Morgan M Y, Camilo M E, Luck W, Sherlock S, Hoffbrand A V
Clin Lab Haematol. 1981;3(1):35-44. doi: 10.1111/j.1365-2257.1981.tb01307.x.
The incidence of macrocytosis, defined as a mean corpuscular volume (MCV) of greater than 95 fl and large red cells on peripheral blood film, was determined in 303 alcoholics with liver disease (95 females: 208 males), 60 non-alcoholics with chronic liver disease (44 females: 16 males) and 35 control subjects (15 females: 20 males). Macrocytosis was found in 70.3% (213/303) of alcoholics with liver disease and in 23.3% (14/60) of non-alcoholics with liver disease, P less than 0.001. MCV values greater than 100 fl were seen in 49.5% (150/303) of alcoholics, but in only 3.3% (2/60) of non-alcoholics, P less than 0.001. Macrocytosis was more frequent in female, 86.3% (82/95) than in male alcoholics 63.0% (131/208), P less than 0.001. Serum folate values less than 3 microgram/l were found in 14.5% (44/303) of alcoholics and in 11.7% (7/60) of non-alcoholics. Low serum folate values were found in 18.3% (39/213) of alcoholics with macrocytosis and in 35.9% (28/78) of those with macrocytic anaemia. Twenty alcoholics with pre-cirrhotic liver disease were followed over three months. Macrocytosis was present in 85.0% (17/20) at the outset and in 40% (8/20) 3 months later. The changes in MCV were independent of alcohol intake and serum folate values. Macrocytosis is a useful diagnostic indicator of alcoholism. MCV values greater than 100 fl in patients with liver disease almost invariably indicate alcohol-related disease. In the short-term, changes in MCV are of little use in monitoring alcohol intake.
在303例患有肝病的酗酒者（95名女性：208名男性）、60例患有慢性肝病的非酗酒者（44名女性：16名男性）和35名对照受试者（15名女性：20名男性）中，测定了大细胞性贫血的发生率，其定义为平均红细胞体积（MCV）大于95飞升且外周血涂片上有大红细胞。在患有肝病的酗酒者中，70.3%（213/303）出现大细胞性贫血，而在患有肝病的非酗酒者中，这一比例为23.3%（14/60），P值小于0.001。在酗酒者中，49.5%（150/303）的MCV值大于100飞升，而在非酗酒者中仅为3.3%（2/60），P值小于0.001。女性酗酒者中大细胞性贫血更为常见，为86.3%（82/95），高于男性酗酒者的63.0%（131/208），P值小于0.001。在酗酒者中，14.5%（44/303）的血清叶酸值低于3微克/升，在非酗酒者中为11.7%（7/60）。在患有大细胞性贫血的酗酒者中，18.3%（39/213）血清叶酸值低，在患有大细胞性贫血的酗酒者中，35.9%（28/78）血清叶酸值低。对20例肝硬化前期肝病的酗酒者进行了为期三个月的随访。一开始，85.0%（17/20）存在大细胞性贫血，三个月后为40%（8/20）。MCV的变化与酒精摄入量和血清叶酸值无关。大细胞性贫血是酗酒的一项有用的诊断指标。肝病患者中MCV值大于100飞升几乎总是表明与酒精相关的疾病。短期内，MCV的变化对监测酒精摄入量作用不大。
