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[慢性酒精中毒中的大细胞性贫血与贫血。与肝穿刺活检结果的相关性]

[Macrocytosis and anemia in chronic alcoholism. Correlation with the results of hepatic needle biopsy].

作者信息

Gheno G, Magnabosco V, Mazzei G

出版信息

Minerva Med. 1981 May 19;72(20):1301-6.

PMID:7243021
Abstract

Clinical and laboratory observations were made on 220 chronic alcoholics, regularly taking at least 150 g of alcohol daily. Haematological data concerning white blood cells, platelets and red cells counts, mean corpuscolar volume, hemoglobin and serum iron in these patients were compared with control values obtained from 150 healthy teetotal subjects. Hematological changes in chronic alcoholics were correlated with histological liver damages in transcutaneous needle-biopsies. No statistical differences were evident for white cells and platelets counts and for serum iron content; however, in chronic alcoholics, serum iron content showed a great dispersion around the mean. Mean corpuscolar volume (MCV) was significantly increased (P less than 0,001) in chronic alcoholics (even in those with a normal liver biopsy) but there was no significant difference in the degree and the incidence of macrocytosis between patients showing normal liver appearances or fatty changes only, and those showing more severe damage, i.e, acute alcoholic hepatitis (with or without steatosis), central hyaline-sclerosing necrosis and or hepatofibrosis, cirrhosis and hepatocarcinoma. No significant difference was seen between male and female alcoholics. Macrocytosis may be considered as an early marker for alcoholism but it does not correlate with the type of histological liver damage. Hemoglobin levels were significantly reduced in chronic alcoholics (P less than 0,01): the degree and incidence of anemia were more severe in those patients with advanced liver diseases and in female alcoholics. There is no statistically significant correlation between macrocytosis and anemia.

摘要

对220名慢性酗酒者进行了临床和实验室观察,这些酗酒者每天规律摄入至少150克酒精。将这些患者的白细胞、血小板和红细胞计数、平均红细胞体积、血红蛋白和血清铁的血液学数据与150名健康戒酒者的对照值进行了比较。慢性酗酒者的血液学变化与经皮针刺活检中的肝脏组织学损伤相关。白细胞和血小板计数以及血清铁含量没有明显的统计学差异;然而,在慢性酗酒者中,血清铁含量在平均值周围有很大的离散度。慢性酗酒者的平均红细胞体积(MCV)显著增加(P小于0.001)(即使是肝脏活检正常的患者),但在肝脏外观正常或仅有脂肪变性的患者与那些有更严重损伤的患者之间,即急性酒精性肝炎(有无脂肪变性)、中央透明硬化性坏死和/或肝纤维化、肝硬化和肝癌患者之间,大红细胞症的程度和发生率没有显著差异。男性和女性酗酒者之间没有显著差异。大红细胞症可被视为酗酒的早期标志物,但它与肝脏组织学损伤的类型无关。慢性酗酒者的血红蛋白水平显著降低(P小于0.01):在患有晚期肝病的患者和女性酗酒者中,贫血的程度和发生率更严重。大红细胞症与贫血之间没有统计学上的显著相关性。

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