Bunyaratvej A, Komanasin N, Sriurairatana S, Fucharoen S
Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Thailand.
Southeast Asian J Trop Med Public Health. 1992;23 Suppl 2:60-4.
Platelets from patients with beta-thalassemia/hemoglobin E, both splenectomized and nonsplenectomized cases, were examined in comparison to those from normal subjects by scanning electron microscopy. In normal subjects, the majority of platelets were discoid (mean +/- SD, 81.0 +/- 3.9%) with 17.3 +/- 3.5% type I spherical shapes (platelet with long axis/short axis greater than 1.1) and 1.3 +/- 1.0% type II (long axis/short axis = 1.0-1.1). The thalassemic patients had significant lower percentage of discoid platelets (60.9 +/- 8.1% in nonsplenectomized patients, 49.2 +/- 9.1% in splenectomized patients) and increase in spherical platelets (nonsplenectomized patients had 36.6 +/- 8.3% type I, 4.0 +/- 1.5% type II; splenectomized patients had 43.4 +/- 7.9% type I, 8.3 +/- 4.5% type II). Study of platelet reversibility from pseudopods to smooth surface showed that thalassemic platelets had poorer reversibility than normal platelets. Splenectomized patients had lower platelet pseudopod reversibility than nonsplenectomized cases. The shape changes and impaired reversibility of platelet pseudopods may be associated with the high tendency of pulmonary thrombus in beta-thal/HbE patients.
通过扫描电子显微镜，对β地中海贫血/血红蛋白E患者（包括脾切除和未脾切除病例）的血小板与正常受试者的血小板进行了检查。在正常受试者中，大多数血小板呈盘状（平均值±标准差，81.0±3.9%），17.3±3.5%为I型球形（长轴/短轴大于1.1的血小板），1.3±1.0%为II型（长轴/短轴=1.0 - 1.1）。地中海贫血患者的盘状血小板百分比显著降低（未脾切除患者为60.9±8.1%，脾切除患者为49.2±9.1%），球形血小板增加（未脾切除患者有36.6±8.3%的I型，4.0±1.5%的II型；脾切除患者有43.4±7.9%的I型，8.3±4.5%的II型）。对血小板从伪足到光滑表面的可逆性研究表明，地中海贫血患者的血小板可逆性比正常血小板差。脾切除患者的血小板伪足可逆性低于未脾切除病例。血小板伪足的形状变化和可逆性受损可能与β地中海贫血/血红蛋白E患者肺血栓形成的高倾向有关。
