d'Onofrio G, Chirillo R, Zini G, Caenaro G, Tommasi M, Micciulli G
Research Center for the Development and Clinical Evaluation of Automated Methods in Hematology, Università Cattolica del Sacro Cuore, Rome, Italy.
Blood. 1995 Feb 1;85(3):818-23.
Using the new Bayer H*3 hematology analyzer (Leverkusen, Germany), we have determined red blood cell and reticulocyte indices in 64 healthy subjects, in patients with microcytosis due to iron deficiency (58 patients) and heterozygous beta-thalassemia (40 patients), and in patients with macrocytosis (28 patients). We found in all cases that reticulocytes were larger than mature red cells by 24% to 35%, with a hemoglobin concentration 16% to 25% lower and a similar hemoglobin content. The correlation between red cell and reticulocyte indices was strikingly tight (r = .928 for volume, r = .929 for hemoglobin concentration, r = .972 for hemoglobin content) in all four groups, regardless of red blood cell size. The ratio of reticulocyte to red blood cell mean corpuscolar volume (MCV ratio) was constantly above 1. Inversion of the MCV ratio was observed only in four patients. It was always abrupt and transitory and was associated with erythropoietic changes leading to the production of red blood cells of a different volume (treatment of megaloblastic anemia, functional iron deficiency, bone marrow transplantation). In two cases of marrow transplantation, reticulocyte volume fell during the aplastic phase after conditioning chemotherapy and then rapidly increased up to values higher than before; this production of macroreticulocytes was the earliest sign of engraftment.
使用新型拜耳H*3血液分析仪（德国勒沃库森），我们测定了64名健康受试者、58名缺铁性小细胞性贫血患者、40名杂合子β地中海贫血患者以及28名大细胞性贫血患者的红细胞和网织红细胞指数。我们发现在所有病例中，网织红细胞比成熟红细胞大24%至35%，血红蛋白浓度低16%至25%，但血红蛋白含量相似。在所有四组中，无论红细胞大小如何，红细胞和网织红细胞指数之间的相关性都非常紧密（体积相关系数r = 0.928，血红蛋白浓度相关系数r = 0.929，血红蛋白含量相关系数r = 0.972）。网织红细胞与红细胞平均体积比（MCV比）始终高于1。仅在4例患者中观察到MCV比倒置。这种倒置总是突然且短暂的，并且与导致产生不同体积红细胞的造血变化有关（巨幼细胞贫血的治疗、功能性缺铁、骨髓移植）。在2例骨髓移植病例中，网织红细胞体积在预处理化疗后的再生障碍期下降，然后迅速增加至高于之前的值；这种大网织红细胞的产生是植入的最早迹象。
