Watanabe K, Kawai Y, Takeuchi K, Shimizu N, Iri H, Ikeda Y, Houwen B
Department of Laboratory Medicine, School of Medicine, Keio University, Tokyo, Japan.
J Clin Pathol. 1994 Aug;47(8):736-9. doi: 10.1136/jcp.47.8.736.
To determine the maturity of reticulocytes in patients with anaemia as a result of various haematological disorders including those with qualitative abnormalities such as ineffective erythropoiesis or dyserythropoiesis.
The number of mature reticulocytes was measured with flow cytometry in venous blood samples from 122 patients with haematological disorders and 100 healthy controls. Reticulocytes were classified into three categories by the fluorescence intensity of auramin O staining: low fluorescence ratio (LFR), medium fluorescence ratio (MFR), and high fluorescence ratio (HFR). Immature reticulocytes were determined as the aggregate of MFR and HFR (%).
The mean (2SD) number of immature reticulocytes in 100 normal subjects was 9.0 (7.0)%. Significantly high mean values of immature reticulocytes with a normal or reduced reticulocyte count were shown in 90 patients with dyserythropoietic or ineffective erythropoietic conditions, such as acute myeloid leukaemia (AML) (n = 37), myelodysplastic syndrome (MDS) (n = 35), aplastic anaemia (AA) (n = 8), or megaloblastic anaemia (MA), (n = 6). Reticulocyte ratios returned to normal after successful treatment of patients with AML (n = 10) and MA (n = 3). However, high percentages of immature reticulocytes with increased reticulocyte counts were consistently observed in patients with enhanced erythropoiesis such as those with acquired autoimmune haemolytic anaemias (AIHA) (n = 4) or acute blood loss (ABL) (n = 4). Reticulocyte maturity was within the normal range in patients with reduced erythropoiesis such as occurs in chronic renal failure (CRF) (n = 11), or in iron deficiency anaemia (IDA) (n = 13).
The evaluation of reticulocyte maturity with total reticulocyte count seems to be clinically useful for estimating the qualitative impairment of erythropoiesis, and so could help differentiate haematological disorders.
确定因各种血液系统疾病导致贫血的患者中网织红细胞的成熟度，这些疾病包括具有质量异常的疾病，如无效红细胞生成或异常红细胞生成。
采用流式细胞术检测122例血液系统疾病患者和100例健康对照者静脉血样本中成熟网织红细胞的数量。通过金胺O染色的荧光强度将网织红细胞分为三类：低荧光率（LFR）、中荧光率（MFR）和高荧光率（HFR）。未成熟网织红细胞被确定为MFR和HFR的总和（%）。
100名正常受试者中未成熟网织红细胞的平均（2标准差）数量为9.0（7.0）%。90例存在异常红细胞生成或无效红细胞生成情况的患者，如急性髓系白血病（AML）（n = 37）、骨髓增生异常综合征（MDS）（n = 35）、再生障碍性贫血（AA）（n = 8）或巨幼细胞贫血（MA）（n = 6），显示出未成熟网织红细胞的平均值显著升高，且网织红细胞计数正常或降低。AML患者（n = 10）和MA患者（n = 3）成功治疗后，网织红细胞比例恢复正常。然而，在红细胞生成增强的患者中，如获得性自身免疫性溶血性贫血（AIHA）患者（n = 4）或急性失血（ABL）患者（n = 4），始终观察到未成熟网织红细胞百分比升高且网织红细胞计数增加。在红细胞生成减少的患者中，如慢性肾衰竭（CRF）患者（n = 11）或缺铁性贫血（IDA）患者（n = 13），网织红细胞成熟度在正常范围内。
用总网织红细胞计数评估网织红细胞成熟度在临床上似乎有助于估计红细胞生成的质量损害，从而有助于鉴别血液系统疾病。
