Novak R W
Am J Dis Child. 1984 Feb;138(2):183-5. doi: 10.1001/archpedi.1984.02140400065016.
Enzymes released from bacteria can alter the surfaces of RBCs rendering them susceptible to destruction by antibodies present in a high percentage of adult plasmas. Such RBC alterations were observed in four of 20 consecutive cases of radiologically proved necrotizing enterocolitis. Involved infants were seriously ill, three of four demonstrating bowel perforation. Bacteria of the genus Clostridium were isolated from blood or peritoneal fluid in three of four affected patients and elaborated appropriate RBC-altering enzymes in vitro. Two patients who had received plasma-containing products experienced notable hemolysis. Patients treated with washed products and plasma protein fractions lacking immunoglobulins had no hemolytic problems. The alteration of the RBC membrane is easily detected by a rapid, simple lectin agglutination test.
细菌释放的酶可改变红细胞表面，使其易被大多数成人血浆中存在的抗体破坏。在连续20例经放射学证实为坏死性小肠结肠炎的病例中，有4例观察到了这种红细胞改变。受累婴儿病情严重，4例中有3例出现肠穿孔。在4例受影响患者中的3例血液或腹腔液中分离出梭状芽孢杆菌属细菌，并在体外产生了适当的红细胞改变酶。两名接受含血浆制品治疗的患者出现了明显的溶血。用洗涤制品和缺乏免疫球蛋白的血浆蛋白组分治疗的患者没有溶血问题。通过快速、简单的凝集素凝集试验很容易检测到红细胞膜的改变。
