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[不同类型贫血中红细胞的密度特异性分布]

[Density-specific distribution of erythrocytes in different types of anemia].

作者信息

Shurkhina E S, Nesterenko V M, Kolodeĭ S V, Tsvetaeva N V, Ermakova T A, Nikulina O F, Kolosheĭnova T I, Ataullakhanov F I

出版信息

Ter Arkh. 2009;81(1):48-51.

Abstract

AIM

To study density-specific distribution of erythrocytes (DSDE) in different types of anemia.

MATERIAL AND METHODS

DSDE was determined in anemic patients by fractionation of the whole blood in hematocritic capillaries in the presence of mixtures of dimethyl- and dibutylphthalates with known density.

RESULTS

Parameters are proposed which characterize DSDE changes typical for each type of anemia: mean erythrocyte density (MED)--mean density of total erythrocytic population; DSDE width (W)--a characteristic of erythrocytic population heterogeneity; light fraction of erythrocytes (LEF)--% of the cells with density less than 1.086 g/ml (hypochromic cells and reticulocytes); dense fraction of erythrocytes (DEF)--% of cells with density over 1.112 g/ml (hyperchromic cells forming as a result of erythrocyte dehydration). DSDE parameters for different types of anemia differed: reduced MED was typical for iron deficiency anemia (IDA) and paroxysmal nocturnal hemoglobinuria (PNH), increased DEF was seen in microspherocytic anemia (MSA), autoimmune hemolytic anemia (AHA), deficiency of glucose-6-phosphate dehydrogenase, increased LEF was observed in reticulocytosis in all anemia types except MSA, DSDE W was larger in MSA, AHA, PNA.

CONCLUSION

DSDE is determined by proportion of erythropoiesis and sequestration of erythrocytes as well as pathological impacts leading to impairment of membrane permeability for cations and erythrocytic metabolism. Informative value of DSDE parameters makes them effective for diagnostic screening of anemias and control over course of different diseases.

摘要

目的

研究不同类型贫血中红细胞密度特异性分布(DSDE)情况。

材料与方法

在贫血患者中,通过在已知密度的邻苯二甲酸二甲酯和邻苯二甲酸二丁酯混合物存在的情况下,利用血细胞比容毛细管对全血进行分级分离来测定DSDE。

结果

提出了表征每种贫血类型典型DSDE变化的参数:平均红细胞密度(MED)——总红细胞群体的平均密度;DSDE宽度(W)——红细胞群体异质性的特征;红细胞轻组分(LEF)——密度小于1.086 g/ml的细胞百分比(低色素细胞和网织红细胞);红细胞重组分(DEF)——密度超过1.112 g/ml的细胞百分比(因红细胞脱水形成的高色素细胞)。不同类型贫血的DSDE参数不同:缺铁性贫血(IDA)和阵发性夜间血红蛋白尿(PNH)典型表现为MED降低,小球形红细胞贫血(MSA)、自身免疫性溶血性贫血(AHA)、葡萄糖-6-磷酸脱氢酶缺乏时可见DEF增加,除MSA外的所有贫血类型中网织红细胞增多时观察到LEF增加,MSA、AHA、PNA中DSDE W更大。

结论

DSDE由红细胞生成与隔离的比例以及导致阳离子膜通透性受损和红细胞代谢的病理影响所决定。DSDE参数的信息价值使其在贫血的诊断筛查和不同疾病病程的监测中有效。

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