Turchetti V, De Matteis C, Leoncini F, Trabalzini L, Guerrini M, Forconi S
Istituto di Semeiotica Medica e Geriatria, Università degli Studi di Siena, Policlinico Le Scotte, Siena, Italy.
Clin Hemorheol Microcirc. 1997 May-Jun;17(3):209-15.
In our study we evaluated erythrocytic morphology in different pathologies which can modify flowing red cells. We followed the methodology proposed by Zipursky which allows a three-dimensional evaluation of the red cell and a classification according to the shapes observed through the optical microscope. We studied 150 subjects: 20 normal subjects, 58 patients suffering from vascular diseases, 40 affected by diabetes (type II) (10 without and 30 with vascular diseases), 22 patients with liver disease, 5 patients with monoclonal gammopathies and 5 dehydrated patients. Results show that in normal subjects bowls, which is the shape of the most deformable red cells, are more (55%) than discocytes (44%); the altered forms are only 1%. In vascular patients we noted a statistically significant increase of discocytes (60%). There are no significant differences between subjects affected by diabetes without vascular disease and normal subjects. In diabetics with vascular diseases there are more discocytes (57%) and some altered forms (3%). In patients suffering from chronic hepatitis a great increase (13%) in echinocytes and knizocytes was noticed, which suggests an alteration in the fluidity of the membrane. Our observations testify the importance of this simple methodology in focusing the morphological alterations which can be accounted for both by pathologies of the red cells and by changes in their metabolism.
在我们的研究中,我们评估了不同病理状态下红细胞的形态,这些病理状态会改变流动的红细胞。我们遵循了齐普尔斯基提出的方法,该方法允许对红细胞进行三维评估,并根据通过光学显微镜观察到的形状进行分类。我们研究了150名受试者:20名正常受试者、58名患有血管疾病的患者、40名患有(II型)糖尿病的患者(10名无血管疾病,30名有血管疾病)、22名肝病患者、5名单克隆丙种球蛋白病患者和5名脱水患者。结果显示,在正常受试者中,碗状红细胞(最易变形的红细胞形状)较多(55%),而双凹圆盘状红细胞较少(44%);异常形态仅占1%。在血管疾病患者中,我们注意到双凹圆盘状红细胞有统计学意义的增加(60%)。无血管疾病的糖尿病患者与正常受试者之间无显著差异。患有血管疾病的糖尿病患者中,双凹圆盘状红细胞较多(57%),且有一些异常形态(3%)。在慢性肝炎患者中,棘状红细胞和皱缩红细胞大幅增加(13%),这表明细胞膜流动性发生了改变。我们的观察证明了这种简单方法在聚焦形态学改变方面的重要性,这些改变既可以由红细胞的病理状态引起,也可以由其代谢变化引起。