Balcells A, Ingelmo M, Vivancos J, Vives J L, Ardiaca A, Elías A
Med Clin (Barc). 1979 Nov 10;73(8):312-4.
The present study reported a group of 168 chronically alcoholic patients with a daily ingestion superior to 80 grams. Twenty of these patients (10 percent) did not have liver disease, and 148 (68.5 percent) had different forms of liver disease classified by histopathologic examination. Considering a 97 fi MCV as macrocytosis, we have found in the group of alcoholics without hepatopathy a 50 percent rate of macrocythemia with a mean value of 97.9 fl. In the group of chronic alcoholics with liver disease there was a 64.2 percent macrocytosis with a mean value of 100 fl. We have also studied 43 (21.5 percent) patients with cryptogenetic cirrhosis with a 32.6 percent macrocytosis and a mean value of 93.9 fl. With respect to the alcoholic hepatopathy subgroups, macrocytosis is more frequent in portal fibrosis and acute alcoholic hepatitis, the mean value being higher in the latter. We consider macrocytosis to be frequent among alcoholics, and a good persistence indicator of alcoholic ingestion, pathogenically linked to the now proven dyserythropoietic factor of the alcohol upon the bone marrow. There is no statistically significant correlation between anemia and reticulocytes. We consider macrocytosis to be a more precocious data, and believe that the positive correlation with certain intraerythrocitary enzymes in the juvenile population of red cells corroborates this fact. With respect to the rest of parameters studied there was a correlation with gammaglutamiltranspeptidase, glutamic-oxalacetic transaminase, and the value of prothrombin. The values of mean macrocytosis and elevations of gammaglutamiltranspeptidase and glutamic-oxalacetic transaminase are good persistence indicators of alcoholic ingestion.
本研究报告了一组168例每日酒精摄入量超过80克的慢性酒精中毒患者。其中20例患者（10%）没有肝脏疾病，148例（68.5%）经组织病理学检查患有不同形式的肝脏疾病。将97飞升的平均红细胞体积（MCV）视为大细胞性贫血，我们发现在无肝病的酒精中毒患者组中，大红细胞血症发生率为50%，平均值为97.9飞升。在患有肝病的慢性酒精中毒患者组中，大细胞性贫血发生率为64.2%，平均值为100飞升。我们还研究了43例（21.5%）隐源性肝硬化患者，其大细胞性贫血发生率为32.6%，平均值为93.9飞升。关于酒精性肝病亚组，大细胞性贫血在门脉纤维化和急性酒精性肝炎中更常见，后者的平均值更高。我们认为大细胞性贫血在酒精中毒患者中很常见，是酒精摄入的一个良好持续指标，在发病机制上与现已证实的酒精对骨髓的红细胞生成异常因子有关。贫血与网织红细胞之间无统计学显著相关性。我们认为大细胞性贫血是一个更早期的数据，并相信与幼稚红细胞群体中某些红细胞内酶的正相关性证实了这一事实。关于所研究的其他参数，与γ-谷氨酰转肽酶、谷草转氨酶和凝血酶原值存在相关性。平均大细胞性贫血值以及γ-谷氨酰转肽酶和谷草转氨酶升高是酒精摄入的良好持续指标。
