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目的 :探讨急性白血病 ( AL)和贫血患者噬血细胞 ( Hem)变化 ,以阐明 Hem在部分早幼粒细胞白血病( M3)出现的临床意义。方法 :观察 2 2 3例骨髓 Hem ,其中 5 1例 M3,72例其它 AL及 10 0例贫血患者。结果 :M3患者 Hem阳性 12例 ( 2 3.5 % )较其它 AL组 ( 4.2 % )和贫血组 ( 5 .0 % )明显增多 (均为 P <0 .0 1)。 M3患者的平均每片 Hem数为 2 9.4只 ,也明显多于其它 AL组 ( 2 .8只 )和贫血组 ( 2 .3只 )。随机选取 2 0例化疗后的 M3患者 ,其中 6例阳性患者化疗后的骨髓仍有 3例 Hem明显增高 ,3例已明显减少 ,而 14例阴性患者未见 Hem变化。结论 :M3伴 Hem增多作为部份 M3患者的一种特殊细胞学变化 ,对 M3的鉴别诊断及 M3患者易引发全血细胞减少和弥散性血管内凝血等发病机制的探讨都有一定的临床价值
Objective: To investigate the changes of hemophagocytic (Hem) in patients with acute leukemia (AL) and anemia to clarify the clinical significance of Hem in some promyelocytic leukemia (M3). Methods: Twenty-three cases of bone marrow Hem were observed, including 51 cases of M3, 72 cases of other AL and 100 cases of anemia. Results: Hem positive in M3 patients was significantly higher than that in other AL patients (4.2%) and anemia patients (5.0%) (all P <0.01) in 12 patients (23.5%). The average number of Hem in M3 patients was 2 9.4, which was significantly higher than that in other AL patients (2. 8) and anemia patients (2.3). Twenty patients with M3 after chemotherapy were randomly selected. Among the 6 positive patients, 3 patients had positive Hem after chemotherapy, 3 patients had obviously decreased, and 14 patients had negative Hem. Conclusion: The increase of M3 with Hem is a special cytological change in some patients with M3. It has certain clinical value in the differential diagnosis of M3 and the pathogenesis of M3 in patients with pancytopenia and disseminated intravascular coagulation