Jackson C W, Smith P J, Edwards C C, Whidden M A
J Lab Clin Med. 1979 Sep;94(3):500-9.
In this study we have measured platelet and megakaryocyte concentration, blood volume, and platelet survival of mice after RBC hypertransfusion to PCVs of 62% to 90%. The platelet concentration of mice with PCVs up to 75% was decreased by up to one half. At higher PCVs a more severe thrombocytopenia developed, with platelet concentrations decreased to less than 10% of baseline in approximately one half of the mice. Blood volumes of the hypertransfused mice were increased up to twofold. Megakaryocyte concentrations were normal or increased. Platelet survival in mice with PCVs less than 75% was normal but was sharply decreased for mice with higher PCVs. The decrease in platelet concentration at moderately elevated PCVs may be explained by hemodilution in the larger blood volume. However, hemodilution alone cannot explain the severe thrombocytopenia at higher PCVs. The presence of decreased platelet survival with normal or increased megakaryocyte concentrations in this latter group suggests that the severe thrombocytopenia is the result of more rapid platelet destruction. In summary, elevation of the PCV by RBC hypertransfusion produces thrombocytopenia. The severity of the thrombocytopenia and the mechanisms involved in producing it change abruptly when the PCV exceeds 75%. These findings should be considered in interpretations of the influence of RBC hypertransfusion on hematopoiesis and in clinical and experimental studies of thrombopoiesis in polycythemic subjects.
在本研究中,我们测定了红细胞大量输血使血细胞比容(PCV)达到62%至90%后小鼠的血小板和巨核细胞浓度、血容量以及血小板生存期。血细胞比容高达75%的小鼠血小板浓度降低了一半。在更高的血细胞比容水平时,出现了更严重的血小板减少症,约一半小鼠的血小板浓度降至基线的10%以下。大量输血小鼠的血容量增加了两倍。巨核细胞浓度正常或升高。血细胞比容低于75%的小鼠血小板生存期正常,但血细胞比容更高的小鼠血小板生存期急剧下降。中等程度升高的血细胞比容时血小板浓度的降低可能是由于血容量增加导致的血液稀释所致。然而,单纯的血液稀释无法解释更高血细胞比容时的严重血小板减少症。后一组中血小板生存期降低而巨核细胞浓度正常或升高,这表明严重的血小板减少症是血小板破坏加速的结果。总之,红细胞大量输血使血细胞比容升高会导致血小板减少症。当血细胞比容超过75%时,血小板减少症的严重程度及其产生机制会突然改变。在解释红细胞大量输血对造血的影响以及在真性红细胞增多症患者血小板生成的临床和实验研究中,应考虑这些发现。