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酒精引起的造血变化(作者译)

[Alcohol induced changes in hemopoiesis (author's transl)].

作者信息

Heidemann E, Nerke O, Waller H D

出版信息

Klin Wochenschr. 1981 Dec 1;59(23):1303-12. doi: 10.1007/BF01711180.

Abstract

In a prospective trial with 120 chronic alcoholics (July, 1978 to January, 1980) on admission the following haematological values significantly different from those of the normal population were found: elevated erythrocyte mean corpuscular volume (64%), increased mean corpuscular hemoglobin (32%), thrombocytopenia (48%), increased percentage of bone marrow sideroblasts (35%), decreased percentage of sideroblasts (37%), megaloblastic bone marrow changes (55%) including nuclear abnormalities (32%), and vacuolization in red cell (20%) and white cell (16%) precursors. These changes were independent of liver cirrhosis with hypersplenism (increased mean corpuscular volume in 52% of the patients who did not have liver cirrhosis, increased mean corpuscular volume in 76% of the patients who were cirrhotic but not suffering from major bleeding). Platelets returned to normal values within 6 days of discontinuation of alcohol ingestion. In respect to iron metabolism we found the following changes: decreased serum iron concentration (32%), increased iron concentration (42%), increased total iron binding capacity (54%), increased ferritin (41%), decreased transferrin (20%). In contrast to data from the Anglo-American literature, serum folate concentrations were mostly normal in our patients (87%). This may be due to different eating and drinking habits. The percentage of bone marrow sideroblasts was also lower in our patients than those described in the literature mentioned above. The changes in maturation are likely to be caused partially by a toxic effect of alcohol on nuclear metabolism of bone marrow cells.

摘要

在一项对120名慢性酒精中毒患者进行的前瞻性试验中(1978年7月至1980年1月),入院时发现以下血液学值与正常人群有显著差异:红细胞平均体积升高(64%)、平均红细胞血红蛋白增加(32%)、血小板减少(48%)、骨髓铁粒幼细胞百分比增加(35%)、铁粒幼细胞百分比降低(37%)、巨幼细胞性骨髓改变(55%)包括核异常(32%),以及红细胞(20%)和白细胞(16%)前体细胞中的空泡化。这些变化与伴有脾功能亢进的肝硬化无关(无肝硬化患者中52%平均红细胞体积增加,肝硬化但无大出血患者中76%平均红细胞体积增加)。停止饮酒后6天内血小板恢复到正常值。关于铁代谢,我们发现了以下变化:血清铁浓度降低(32%)、铁浓度增加(42%)、总铁结合力增加(54%)、铁蛋白增加(41%)、转铁蛋白降低(20%)。与英美的文献数据相反,我们患者的血清叶酸浓度大多正常(87%)。这可能是由于不同的饮食习惯。我们患者的骨髓铁粒幼细胞百分比也低于上述文献中描述的水平。成熟过程中的变化可能部分是由酒精对骨髓细胞核代谢的毒性作用引起的。

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