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目的探讨排除再生障碍性贫血及白血病，MM等能确诊血小板生成减少外一些疾病巨核细胞多形性改变的意义。将巨核细胞多形性形态定义5类[1]分别为：Ⅰ型（包含型），Ⅱ型（少分叶核型）Ⅲ型（巨大多分叶核型），Ⅳ型（小核固缩型），Ⅴ型（脱落型），另外我们把正常巨核细胞分为Ⅵ型。方法136例血小板减少性患者采取骨髓0.1~0.3ml，获取骨髓涂片标本，骨髓涂片用瑞氏染色法染色，将骨髓片中的巨核细胞进一步分析。结果①脑梗塞及高血压5例：Ⅱ5.5%,Ⅲ5.5%,Ⅴ5.5%,Ⅵ83.5%.②不明原因巨核细胞成熟障碍30例，I 0.2%,Ⅱ4.1%,Ⅲ4.7%,Ⅳ0.4%,Ⅴ8.2%,Ⅵ型82.4%。③巨核细胞减少4例，Ⅱ5.5%,Ⅲ11%,Ⅴ1.5%，Ⅵ72%。④增生性贫血24例，Ⅰ0.33%,Ⅱ,2.65%,Ⅲ,0.99%,Ⅳ0.33%,Ⅴ,5.96%,Ⅵ,89.74%。⑤ITP20例：Ⅰ0.2%,Ⅱ2%,Ⅲ1%,Ⅳ0.8%,Ⅴ4%,Ⅵ92%。⑥MDS8例：Ⅱ0.8%,Ⅲ11.9%,Ⅴ9.5%,Ⅵ86.3%,小原巨核细胞9.5%。⑦巨幼细胞性贫血4例：Ⅲ型20%，Ⅴ型3.9%,Ⅵ型76.1%。⑧粒细胞减少症3例：Ⅴ型7%，Ⅵ型93%。⑨人粒细胞无形体病立克次病1例：Ⅲ型4个，Ⅴ型2个，Ⅵ型28个。结论①以上9类中Ⅰ型Ⅱ型Ⅳ型巨核细胞较低。②MDS中Ⅲ型Ⅴ型巨核细胞显著增高。 MDS小原巨核细胞比例增高。③巨幼细胞性贫血Ⅲ型巨核细胞比例增高。④脑梗塞及高血压病Ⅱ型Ⅲ型巨核细胞比例增高。“,”Objective To investigate excluding aplastic anemia and leukemia, MM can diagnose some diseases decreased platelet and megakaryocyte polymorphic change significance. The megakaryocyte polymorphic form defined 5 types of [1] were:type I (including type),type Ⅱ(smal leaf type III (karyotype) huge multilobular karyotype), typeⅣ(smal nuclear pyknosis type),V(drop type),we put the normal megakaryocyte divided into type VI. Methods:136 cases of thrombocytopenic patients to take 0.1-0.3 ml of bone marrow,bone marrow smear specimens were obtained,bone marrow smears stained with Wright's staining staining,the megakaryocyte bone marrow in the further analysis. Results:5 cases of cerebral infarction and hypertension:II 5.5%, Ⅲ5.5%, V 5.5%, 30 cases of 83.5%, the unexplained megakaryocyte maturation disorder of I 0.2%, 4.1%,4.7% and 0.4% V Ⅲ, Ⅳ,8.2%,and 82.4% of type VI.The megakaryocyte reduced in 4 cases,5.5%,III 11%, V 1.5%, V 72%. ④ proliferative anemia in 24 cases,I 0.33%,II,III,IV,2.65%,0.99%,0.33%,5.96%,V,VI,89.74%.The ITP20 example:I 0.2%, II 2%,III 1%,IV 0.8%,V 4%,V 92%.MDS8:0.8%casesⅡ,Ⅲ11.9%,9.5%V, VI 86.3%, 9.5%smal megakaryocyte.In 4 cases the megaloblastic anemia:type 20%,3.9%type Ⅴ, Ⅵ type 76.1%. ⑧neutropenia in 3 cases:7% typeⅤ, Ⅵ type 93%.1 cases of zoonotic disease made the human granulocytic anaplasmosis:type4,2typeⅤ, Ⅵ type 28. Conclusion: the above 9 categories of 1 type I and II type IV megakaryocyte low.Type III2:MDS Ⅴ megakaryocyte increased significantly.Increased MDS smal megakaryoblastic ratio.3:the increase of megakaryocyte proportion of megaloblastic anemia type III.4:the increase of megakaryocyte percentage of cerebral infarction and hypertensive disease type III.