d'Onofrio G, Kuse R, Foures C, Jou J M, Pradella M, Zini G
Universita Cattolica, Roma, Italy.
Clin Lab Haematol. 1996 Dec;18 Suppl 1:29-34.
The increased precision of flow cytometric techniques permits the recognition of small differences even in the low or normal range of the reticulocyte count. Moreover, measurement of the RNA content of reticulocytes makes possible the identification of the youngest highly fluorescent macroreticulocytes (HFR) prematurely delivered from bone marrow in conditions of increased erythropoietic stimulation. The aim of this study was the definition, using the dedicated flow cytometers Sysmex R-1000 or R-3000 (Toa Medical Electronics Ltd, Kobe, Japan), of reticulocyte absolute number and HFR percentage in patients with haematological disorders prior to any treatment. Analysis of 54 healthy subjects and 100 untreated patients with five types of haematological disease is presented. In haemolytic anaemias (15 cases) both the reticulocyte count and HFR were greatly increased and the reticulocyte count was inversely correlated with Hb level, as in the reference population. In polycythaemia vera (20 cases) reticulocytes were moderately increased and directly correlated with Hb. In dyserythropoietic syndromes (20 cases) reticulocytes were low and HFR moderately increased; HFR showed an inverse correlation with Hb. In acute myeloid leukaemia (30 cases) reticulocytes were low and HFR increased; reticulocytes correlated with both HFR and Hb. In acute lymphoid leukaemia (15 cases), while the reticulocyte count did not differ from the reference group, the HFR was increased. These results provide reference values for the evaluation of reticulocyte counts and HFR in haematological diseases. From a physiopathological standpoint, they suggest that in anaemic patients the reticulocyte count directly reflects effective bone marrow erythrocyte production, while the proportion of circulating HFR more closely reflects the intensity of erythropoietic stimulation.
流式细胞术技术精度的提高使得即使在网织红细胞计数处于低水平或正常范围内时，也能够识别微小差异。此外，对网织红细胞RNA含量的测量使得在红细胞生成刺激增加的情况下，能够识别出从骨髓中过早释放的最年轻的高荧光大网织红细胞（HFR）。本研究的目的是使用Sysmex R - 1000或R - 3000专用流式细胞仪（日本神户东亚医疗电子有限公司），确定血液系统疾病患者在接受任何治疗之前的网织红细胞绝对数量和HFR百分比。本文呈现了对54名健康受试者和100名未经治疗的患有五种血液系统疾病的患者的分析结果。在溶血性贫血（15例）中，网织红细胞计数和HFR均显著增加，且网织红细胞计数与血红蛋白水平呈负相关，这与参考人群的情况相同。在真性红细胞增多症（20例）中，网织红细胞适度增加且与血红蛋白呈正相关。在红系造血异常综合征（20例）中，网织红细胞计数较低而HFR适度增加；HFR与血红蛋白呈负相关。在急性髓系白血病（30例）中，网织红细胞计数较低而HFR增加；网织红细胞与HFR和血红蛋白均相关。在急性淋巴细胞白血病（15例）中，虽然网织红细胞计数与参考组无差异，但HFR增加。这些结果为评估血液系统疾病中网织红细胞计数和HFR提供了参考值。从生理病理学角度来看，它们表明在贫血患者中，网织红细胞计数直接反映了有效的骨髓红细胞生成，而循环中HFR的比例更密切地反映了红细胞生成刺激的强度。
