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目的 观察特发性血小板减少性紫癜(ITP)、再生障碍性贫血(AA)及骨髓增生异常综合征(MDS)患儿骨髓巨核细胞(MK)形态与造血功能,分析不同血小板减少症发生的原因,以期对其进行早期鉴别诊断。方法 对 16例ITP、17例AA、16例MDS患儿,进行骨髓涂片CD41α免疫酶标染色检测;并采用血浆凝块法体外培养骨髓单个核细胞及免疫酶标法进行巨核细胞集落检测;分组进行统计学分析和比较。结果 ITP患儿小巨核细胞及I型淋巴样小巨核细胞检出率分别为 87%和 7%,与对照组比较差异无统计学意义;小巨核细胞总数及巨核细胞集落形成单位 (CFU MK)、爆式巨核细胞集落形成单位(BFU MK)分别为 602 /mm2、93个 /2×105 MNC和 6 5个 /2×105 MNC,高于对照组,前两者与对照组比较差异有统计学意义。AA患儿小巨核细胞检出率、计数及CFU MK与BFU MK的形成率分别为 43%、0 5 /mm2、0个 /2×105 MNC和 0个 /2×105 MNC,低于对照组,与对照组比较差异有统计学意义。MDS患儿小巨核细胞检出率 87%,与正常对照组比较差异无统计学意义,但总数及I型淋巴样小巨核细胞检出率分别为 37 /mm2、73%,高于对照组,差异有统计学意义;CFU MK形成率 3个 /2×105 MNC与对照组比较差异无统计学意义,与对照组 90%可信区间比较,有 63%的患儿CFU MK降低, 25%增高
Objective To investigate the morphology and hematopoietic function of bone marrow megakaryocytes (MK) in children with idiopathic thrombocytopenic purpura (ITP), aplastic anemia (AA) and myelodysplastic syndrome (MDS) and to analyze the causes of different thrombocytopenia , With a view to its early differential diagnosis. Methods 16 cases of ITP, 17 cases of AA and 16 cases of MDS were examined by immunofluorescence staining of CD41α in bone marrow smears. The bone marrow mononuclear cells (BMMNCs) were cultured with clot in vitro and the cell mass index was used to detect the megakaryocytes. Grouping for statistical analysis and comparison. Results The detection rates of small megakaryocytes and type I lymphoid megakaryocytes in ITP children were 87% and 7%, respectively. There was no significant difference between the two groups in the number of small megakaryocytes and the number of megakaryocyte colony forming units (CFU MK) , Blast megakaryocyte colony forming units (BFU MK) were 602 / mm2, 93/2 × 105 MNC and 65/2 × 105 MNC respectively, which were higher than those in the control group Significance of learning. The detection rate of small megakaryocytes in children with AA and the formation rates of CFU MK and BFU MK were 43%, 0 5 / mm 2, 0/2 × 105 MNC and 0/2 × 105 MNC, respectively, lower than those in the control group , Compared with the control group, the difference was statistically significant. The detection rate of small megakaryocytes in MDS children was 87%, which showed no significant difference compared with the normal control group, but the total number and the detection rate of type I lymphoid small megakaryocytes were 37 / mm2 and 73% The difference was statistically significant; CFU MK formation rate of 3/2 × 105 MNC compared with the control group was no significant difference compared with 90% confidence interval of the control group, 63% of children CFU MK decreased 25%