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目的 进行急性巨核细胞白血病患者的骨髓细胞形态学、细胞化学和染色体核型分析.方法 选取18例急性巨核细胞白血病患者,进行骨髓采集和分离,获得有核细胞,用以制成普通透射电镜标本、血小板过氧化物酶(PPO)细胞组化电镜标本和骨髓涂片,通过细胞电镜的观察结果和PPO阳性反应结果等对患者的骨髓细胞进行细胞形态学、细胞化学和染色体核型分析.结果 15例患者的骨髓巨核细胞以原始巨核细胞(Ⅰ期)为主,观察结果显示胞间含有少量致密颗粒和α颗粒,胞内不存在分界膜和表面连接管道系统,核较圆,细胞质中存在少量的微管、致密颗粒和膜性囊腔;另外3例患者的骨髓细胞除含有原始巨核细胞外还有大量的幼稚巨核细胞(Ⅱ期)及巨核细胞(Ⅲ期),并且细胞的大小明显不均等;PPO阳性反应的检验结果均呈阳性,阳性率的范围为1％～75％;骨髓涂片观察和染色反应结果显示,原始巨核细胞和幼稚巨核细胞均清晰可见,CD41免疫组化的染色反应呈阳性,并且多为复杂染色体核型.结论 急性巨核细胞白血病患者除少数患者的骨髓细胞包含大量的幼稚巨核细胞和巨核细胞外,大多数患者的骨髓细胞以原始巨核细胞为主,另外患者的PPO阳性反应的阳性率无规律分布、染色体核型复杂.“,”Objective To analyze the morphology, cytochemistry and chromosome karyotype of bone marrow cells in patients with acute megakaryocytic leukemia. Methods 18 patients with acute megakaryocytic leukemia were enrolled in this study. Nucleated cells were obtained by collecting and isolating the bone marrow of patients, which were used to make ordinary transmission electron microscopy specimens, platelet peroxidase cell histomorphometric specimens and bone marrow smears. Then cell morphology, cytochemistry and chromosome karyotype analysis of bone marrow cells were analysed through the results of cell electron microscopy observation and PPO positive reaction. Results Bone marrow megakaryocytes in 15 patients were predominantly primitive megakaryocytes, and there was a small number of dense particles and α particles between the cells, but without decomposition film and surface connected pipeline system. The bone marrow cells of another 3 patients, with unequal size, not only contained the original megakaryocytes but also had a large number of immature megakaryocytes and megakaryocytes. PPO positive test results were positive and the positive rate in the range of 1％ to 75％. Bone marrow smear observation and staining results showed that the original megakaryocytes and immature megakaryocytes are clearly visible, CD41 immunohistochemical staining was positive, and mostly complex chromosome karyotype. Conclusion On the one hand, the main bone marrow cells of the most patients were primitive megakaryocytes and a small number of patients with a large number of immature megakaryocytes and megakaryocytes. On the other hand, the distribution of PPO positive rate was irregular and the chromosome karyotype was complex.