Casper J T, Koethe S, Rodey G E, Thatcher L G
Blood. 1976 Feb;47(2):183-8.
Differential interference contrast (DIC) microscopy (Nomarsky optics) readily demonstrates the formation of "pits" or crater-like depressions in red cell membranes of splenectomized individuals. Splenic reticuloendothelial dysfunction characteristic of many patients with sickle cell disease (SCD) can be demonstrated by technetium spleen scans, but this technique is expensive, requires injection of radioactive material into children, and is cumbersome to perform at regular intervals. However, pit formation in red cells, which also appears to reflect splenic dysfunction, can readily be quantitated in a finger-stick blood sample using DIC microscopy. In this study, the degree of red cell pitting was compared with results of technetium spleen scans and measurements of Howell-Jolly bodies in individuals with sickle cell disease. The average pitted cell percentage in the control population was 0.5% +/- 0.5 (range 0.0-2.6) and 30.5% +/- 13.9 in the SCD population (range 2.4-71.1) (less than 0.001). Of the individuals studied with SCD, 12 also had technetium (99mTc) sulfur colloid scans and measurements of Howell-Jolly bodies. The percentage of Howell-Jolly bodies was low and did not correlate well with the degree of splenic visualization. However, there was an excellent correlation between pit count and splenic dysfunction as measured by spleen scan. Determination of red cell pitting, therefore, appears to offer a simple means for clinical evaluation of splenic reticuloendothelial function in patients with SCD.
微分干涉差（DIC）显微镜检查（诺马斯基光学）能轻易显示脾切除个体红细胞膜上“凹坑”或火山口样凹陷的形成。许多镰状细胞病（SCD）患者具有的脾网状内皮功能障碍可通过锝脾扫描显示，但该技术费用高昂，需要给儿童注射放射性物质，且定期进行操作繁琐。然而，红细胞中的凹坑形成似乎也反映了脾功能障碍，使用DIC显微镜检查可轻易在手指采血样本中对其进行定量。在本研究中，对镰状细胞病患者的红细胞凹陷程度与锝脾扫描结果及豪-乔小体测量结果进行了比较。对照组人群中平均凹坑细胞百分比为0.5%±0.5（范围0.0 - 2.6），SCD人群中为30.5%±13.9（范围2.4 - 71.1）（P＜0.001）。在研究的SCD个体中，12人还进行了锝（99mTc）硫胶体扫描及豪-乔小体测量。豪-乔小体的百分比很低，与脾显影程度相关性不佳。然而，通过脾扫描测量，凹坑计数与脾功能障碍之间存在极好的相关性。因此，红细胞凹陷的测定似乎为临床评估SCD患者的脾网状内皮功能提供了一种简单方法。
