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中国当代医药  2022, Vol. 29 Issue (8): 42-46    
  临床研究 本期目录 | 过刊浏览 | 高级检索 |
836例全血细胞减少患者临床特征分析
王 欢 叶 芳▲ 李宁宁 舒亚南 童 春 王 玲 张立男
北京市垂杨柳医院血液科,北京 100021
Analysis of the clinical characteristics of 836 patients with pancytopenia
WANG Huan YE Fang▲ LI Ningning SHU Ya′nan TONG Chun WANG Ling ZHANG Linan
Department of Hematology, Beijing Chuiyangliu Hospital, Beijing 100021, China
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摘要 目的 探讨北京市三级综合医院全血细胞减少患者的临床特征。 方法 选取2016年1月至2020年10月北京市垂杨柳医院的836 例全血细胞减少患者作为研究对象,根据病因分成造血系统疾病组(n=287)和非造血系统疾病组(n=488),比较两组血细胞减少程度,并分析和总结全部患者科室分布及病因。 结果 836 例患者中,全血细胞减少程度整体以轻、中度为主。轻、中度贫血患者785 例(93.9%),521 例(62.32%)患者血小板计数为(75~<125)×109/L,763 例(91.15%)患者白细胞计数为(2.0~<3.5)×109/L。 全血细胞减少患者主要分布在血液科、急诊科、呼吸内科、普通外科、消化内科、心内科等科室。 836 例患者根据病因分为造血系统疾病287 例(34.33%)、非造血系统疾病488 例(58.37%)。 造血系统疾病以巨幼细胞性贫血为主要病因(35.19%),其次为骨髓增生异常综合征(19.16%)。非造血系统疾病以感染性疾病为主要病因(34.06%),其次为转移性肿瘤(21.31%)。 造血系统疾病组白细胞、血红蛋白及血小板计数减少程度均高于非造血系统疾病组,差异有统计学意义(P<0.05)。 结论 各专业临床医生应重视寻找全血细胞减少的病因,提高对全血细胞减少的认识和诊疗水平。 除造血系统疾病外,由非造血系统疾病引起的全血细胞减少也占相当比例,对于这样的患者应积极行骨髓细胞学和相关实验室检查明确诊断,避免漏诊及误诊。
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关键词 全血细胞减少造血系统疾病非造血系统疾病病因分析    
Abstract:Objective To investigate the clinical characteristics of patients with pancytopenia in the third-class comprehensive hospital preliminarily. Methods A total of 836 patients with pancytopenia in our hospital from January 2016 to October 2020 were selected as the subjects, and divided into hemotopathy group (287 cases) and non-hemotopathy group (488 cases). The blood cell reduction degree were compared between the two groups. The distribution and cause of all patients were analyzed and summarized. Results Among the 836 patients, the degree of pancytopenia was mainly mild or moderate.There were 785 cases(93.9%)of mild and moderate anemia,Pations of platelet count([75-<125]×109/L)was 21 cases(62.32%),WBC count([2.0-<3.5]×109/L)was 763 cases(91.15%).Patients with pancytopenia were mainly distributed in Department of Haematology, Department of Emergency, Department of Respiratory Medicine, Department of General Surgery,Department of Gastroenterology,Department of Cardiology and other departments.According to the etiology, the 836 patients were divided into 287 cases (34.33%) of hemotopathy and 488 cases (58.37%) of non-hemotopathy.In hematopoietic system, megaloblastic anemia mainly accounted for 35.19%, followed by myelodysplastic syndrome(19.16%). In non-hematopoietic system, infection disease accounted for 34.06%, followed by metastatic tumor (18.5%).The decrease degree of leukocyte, hemoglobin and platelet in hemotopathy was higher than that in non-hemotopathy, the difference was statistically significant(P<0.05).Conclusion Clinicians of all specialties should pay attention to finding the etiology of pancytopenia,and improve the level of diagnosis and treatment. Pancytopenia is mainly caused by hematopoietic disorders, non-hematopoietic diseases also accounts for a certain percentage. Bone marrow cytology and laboratory tests should be actively performed to confirm the diagnosis and avoid missed diagnosis and misdiagnosis.
Key wordsPancytopenia    Cause analysis    Hemotopathy    Non-hemotopathy
    
基金资助:北京市朝阳区科技计划项目(CYSF1812);北京市科委计划项目(Z191100006619054)。
通讯作者: 叶芳(1973-),女,湖北咸宁人,博士,主任医师,硕士研究生导师,研究方向:恶性血液病的诊断与治疗。   
作者简介: 王欢(1987-),女,河北石家庄人,硕士,研究方向:恶性血液病的基础与临床研究。
引用本文:   
王欢; 叶芳; 李宁宁; 舒亚南; 童春; 王玲; 张立男. 836例全血细胞减少患者临床特征分析[J]. 中国当代医药, 2022, 29(8): 42-46.
WANG Huan YE Fang▲ LI Ningning SHU Ya′nan TONG Chun WANG Ling ZHANG Linan. Analysis of the clinical characteristics of 836 patients with pancytopenia. 中国当代医药, 2022, 29(8): 42-46.
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