Fehr J, Knob M
Blood. 1979 May;53(5):966-76.
In seeking a sensitive indicator for quantitative assessment of hemolytic disease, we found a close dependence of red cell creatine level on cell age. Studies in 21 patients with steady-state hemolysis showed high correlation (r=0.89, p less than 0.001) between reticulocyte counts and red cell creatine levels. Excluding elevation of the creatine level as a variable epiphenomenon of increased erythropoietic activity, density separation of normal red cells revealed distinctly higher creatine levels in younger cells. The reticulocyte counts and creatine levels as quantitative predictors of hemolytic processes were compared: in severe hemolytic anemias (T50Cr less than 11 days), erythrocyte survival (T50Cr) correlated well with creatine levels (r = -0.86, p less than 0.01) and, to a lesser degree, with reticulocyte counts (r = -0.72, p less than 0.05). In milder disease (T50Cr greater than 11 days), however, no correlation existed between reticulocyte counts and T50Cr, whereas the creating levels correlated closely with T50Cr (r = -0.84, p less than 0.001). Thus, on the basis of our regression equations, useful estimation of red cell survival may be obtained from single measurements of erythrocyte creatine.
在寻找用于定量评估溶血性疾病的敏感指标时，我们发现红细胞肌酸水平与细胞年龄密切相关。对21例稳态溶血患者的研究表明，网织红细胞计数与红细胞肌酸水平之间存在高度相关性（r = 0.89，p < 0.001）。排除肌酸水平升高作为红细胞生成活性增加的可变附带现象，对正常红细胞进行密度分离显示，较年轻细胞中的肌酸水平明显更高。对作为溶血过程定量预测指标的网织红细胞计数和肌酸水平进行了比较：在严重溶血性贫血（T50Cr < 11天）中，红细胞生存期（T50Cr）与肌酸水平相关性良好（r = -0.86，p < 0.01），与网织红细胞计数的相关性较小（r = -0.72，p < 0.05）。然而，在较轻的疾病（T50Cr > 11天）中，网织红细胞计数与T50Cr之间不存在相关性，而肌酸水平与T50Cr密切相关（r = -0.84，p < 0.001）。因此，根据我们的回归方程，通过单次测量红细胞肌酸即可对红细胞生存期进行有效估计。
