Roy M S, Rodgers G P, Podgor M J, Noguchi C T, Nienhuis A W, Schechter A N
Br J Ophthalmol. 1985 Aug;69(8):629-32. doi: 10.1136/bjo.69.8.629.
A consecutive series of 22 stable adult inpatients with sickle cell anaemia were examined for the presence and severity of spontaneous 'comma' signs of the conjunctiva. Fifteen patients had severe conjunctival signs (more than 10 commas in the worse eye). The presence of severe conjunctival signs was associated with a broader distribution of intraerythrocytic haemoglobin concentrations (p = 0.0005). The patient group with severe conjunctival signs was not found to be significantly different from the group without such signs for age, sex, haemoglobin value, reticulocyte count, alpha-globin gene number, percentage fetal haemoglobin, or the proportion of very dense cells (CHC greater than 37 g/dl). Thus the singular heterogeneity of the erythrocytes in sickle cell disease may be indicative of the factor(s) responsible for the diagnostic comma sign.
对连续的22例患有镰状细胞贫血的稳定成年住院患者进行检查，以确定结膜自发“逗号”征的存在情况及严重程度。15例患者有严重的结膜体征（病情较重的眼睛中逗号超过10个）。严重结膜体征的存在与红细胞内血红蛋白浓度的分布范围更广有关（p = 0.0005）。未发现有严重结膜体征的患者组在年龄、性别、血红蛋白值、网织红细胞计数、α珠蛋白基因数量、胎儿血红蛋白百分比或极密细胞比例（CHC大于37 g/dl）方面与无此类体征的患者组有显著差异。因此，镰状细胞病中红细胞的独特异质性可能表明了导致诊断性逗号征的因素。
