检检查。比较两组患者的骨髓增生程度、骨髓铁染色比例和骨髓活检Gomori网状纤维染色分级比例。结果在骨髓涂片检查中,ACD组骨髓增生程度、粒红比值明显高于IDA组(P<0.05);ACD组细胞外铁阳性分布明显高于IDA组(P<0.05);两组患者细胞内铁数目比较差异未见统计学意义(P>0.05);ACD组网状纤维增生程度明显高于IDA组(P<0.05)。结论在IDA与ACD的鉴别诊断中骨髓活检有一定临床意义,骨髓活检联合骨髓涂片检查有助于提高ACD的诊断水平。
Objective To investigate the clinical effects of bone marrow smear and bone marrow biopsy in patients with iron deficiency anemia (IDA) and chronic anemia (ACD). Methods Fifty-six IDA patients and 64 ACD patients from January 2012 to December 2015 were selected as study subjects. According to the condition, they were divided into IDA group and ACD group. All patients underwent bone marrow smear and bone marrow biopsy. The degree of myeloproliferation, the ratio of bone marrow iron staining and the grading ratio of bone marrow biopsy Gomori reticular fibers were compared between the two groups. Results In the bone marrow smear examination, the degree of bone marrow hyperplasia and granulocyte red ratio in ACD group were significantly higher than those in IDA group (P <0.05). The extracellular iron distribution in ACD group was significantly higher than that in IDA group (P <0.05) There was no significant difference in the number of internal iron (P> 0.05). The degree of reticular fibrosis in ACD group was significantly higher than that in IDA group (P <0.05). Conclusion Bone marrow biopsy has some clinical significance in the differential diagnosis of IDA and ACD. Bone marrow biopsy combined with bone marrow smear test can help to improve the diagnosis of ACD.