Lesesve J-F, Martin M, Banasiak C, André-Kerneïs E, Bardet V, Lusina D, Kharbach A, Geneviève F, Lecompte T
Hematology laboratories at Nancy, Nancy, France.
Int J Lab Hematol. 2014 Aug;36(4):439-43. doi: 10.1111/ijlh.12168. Epub 2013 Nov 22.
The presence of schistocytes on the peripheral blood film during disseminated intravascular coagulation (DIC) remains controversial.
We examined schistocytes count on blood films from 35 DIC patients and checked morphological anomalies of all RBCs.
Thirty of 35 patients presented with schistocytes and 22 with acanthocytes, which was the commonest shape anomaly. Mean percentage ± standard deviation was 0.33 ± 0.38%, median value was 0.1%, and range was 0-1.4%. The patients with schistocytes ≥ 1% had circumstances frequently associated with increased schistocytes count (promyelocytic leukaemia, pregnancy, severe infection).
Schistocytes were thus frequently observed in DIC patients, usually with low percentage, within or close to the reference range (<0.5%). Schistocytes measurement is not a clue test for the initial diagnosis of DIC, but might be of clinical value to suggest an associated or underlying thrombotic microangiopathy if ≥ 1%.
在弥散性血管内凝血(DIC)期间外周血涂片上出现裂红细胞仍存在争议。
我们检查了35例DIC患者血涂片上的裂红细胞计数,并检查了所有红细胞的形态异常。
35例患者中有30例出现裂红细胞,22例出现棘红细胞,这是最常见的形态异常。平均百分比±标准差为0.33±0.38%,中位数为0.1%,范围为0 - 1.4%。裂红细胞≥1%的患者常有与裂红细胞计数增加相关的情况(早幼粒细胞白血病、妊娠、严重感染)。
因此,在DIC患者中经常观察到裂红细胞,通常比例较低,在参考范围内或接近参考范围(<0.5%)。裂红细胞检测并非DIC初始诊断的线索性检查,但如果≥1%,可能对提示相关或潜在的血栓性微血管病具有临床价值。