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患者,男,70岁,干部,因面色苍白,活动后胸背部刺痛4个月,发烧、鼻衄1周于1991年1月8日入院。查体:T38.3℃。重度贫血貌,皮肤散在出血点,胸骨压痛,脾肋下1cm。实验室检查:血红蛋白55g/L,白细胞9.8X10~3/L,N0.52,L0.24,M0.03,E0.02,幼粒细胞0.10,幼红细胞0.09,血小板30x10~3/L,网织红细胞0.028,骨髓穿刺第1次干抽,第2次混血示原十早幼粒细胞0.23,腰椎Ⅹ线片,第1～5腰椎体有斑块状硬化现象。左髋前骨髓活检,骨小梁清晰,骨纤维组织增生,粒系增生活跃,见少数成族状排列的早期幼稚粒细胞,红系成熟轻少见,巨核系明显活跃,单核样,多核样巨核细胞多见。意见:骨髓增生异常综合征(MDS,RAEB—t)并骨髓纤维化。入院后反复龈出血、鼻衄、肺、痔疮感染,给子输血、止血
Patient, male, 70 years old, cadre, pale, activity chest and back stabbing for 4 months, fever, epistaxis 1 week on January 8, 1991 admitted. Physical examination: T38.3 ℃. Severe anemia appearance, scattered in the skin bleeding point, sternal tenderness, spleen ribs 1cm. Laboratory tests: hemoglobin 55g / L, white blood cells 9.8X10 ~ 3 / L, N0.52, L0.24, M0.03, E0.02, promyelocytic 0.10, erythroblasts 0.09, platelets 30x10 ~ 3 / L, Reticulocyte 0.028, bone marrow puncture the first dry pumping, the second hybrid showed primitive ten promyelocytic 0.23, lumbar Ⅹ ray, 1 ~ 5 lumbar vertebral body plaque sclerosis. Left hip before bone marrow biopsy, clear trabecular bone, bone fibrous tissue hyperplasia, granulocyte hyperplasia active, see a small number of ethnic navel early immature granulocytes, erythroid mature rare, obviously active megakaryocyte, mononuclear, multicucleant Megakaryocytes more common. Opinion: Myelodysplastic syndrome (MDS, RAEB-t) and myelofibrosis. Repeated gingival bleeding after admission, epistaxis, lung, hemorrhoids infection, to the child blood transfusion, bleeding