[1]冯 瑾,魏绪仓.肝硬化患者骨髓造血系统异常的机制研究进展及其骨髓细胞学检查的临床意义[J].现代检验医学杂志,2023,38(02):200-204.[doi:10.3969/j.issn.1671-7414.2023.02.038 ]
　FENG Jin,WEI Xu-cang.Research Progress on the Mechanism of Bone Marrow Hematopoietic System Abnormalities in Patients with Liver Cirrhosis and Its Clinical Significance of Bone Marrow Cytology[J].Journal of Modern Laboratory Medicine,2023,38(02):200-204.[doi:10.3969/j.issn.1671-7414.2023.02.038 ]
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肝硬化患者骨髓造血系统异常的机制研究进展及其骨髓细胞学检查的临床意义()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年02期
页码:
200-204
栏目:
综述
出版日期:
2023-03-15

文章信息/Info

Title:
Research Progress on the Mechanism of Bone Marrow Hematopoietic System Abnormalities in Patients with Liver Cirrhosis and Its Clinical Significance of Bone Marrow Cytology
文章编号:
1671-7414（2023）02-200-05
作者:
冯 瑾1; 魏绪仓2
（1.西安医学院，西安 710068；2.陕西省人民医院血液研究室，西安 710068）
Author(s):
FENG Jin1; WEI Xu-cang2
（1.Xi’an Medical College, Xi’an 710068, China；2.Blood Research Laboratory, Shaanxi Provincial People’s Hospital, Xi’an 710068, China）
关键词:
肝硬化; 骨髓造血; 骨髓细胞学检查
分类号:
R575.2；R446.8
DOI:
10.3969/j.issn.1671-7414.2023.02.038
文献标志码:
A
摘要:
肝硬化是由于各种原因造成慢性肝损伤后导致肝脏结构改变的一个病理过程。在疾病发展过程中可有造血系统的异常：出现外周血细胞的减少、骨髓造血细胞形态异常，以及造血干细胞和造血调控因子水平的改变。了解肝硬化骨髓造血系统异常机制和骨髓细胞学检查的临床价值对于肝硬化辅助诊断、治疗、预后及研究都具有重要意义，但目前临床上对肝硬化患者进行骨髓细胞学检查的开展度不高，因此该研究对肝硬化骨髓造血系统异常的机制及其骨髓及外周血细胞学特点作一综述，以期提高临床医生对肝硬化患者骨髓细胞学检查的重视，进一步提高肝硬化患者的诊疗水平。
Abstract:
Cirrhosis is a pathological process that leads to changes in liver structure after chronic liver damage due to various reasons. In the course of its disease development, there may be abnormalities in the hematopoietic system, a decrease in peripheral blood cells, abnormal morphology of bone marrow hematopoietic cells, and changes in hematopoietic stem cells and hematopoietic regulators. Understanding the abnormal mechanism of the bone marrow hematopoietic system of cirrhosis and the clinical value of bone marrow cytology are of great significance for the auxiliary diagnosis, treatment, prognosis and research of cirrhosis, and the current clinical implementation of bone marrow cytology in patients with cirrhosis is not high, so reviews the mechanism of abnormal bone marrow hematopoietic system of cirrhosis and its myeloid cytology.

参考文献/References:

[1] 单姗 , 赵连晖 , 马红 , 等．肝硬化的定义、病因及流行病学 [J].临床肝胆病杂志 , 2021, 37(1): 14-16. SHAN Shan, ZHAO Lianhui, MA Hong, et al. Definition,etiology,and epidemiology of liver cirrhosis [J]. Journal of Clinical Hepatology, 2021, 37(1): 14-16.
[2] GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016[J]. Lancet,2018,392(10152):1015-1035.
[3] fiTZMAURICE C, AKINYEMIJU T F, AL LAMI F H, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: a systematic analysis for the global burden of disease study[J/OL].JAMA Oncol, 2018, 4(11):1553-1568.
[4] MOON A M, SINGAL A G, TAPPER E B. Contemporary epidemiology of chronic liver disease and cirrhosis[J]. Clinical Gastroenterology and Hepatology, 2020, 18(12): 2650-2666.
[5] 国家卫生健康委员会 . 2021中国卫生健康统计年鉴 [M]. 北京 : 中国协和医科大学出版社 , 2021. National Health Commission. 2021 China Health Statistical Yearbook [M]. Beijng: China Union Medical College Press, 2021.
[6] 陆光生 ,景晔 ,徐和福 ,等 . 肝炎肝硬化血细胞减少与骨髓病态造血及脾功能相关性研究 [J].中国医学装备 , 2016, 13(11), 93-97. LU Guangsheng, JING Ye, XU Hefu, et al. Study on the correlation between the blood cell reduction of hepatitis cirrhosis, the pathological hematopoiesis of bone marrow and spleen function [J]. China Medical Equipment, 2016, 13(11), 93-97.
[7] AM ESCH J S, KNOEFEL W T, KLEIN M, et al. Portal application of autologous CD133+ bone marrow cells to the liver: a novel concept to support hepatic regeneration[J]. Stem Cells (Dayton, Ohio), 2005, 23(4): 463-470.
[8] BIHARI C, ANAND L, ROOGE S, et al. Bone marrow stem cells and their niche components are adversely affected in advanced cirrhosis of the liver[J]. Hepatology (Baltimore, Md.), 2016, 64(4): 1273-1288.
[9] 文良志 , 熊吉 , 孙文静 , 等．肝硬化与骨髓造血 [J].实用肝脏病杂志 , 2017, 20(4): 391-393.WEN Liangzhi, XIONG Ji, SUN Wenjing, et al. Liver cirrhosis and bone marrow hematopoiesis[J]. Journal of Practical Hepatology, 2017, 20(4): 391-393.
[10] LEGUIT R J, RAYMAKERS R A P, HEBEDA K M, et al. CCN2 (cellular communication network factor 2) in the bone marrow microenvironment, normal and malignant hematopoiesis[J]. Journal of Cell Communication and Signaling, 2021, 15(1): 25-56.
[11] MENDELSON A, FRENETTE P S. Hematopoietic stem cell niche maintenace during homeostasis and regeneration[J/ OL]. Nature Medicine, 2014, 20(8): 833-846.
[12] TAO Yachao, CHEN Enqiang. Clinical application of stem cell in patients with end-stage liver disease: progress and challenges[J]. Annals of Translational Medicine, 2020, 8(8): 564.
[13] EOM Y W, KIM G, BAIK S K. Mesenchymal stem cell therapy for cirrhosis: Present and future perspectives[J]. World Journal of Gastroenterology: 2015, 21(36): 10253-10261.
[14] VERMA N, SINGH A, SINGH V. Haematopoietic stem cells in cirrhosis[J]. The Lancet Gastroenterology Hepatology, 2018, 3(5): 298.
[15] RAUBER P, LAMMERT F, GROTEMEYER K, et al. Immature platelet fraction and thrombopoietin in patients with liver cirrhosis: A cohort study[J]. PLoS One, 2018, 13(2): e0192271.
[16] WANG Xianyao, WANG Huizhen, LU Junhou, et al. Erythropoietin-modified mesenchymal stem cells enhance anti-fibrosis efficacy in mouse liver fibrosis model[J]. Tissue Engineering and Regenerative Medicine, 2020, 17(5): 683-693.
[17] LEFRAN?AIS E, ORTIZ-MU?OZ G, CAUDRILLIER A, et al. The lung is a site of platelet biogenesis and a reservoir for haematopoietic progenitors[J]. Nature, 2017, 544(7648): 105-109.
[18] 胡维亨 , 任军．人乙型肝炎病毒 DNA阳性血清对人骨髓间充质干细胞向肝细胞分化的影响 [J]．北京大学学报 (医学版 ), 2008, 40(5)：459-464． HU Weiheng, REN Jun. Impact of hepatitis B virus infected serum on the hepatic differentiation of human bone marrow mesenchymal stem cells [J]. Journal of Peking University(Health Sciences), 2008, 40(5): 459-464.
[19] O’MALLEY D P , SMITH L , FEDORIW Y . 6-Benign causes of bone marrow abnormalities including infections, storage diseases, systemic disorders, and stromal changes[M].// Hematopathology(3th Ed) . Philadelphia: Elsevier, 2018: 184-209,e1.
[20] 张飞 , 张志勇． 763例肝硬化患者的病因及临床特点分析 [J]. 临床消化病杂志 , 2019, 31(2): 89-92. ZHANG Fei, ZHANG Zhiyong. Etiology and clinical characteristics of patients with cirrhosis in 763 cases[J]. Chinese Journal of Clinical Gastroenterology, 2019, 31(2): 89-92.
[21] 苟欢 , 安新颖 , 童俞嘉 , 等．近 5年国际酒精性肝硬化研究状况分析 [J].胃肠病学和肝病学杂志 , 2022, 31(2): 165-172. GOU Huan, AN Xinying, TONG Yujia, et al. Analysis of international research on alcoholic liver cirrhosis in recent 5 years[J]. Chinese Journal of Gastroenterology and Hepatology, 2022, 31(2): 165-172.
[22] 杨宁 , 丁扬 , 李妍 , 等．丙型病毒性肝炎肝硬化和酒精性肝硬化患者骨髓象特点分析 [J]．中国病毒病杂志 , 2018, 8(2)：146-150． YANG Ning, DING Yang, LI Yan, et al. Bone marrow image analysis of patients with hepatitis C cirrhosis and alcoholic liver cirrhosis[J]. Chinese Journal of Viral Diseases, 2018, 8(2): 146-150.
[23] 武鹏 , 苑文雯 , 李沛然 , 等．乙型肝炎肝硬化与酒精性肝硬化患者骨髓细胞学检查结果分析 [J].中国急救复苏与灾害医学杂志 , 2014, 4：324-327． WU Peng, YUAN Wenwen, LI Peiran, et al. Analysis of hepatitis B liver cirrhosis and alcoholic liver cirrhosis patients with bone marrow cytology[J]. China Journal of Emergency Resuscitation and Disaster Medicine, 2014, 4: 324-327.
[24] ISRINGHAUSEN S, MUN Y V, KOVTONYUK L, et al. Chronic viral infections persistently alter marrow stroma and impair hematopoietic stem cell fitness[J]. The Journal of Experimental Medicine, 2021, 218(12): e20192070.
[25] 符火 , 林尤仕 .失代偿期肝硬化患者全血细胞减少的临床病因与血象、骨髓象分析 [J].中国卫生检验杂志 , 2016, 26(1):90-92, 97. FU Huo, LIN Youshi. Analysis of the clinical etiology of pancytopenia, blood marrow and bone marrow in patients with loss compensation period liver cirrhosis [J]. Chinese Journal of Health Laboratory Technology, 2016, 26(1):90-92, 97.
[26] 何刚 , 李宏波．肝炎后肝硬化血象及骨髓象的临床分析 [J].全科医学临床与教育 , 2014, 12(2): 188-189, 116. HE Gang, LI Hongbo. Clinical analysis of blood and bone marrow after hepatitis[J]. Clinical Education of General Practice, 2014, 12(2): 188-189, 116.
[27] 李彩霞 , 王伟 , 毛剑锋 .肝炎后肝硬化血象骨髓象分析 [C].//2007年浙江省检验医学学术年会论文汇编 .杭州 : 浙江省医学会医学检验学分会 , 2007-09-01, 2007: 641-643. LI Caixia, WANG Wei, MAO Jianfeng. Analysis of blood and bone marrow images of liver cirrhosis after hepatitis[C]. // Proceedings of the Zhejiang Laboratory Medicine Annual Conference, Hangzhuo: Laboratory Medicine Branch of Zhejiang Medical Association, 2007-09-01, 2007:641-643.
[28] 马艳丽．肝硬化脾功能亢进 56例骨髓象临床观察 [J].中国误诊学杂志 , 2009, 9(18)：4457-4458． MA Yanli. Clinical observation of bone marrow images in 56 cases of hypersplenism in cirrhosis[J]. Chinese Journal of Misdiagnostics, 2009, 9(18): 4457-4458.
[29] 向治纬 , 谢会忠 , 余丽君 , 等 .失代偿期肝硬化患者 60例骨髓细胞学分析 [J].实用医学杂志 , 2012, 28 (1):98-101. XIANG Zhiwei, XIE Huizhong, YU Lijun, et al. Cytology analysis of 60 patients with decompensated liver cirrhosis[J]. Journal of Practical Medicine, 2012, 28(1):98-101.
[30] 陈秀花 , 郑晓燕 , 彭春仙．肝硬化失代偿期血液异常的临床病因与外周血象、骨髓象特征分析 [J]．中国卫生检验杂志 , 2019, 29(12)：1522-1524． CHEN Xiuhua, ZHENG Xiaoyan, PENG Chunxian. Analysis of clinical etiology, peripheral blood and bone marrow features in patients with decompensated cirrhosis and hematological abnormality[J]. Chinese Journal of Health Laboratory Technology, 2019, 29(12): 1522-1524.
[31] 陈会军 .失代偿期肝硬化患者骨髓细胞学检查结果分析 [J].当代医学 , 2019, 25(12)：51-53． CHEN Huijun. Analysis of bone marrow cytology in patients with decompensated cirrhosis[J]. Contemporary Medicine, 2019, 25(12): 51-53.
[32] 付蓉 , 刘春燕．再生障碍性贫血诊断与治疗中国专家共识 (2017版 )解读 [J]．临床血液学杂志 , 2017, 30(11)：821-825． FU Rong, LIU Chunyan. Interpretation of "expert consensus on the diagnosis and management of aplastic anemia in China (2017)"[J]. Journal of Clinical Hematology, 2017, 30(11): 821-825.
[33] 鲍峰 , 蒋安 , 李宗芳 , 等．肝硬化门脉高压症脾亢患者脾切除前后骨髓象变化及其机制的研究 [C].//第三届中国现代医学研究方法暨学科交叉创新研讨会 , 2009上海医学科研管理年会论文集．上海：上海交通大学医学部 , 2009-01-01, 2009：182． BAO Feng, JIANG An, LI Zongfang, et al. Changes and mechanisms of bone marrow before and after splenectomy in patients with portal hypertension in liver cirrhosis[C]. // The 3rd Chinese Symposium on Modern Medical Research Methods and Interdisciplinary Innovation, Proceedings of Shanghai Medical Research Management Annual Conference 2009. Shanghai: Medical Science Center, Shanghai Jiaotong University, 2009-01-01, 2009: 182.
[34] 吕云福 , 刘允怡 , 吴鸿飞 , 等 .肝硬化门静脉高压症并发外周血细胞减少的病因及其构成比研究 [J].中华普通外科杂志 , 2018, 33(7): 559-562.Lü Yunfu, LIU Yunyi, WU Hongfei, et al. Peripheral cytopenia and its contituent ratio in cirrhotic portal hypertension[J]. Chinese Journal of General Surgery, 2018, 33(7): 559-562.
[35] Lü Yunfu, YEE LAU W, WU Hongfei, et al. Causes of peripheral cytopenia in hepatitic cirrhosis and portal hypertensive splenomegaly[J]. Experimental Biology and Medicine (Maywood, N.J.), 2017, 242(7): 744-749.
[36] 曹威 , 韩海霞 , 陈诚．乙肝肝硬化血细胞减少患者骨髓象改变与LDH水平及其临床意义[J]．交通医学, 2018, 32(4)：363-365． CAO Wei, HAN Haixia, CHEN Cheng. Bone marrow changes and LDH levels and their clinical significance in patients with hepatitis B cirrhosis cytopenia[J]. Medical Journal of Communications, 2018, 32(4): 363-365.
[37] 佘鹏 , 魏欣．临床实验室骨髓细胞形态学检验的质量要求及实践思考 [J]．现代检验医学杂志 , 2019, 34(6)：157-160． SHE Peng, WEI Xin. Quality requirements and practical thinking of bone marrow cell morphology examination in clinical laboratory[J]. Journal of Modern Laboratory Medicine, 2019, 34(6): 157-160.
[38] 李俊法．经肝动脉自体骨髓干细胞肝内移植治疗失代偿期肝硬化的临床应用可能性及效果 [J].医学理论与实践 , 2017, 30(3)：373-374． LI Junfa. Clinical application possibility and effect of intrahepatic transplantation of transhepatic artery autologous bone marrow stem cells in the treatment of decompensated cirrhosis[J]. The Journal of Medical Theory and Practice, 2017, 30(3): 373-374.

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备注/Memo

备注/Memo:
收稿日期：2022-11-06 修回日期：2022-11-23
作者简介：冯瑾（1994-），女，硕士研究生在读，检验医师（初级），研究方向：骨髓活检 /形态学诊断，E-mail: fengjin0813@163.com。
通讯作者：魏绪仓，研究员，E-mail:weixucang62@sina.com。

更新日期/Last Update: 2023-03-15