[骨髓增生异常综合征40例的临床分析]骨髓增生异常综合征

　　[摘要] 目的 探讨骨髓增生异常综合征（MDS）患者的临床特点，以利于临床诊断和治疗。方法 对2001年1月～2011年10月在我院住院的MDS患者40例的临床资料进行回顾性分析。对本组资料中收集的难治性贫血（RA）20例、环形铁粒细胞性难治性贫血（RAS）2例、难治性贫血伴有原始细胞增多（RAEB）12例、难治性贫血伴原始细胞增多转变型（RAEB-T）6例分别进行化疗治疗，观察其治疗效果及各亚型的转归情况，以及外周血常规变化。 结果 40例MDS患者中，基本缓解12例，明显进步10例，进步7例，无效11例。其中，11例转化为急性白血病（AL），占27.5%，从诊断MDS之日起转化为AL的平均时间为23.4个月。RA型血红蛋白[（69.3±23.4）g/L vs（52.6±20.1）g/L）]、白细胞数[（3.5±1.3）×109/L vs（2.2±0.5）×109/L]治疗后较治疗前明显升高（P 0.05）。 结论 MDS的治疗效果及转归与其亚型有关，对MDS进行治疗应根据各亚型患者的年龄、转归情况、骨髓病态造血程度等进行综合分析，采用个体化治疗的原则，以提高患者的治疗效果。
　　[关键词] 骨髓增生异常综合征；贫血；血象；骨髓象
　　[中图分类号] R551 [文献标识码] A [文章编号] 1673-7210（2012）07（a）-0058-03
　　Clinical analysis of myelodysplastic syndromes in 40 patients
　　XIAO Tangjie1 CHEN Su′e2
　　1.Department of Hematology, the People′s Hospital of Yangxin County in Huangshi City, Hubei Province, Yangxin 435200, China; 2.Centers for Disease Control of Yangxin County in Huangshi City, Hubei Province, Yangxin 435200, China
　　[Abstract] Objective To explore the clinical character of patients with myelodysplastic syndromes (MDS) for the diagnose and treatment. Methods The data of 40 MDS patients from January 2001 to October 2011 in our hospital were retrospectively analyzed. The patients of RA 20 cases, RAS 2 cases, RAEB 12 cases, RAEB-T 6 cases were treated with different chemical treatment methods, the treatment effect, the outcome of each subtype, as well as peripheral blood changes were observed. Results Of 40 patients, basic relief in 12 cases, significant improvement in 10 cases, progress in 7 cases, invalid in 11 cases. 11 cases transferred into the AL, accounting for 27.5%, from the date of diagnosis of MDS into the AL, the average time was 23.4 months. For the patients in the RA type, there was a significant difference on the HB[(69.3±23.4)g/L vs (52.6±20.1)g/L] and WBC[(3.5±1.3)×109/L vs (2.2±0.5)×109/L)(P 0.05). Conclusion The treatment and prognosis of MDS are related with MDS subtypes, for the treatment of MDS, which should be based on the patient"s age, outcome of the situation, the extent of bone marrow dysplasia, and comprehensive analysis, to adopt the principle of individual treatment, in order to improve the effect of patients.