Homann C, Hasselbalch H C
Medicinsk afdeling B, Bispebjerg Hospital, København.
Ugeskr Laeger. 1992 Aug 3;154(32):2184-7.
The most common haematological abnormalities in alcoholism are raised mean corpuscular volume of the erythrocytes and thrombocytopenia. The etiology is multifactorial including malnutrition with folate deficiency, a direct toxic influence of alcohol and sequestration in an enlarged spleen. Sideroblastic anaemia caused by interference of alcohol with the metabolism of pyridoxine is common and so is haemolytic anaemia caused by hypersplenism and megaloblastic anaemia. Leucopenia can be seen and is probably caused by a direct toxic effect of alcohol on the bone marrow. Other potentially toxic changes are impaired chemotaxis, motility and adherence of the granulocytes and impaired blast-transformation of the lymphocytes. In the bone marrow, vacuolized precursors of myelo- and erythropoiesis are seen. The bone marrow may be hypocellular. Other changes in the bone marrow are increased but ineffective erythropoiesis with defective iron metabolism, vacuolized pro-erythroblasts, multinucleated erythroblasts, megaloblasts and iron-containing plasma cells.
酒精中毒最常见的血液学异常是红细胞平均体积升高和血小板减少。其病因是多因素的，包括伴有叶酸缺乏的营养不良、酒精的直接毒性影响以及脾脏肿大导致的血细胞滞留。酒精干扰吡哆醇代谢引起的铁粒幼细胞性贫血很常见，脾功能亢进引起的溶血性贫血和巨幼细胞贫血也很常见。可出现白细胞减少，可能是酒精对骨髓的直接毒性作用所致。其他潜在的毒性变化包括粒细胞趋化性、运动性和黏附性受损以及淋巴细胞原始转化受损。在骨髓中，可见髓系和红系造血的空泡化前体细胞。骨髓可能细胞减少。骨髓的其他变化包括红细胞生成增加但无效，伴有铁代谢缺陷、空泡化早幼红细胞、多核幼红细胞、巨幼细胞和含铁浆细胞。
