目的探讨外周血白细胞、红细胞和血小板三系同时减少时的骨髓变化及常见病因。方法对168例全血细胞减少症患者的骨髓检查及诊断资料进行回顾分析。结果 134例全血细胞减少的病因以血液系统疾病为主,占79.8%,其中常见的有再生障碍性贫血占39.5%,骨髓增生异常综合征占17.9%,急性白血病占16.4%。非血液系统疾病34例,占20.2%,其中急慢性肝病11例,重度感染8例,结缔组织8例等。7例儿童全血细胞减少症,其中急性白血病3例,再生障碍性贫血2例,重度感染1例,肝病1例。结论全血细胞减少最常见的病因是造血系统疾病,因此骨髓细胞形态学检查是全血细胞减少症病因诊断的主要手段,部分非造血系统疾病的诊断需结合临床。 Objective To investigate the changes of bone marrow and the common etiologies of leukocytes, erythrocytes and platelets when they are simultaneously decreased in three lines. Methods 168 cases of patients with pancytopenia bone marrow examination and diagnostic data were analyzed retrospectively. Results The cause of 134 cases of pancytopenia was mainly hematologic diseases, accounting for 79.8%. Of them, 39.5% had common aplastic anemia, 17.9% had myelodysplastic syndrome and 16.4% had acute leukemia. 34 cases of non-hematological diseases accounted for 20.2%, of which 11 cases of acute and chronic liver disease, severe infection in 8 cases, 8 cases of connective tissue. Seven cases of children with pancytopenia, including acute leukemia in 3 cases, 2 cases of aplastic anemia, severe infection in 1 case, liver disease in 1 case. Conclusion The most common cause of pancytopenia is hematopoietic system disease. Therefore, morphological examination of bone marrow cells is the main method to diagnose the cause of pancytopenia. Some non-hematopoietic system diseases should be combined with clinical diagnosis.