Stratta P
Nephron. 1985;40(1):67-73. doi: 10.1159/000183430.
Microangiopathic hemolytic anemia is a typical hematological feature of the syndromes characterized by thrombotic microangiopathy as histopathological lesion (hemolytic uremic syndrome and thrombotic thrombocytopenic purpura). Nevertheless endothelial lesions alone do not account for all morphologic red cell abnormalities seen in the blood smear, which cannot be explained only by mechanical damage. At least some of these erythrocytic alterations can be traced to primitive erythrocyte damage (by intrinsic or extrinsic toxic causes) responsible for a hemorrheological unbalance capable of participating in the pathogenetic mechanisms involved. Deformed and fragmented poorly deformable red cells can contribute by themselves to microcirculatory impairment, leading to endocapillary engorgement, increase of peripheral resistances and endothelial damage.
微血管病性溶血性贫血是以血栓性微血管病为组织病理学病变的综合征（溶血性尿毒症综合征和血栓性血小板减少性紫癜）的典型血液学特征。然而，仅内皮病变并不能解释血涂片中所见的所有红细胞形态异常，这些异常不能仅用机械损伤来解释。这些红细胞改变中至少有一些可追溯到原始红细胞损伤（由内在或外在毒性原因引起），这种损伤导致血液流变学失衡，进而参与相关的致病机制。变形和破碎且变形性差的红细胞自身会导致微循环障碍，引起毛细血管内充血、外周阻力增加和内皮损伤。
