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目的回顾分析一例诊断为再障患者,半年后复查骨髓已为急性白血病(M2),分析误诊原因,杜绝这类患者的误诊。方法回顾分析该患者初诊时资料,如临床资料,血常规中红细胞参数,如红细胞平均体积、平均血红蛋白量,及多部位骨髓涂片特点。结果患者因贫血就诊,初诊时经过骨髓涂片、活检诊断为再障,给予促造血治疗效果不明显,半年后复诊诊为急性白血病。讨论和结论回顾维也纳诊断ICUS诊断标准,分析全细胞减少症患者,与诊断标准不典型指标不能忽视,重视这些指标可杜绝这类疾病的误诊。
Objective To retrospectively analyze one patient diagnosed as having an aplastic anemia. After six months, the reexamination of the bone marrow has been diagnosed as acute leukemia (M2). Analyze the misdiagnosis and eliminate the misdiagnosis of these patients. Methods We retrospectively analyzed the data of the patient at the time of initial diagnosis, such as clinical data, red cell parameters in the blood routine, such as the average volume of red blood cells, the average hemoglobin level, and the characteristics of multi-site bone marrow smears. Results The patient was diagnosed with anemia. He had bone marrow smears at the initial diagnosis, biopsy diagnosed as aplastic anemia. The effect of promoting hematopoietic therapy was not obvious. He was diagnosed as acute leukemia after half a year. Discussion and conclusions We reviewed the diagnostic criteria for ICUS in Vienna and analyzed patients with pancytopenia. Atypical indicators cannot be ignored with the diagnostic criteria. Attention to these indicators can prevent misdiagnosis of these diseases.