Cooper R A, Diloy Puray M, Lando P, Greenverg M S
J Clin Invest. 1972 Dec;51(12):3182-92. doi: 10.1172/JCI107145.
Most patients with stable cirrhosis of the alcoholic have "target" red cells; however, a minority have "spur" cells and severe hemolytic anemia. These two syndromes were studied in 27 patients with target cells and 17 patients with spur cells, all of whom had advanced cirrhosis. The cholesterol and phospholipid content of red cell membranes effectively distinguished target cells from spur cells. Target cells alone were rich in lecithin, and both the cholesterol/phospholipid and cholesterol/lecithin mole ratios were greater in spur cells. The cholesterol/phospholipid mole ratio of both types of red cells correlated closely with the free cholesterol saturation of serum lipoproteins, as defined by the amount of free cholesterol relative to phospholipid and protein in these lipoproteins. Lecithin: cholesterol acyltransferase (LCAT) activity was decreased in most patients with target cells and spur cells; however, the relationship between this activity and the lipid abnormalities observed was weak. Serum bile acid levels also correlated poorly with serum and cell lipids. However, in patients with target cells the amount of cholic and deoxycholic acids in serum was approximately equal to the amount of chenodeoxycholic acid, whereas in patients with spur cells chenodeoxycholic acid (the precursor of lithocholic acid) predominated.
大多数酒精性肝硬化稳定期患者有“靶形”红细胞；然而，少数患者有“棘形”红细胞和严重溶血性贫血。对27例有靶形红细胞的患者和17例有棘形红细胞的患者进行了研究，所有患者均为晚期肝硬化。红细胞膜的胆固醇和磷脂含量有效地区分了靶形红细胞和棘形红细胞。仅靶形红细胞富含卵磷脂，棘形红细胞的胆固醇/磷脂和胆固醇/卵磷脂摩尔比均更高。两种类型红细胞的胆固醇/磷脂摩尔比与血清脂蛋白的游离胆固醇饱和度密切相关，血清脂蛋白中游离胆固醇饱和度由游离胆固醇相对于磷脂和蛋白质的量来定义。大多数有靶形红细胞和棘形红细胞的患者卵磷脂胆固醇酰基转移酶（LCAT）活性降低；然而，这种活性与所观察到的脂质异常之间的关系较弱。血清胆汁酸水平与血清和细胞脂质的相关性也较差。然而，有靶形红细胞的患者血清中胆酸和脱氧胆酸的量大约等于鹅去氧胆酸的量，而有棘形红细胞的患者中鹅去氧胆酸（石胆酸的前体）占主导。
