60例AIDS患者骨髓细胞形态学特征及预后关系

Morphological characteristics and prognosis of bone marrow cells in 60 patients with AIDS

摘要:

目的 探讨获得性免疫缺陷综合征（AIDS）患者骨髓细胞形态学特征，为快速诊断AIDS以及预后提供依据。方法 回顾性分析广西医科大学第一附属医院行HIV检查的疑似AIDS患者60例，对其中HIV阳性患者行骨髓细胞学检查，并对检查结果进行统计学分析。结果 AIDS患者取材60份，取材满意度为100%。其中马尔尼菲青霉菌（PM）检出8例、淋巴瘤细胞检出1例；有核细胞增生活跃57例，粒红细胞比值升高27例、降低26例；骨髓细胞常见异常表现型分布前3的依次为：淋巴细胞减少、红细胞核形态异常、红细胞缗钱状排列。截止最后随访时间，60例HIV阳性患者死亡27例，总生存率为45.0%，增生活跃者死亡率为11.67%，低于增生不活跃者（P?<0.05）。结论 AIDS患者的骨髓细胞学特点主要表现为粒细胞、红细胞、巨核细胞系统一系或多系病态造血，淋巴细胞比率降低，常伴组织细胞反应性增殖或活化，骨髓细胞检测可以用于AIDS的筛查。

Abstract:

Objective To investigate the morphological characteristics of bone marrow cells in patients with acquired immunodeficiency syndrome (AIDS), and to provide a clinical basis for the rapid diagnosis of AIDS and the prognosis. Methods The suspected cases of AIDS who underwent HIV examination were retrospectively analyzed. Among them, HIV positive patients were given bone marrow cytology examination, and the results of the examination were statistically analyzed. Results Totally 60 samples were taken and the satisfaction rate was 100%. Penicillium marneffei (PM) was detected in 8 cases, and lymphoma cells was detected in 1 case. There were 57 cases who were active in nucleated cells. Erythrocyte ratio increased in 27 cases, decreased in 26 cases. The first three common abnormal phenotypes of bone marrow cells were lymphocytopenia, abnormal morphology of erythrocyte nucleus and money-like arrangement of erythrocyte. At the end of the follow-up period, there were 27 deaths in 60 HIV-positive patients, with a total survival rate of 45.0% and a mortality rate of 11.67% in hypertrophic active patients, which was much lower than that in hypertrophic inactive patients (P?