Lawrence C, Fabry M E
Am J Med. 1986 Nov;81(5):801-8. doi: 10.1016/0002-9343(86)90349-9.
To define its diagnostic utility in sickle crisis, the erythrocyte sedimentation rates of oxygenated blood were studied in patients with sickle cell anemia and healthy normal subjects using the Guest-Westergren method. A normal range for sedimentation rate as a function of hematocrit was established in 22 normal subjects. Twenty-seven asymptomatic patients with sickle cell anemia had abnormally low sedimentation rates in relation to their hematocrits. Those low sedimentation rates were not increased by substituting plasma from healthy control subjects, which suggests that the low sedimentation rate was a cell-related phenomenon. Sedimentation rates measured in 28 patients with sickle cell anemia at the end of uncomplicated painful crisis increased to levels appropriate for their degree of anemia. In patients with sickle crisis and medical complications, the sedimentation rates were even higher. At the end of an uncomplicated painful crisis, the mean plasma fibrinogen level was significantly higher than at the onset (p less than 0.005). When red cells from patients with sickle cell anemia at the end of crisis were suspended in normal plasma from control subjects, the sedimentation rates remained high. It is concluded that the erythrocyte sedimentation rate of asymptomatic patients with sickle cell anemia is abnormally low due to cellular factors, and the increase during painful crisis is due primarily to red cell changes, modified by plasma factors.
为了确定其在镰状细胞危象中的诊断效用，采用格斯特 - 韦斯特格伦法对镰状细胞贫血患者和健康正常受试者的含氧血液红细胞沉降率进行了研究。在22名正常受试者中建立了作为血细胞比容函数的沉降率正常范围。27名无症状镰状细胞贫血患者的沉降率相对于其血细胞比容异常低。用健康对照受试者的血浆替代后，这些低沉降率并未升高，这表明低沉降率是一种与细胞相关的现象。在28名镰状细胞贫血患者单纯性疼痛危象结束时测得的沉降率升至与其贫血程度相符的水平。在患有镰状细胞危象和医学并发症的患者中，沉降率更高。在单纯性疼痛危象结束时，平均血浆纤维蛋白原水平显著高于发作时（p小于0.005）。当将危象结束时镰状细胞贫血患者的红细胞悬浮于对照受试者的正常血浆中时，沉降率仍然很高。得出的结论是，无症状镰状细胞贫血患者的红细胞沉降率因细胞因素而异常低，而在疼痛危象期间的升高主要是由于红细胞变化，并受到血浆因素的影响。
