以粒系细胞巨变为特征的巨幼细胞性贫血——附6例报告

摘要

ObjectiveTo report 6 cases of megaloblastic anemia (MA) characterized by granulocytic series with extreme or significant hypercellularity and giants. MethodThe characteristics of usual clinic, hemogram and myelogram of MA characterized by extreme or significant hypercellualrity and giants were analyzed with morphologic examination. ResultsIn these cases, there were mostly significantly decreased WBC and Plt in peripheral blood and granulocytic series with extreme or significant hypercellualrity and giants but erythrocytic series with not significant hypercellularity and decreased cell quantity indeed in bone marrow. There was erythrocytic series mostly with slightly or intermediately megaloblastic changes. There were rubriblasts and prorubricytes with less or no typical megaloblastic changes which could be seen in general MA. There was significant therapy effect with vitamin B12 or vitamen B12 and folic acid as general MA. ConclusionThe MA characterized by granulocytic series with extreme or significant hypercellularity and giants was a special type of MA. It is easy to diagnose incorrectly and difficult to diagnose due to deficient cognition to it.%目的报告以粒系细胞显著增生和巨变为特征的巨幼细胞性贫血(MA)。方法用形态学检查方法分析粒系细胞显著增生和巨变为特征MA的一般临床、血象和骨髓象特点。结果此种MA的外周血白细胞(WBC)和血小板(Plt)多呈明显或显著减低，骨髓粒系细胞显著增生和巨变，而幼红细胞增生不明显甚至出现细胞量减少。幼红细胞多为轻中度巨变，一般MA中常见典型的原红和早幼红细胞巨变少见或不见。予以Vit B12或和叶酸一起治疗，具有与一般MA一样的明显疗效。结论认为骨髓粒系细胞显著增生和巨变为特征的MA是一种特殊类型，由于缺乏对它的认识易于造成误诊或一时诊断难定。