论文部分内容阅读
目的:对高原红细胞增多症(HAPC)70例,经髓后上棘取材,观察骨髓形态、组织病理、超级结构,以揭示在高原低氧环境下,骨髓红细胞系统过度异常增生,是HAPC发病的重要因素.方法:骨髓涂片用瑞氏染色、形态学计数和分类.其中12例行骨髓活检,取出10～15mm活组织,分成两块,观察骨髓病理和骨髓超微结构.结果:骨髓形态学、组织病理、超微结构共同改变,即红系列增生极活跃,均有核浆发育不平衡的表现,有核红细胞的分裂指数、细胞分裂象在骨髓分裂中、红与粒细胞的比例均明显高于正常值.形态上红系以间接丝状分裂为主,骨髓组织病理可见,造血组织容积增加,含铁血黄素减少或消失.超微结构红系统的内质网、溶媒体、线粒体减少,线粒体排列紊乱,可见巨大线粒体.结论:HAPC的骨髓红系统过度增生,聚集在增多扩张的静脉窦中,并迅速进入血循环中,以改善低氧情况,但红系的核浆发育不平衡,细胞器的异常改变,所致的病态造血和红细胞的释放失控,可能是HAPC发病的组织结构基础.
OBJECTIVE: To investigate the morphology, histopathology and ultrastructure of bone marrow of 70 HAPC patients with HAPC, and to observe the hyperplasia of myeloid erythrocyte system in the plateau hypoxia environment, which is the pathogenesis of HAPC The bone marrow smears were stained with Wright’s stain, morphological count and classification.Results: Bone marrow morphology was found in 12 cases of bone marrow biopsy and 10 ~ 15mm of living tissue were removed and divided into two groups.Results: Learning, histopathology, ultrastructure common change, the red series of hyperplasia is extremely active, both the performance of nuclear and cytoplasmic imbalance, the index of mitotic index of erythrocytes, cell division in the bone marrow division, red and granulocyte ratio Obviously higher than the normal value.The morphological erythroid was dominated by indirect filamentous division.The histopathology of bone marrow was visible, the volume of hematopoietic tissue increased, the hemosiderin decreased or disappeared.The ultrastructure of endoplasmic reticulum, lysosome and mitochondria Reduced, mitochondria arranged in disorder, showing a huge mitochondria.Conclusion: HAPC bone marrow erythroid hyperplasia, gathered in the expansion and expansion of the sinus, and rapidly into the blood circulation, to improve the hypoxia, but Nuclear plasma system imbalance in development, abnormal organelles, due to dysplasia and uncontrolled release of red blood cells, the base structure may be structured HAPC disease.