Hemoglobin labeled by radioactive lysine; erythrocyte life cycle

A dog, doubly depleted of blood cells and plasma proteins, was fed dl-lysine labeled with C(14) in the epsilon carbon position. In the first 8 hours 28 per cent of the administered C(14) was excreted in the urine; in the first 72 hours, 35 per cent. Twenty-four hours after feeding, 4.2 per cent of the fed C(14) was circulating in the plasma, decreasing to 1 per cent at the end of 17 days. The C(14) content of the blood cells increased from 1 per cent at 24 hours to 5.5 per cent in 5 days and 6.8 per cent in 22 days. Evidence based on the rate of decrease of the C(14) content of circulating blood cells is presented indicating an average life of 115 days for the erythrocyte protein as an entity not interchanging with extracellular constituents. This corresponds closely to the life span of the dog erythrocyte, 112 to 133 days according to the best evidence otherwise available and indicates that this experiment has actually measured the life span of the dog erythrocyte. Following breakdown of blood erythrocytes the protein comprising them is not used preferentially for the formation of new erythrocytes.     

Reference intervals of extended erythrocyte and reticulocyte parameters

Abstract Background: Optical analysis of erythrocytes can provide information on the hemoglobin concentration and content of reticulocytes and mature erythrocytes. Such parameters have proven clinical utility in anemia diagnosis and therapy monitoring. For interpretation, reliable reference ranges are needed. The aim of this study was to establish reference intervals for extended erythrocyte and reticulocyte parameters as measured with the Abbott CELL-DYN Sapphire hematology analyzer. Secondary aims were to study sample stability and to investigate gender- and age dependency of the reference ranges. Methods: Extended RBC parameters were measured in routine samples of a primary health care laboratory. The study cohort included 8161 samples of unique individuals, which were analyzed using Bhattacharya statistics. As a comparison, reference intervals were calculated in a subset of individuals without iron depletion. Results: The majority of erythrocyte and reticulocyte para\xadmeters were normally distributed, allowing calculation of reference intervals. Only for hypo- and hyperchromic erythrocytes non-parametric statistics had to be used. The reference range for mean cellular hemoglobin content of reticulocytes (MCHr) was 28.5-34.5 pg (1.77-2.14 fmol) in the entire study group and 26.0-35.1 pg (1.60-2.17 fmol) in the non iron-depleted subgroup. No differences between sexes were found. Most parameters showed significant age effects in children and adolescents. Conclusions: Reference intervals have been established for extended RBC and reticulocyte parameters for the CELL-DYN Sapphire. Gender effects could not be demonstrated and age effects were of limited size, except for individuals younger than 18 years. Extended RBC parameters are stable for at least 6 h after blood collection.     

健康人群网织红细胞参数及与成熟红细胞参数的比较研究

目的探讨网织红细胞的某些参数与成熟红细胞相应参数间的关系。方法应用西门子Advia 2120血细胞分析仪对112例男性和110例女性健康体检者进行多项网织红细胞参数测定,确认参考范围,并与成熟红细胞5项相应的参数进行比对分析。结果纳入研究者中,女性的网织红细胞百分比(Retic%)、网织红细胞绝对值(Retic#)、网织红细胞平均血红蛋白含量(CHr)、网织红细胞平均体积(MCVr)的参考范围分别为0.45%~1.76%、(22~86)×109/L、30.1~36.4pg、99.5~113.7fL;男性的这4项参数的参考范围分别为0.54%~1.93%、(29~104)×109/L、32.6~36.6pg、97.6~112.7fL。网织红细胞计数男性高于女性,差异有统计学意义(P0.05)。MCVr明显大于成熟红细胞平均体积,且女性略高于男性;CHr明显高于成熟红细胞的平均血红蛋白量,而体积较大的网织红细胞内的平均血红蛋白浓度则低于成熟红细胞的平均血红蛋白浓度;网织红细胞体积分布宽度低于成熟红细胞体积分布宽度;成熟红细胞内血红蛋白含量的均一性则比网织红细胞内血红蛋白含量均一性好。结论建立了网织红细胞一些应用较少的参数的参考范围并与红细胞的相应参数进行了分析。     

Peripheral blood erythrocyte parameters in hemochromatosis: evidence for increased erythrocyte hemoglobin content

We studied peripheral blood erythrocyte parameters and HFE genotypes in 94 hemochromatosis probands and 132 white, normal control subjects. Mean red blood cell counts in probands and control subjects were not significantly different. However, mean values of hemoglobin, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were significantly higher in C282Y/C282Y probands (n = 60) than in wild-type control subjects (n = 65). Probands with other HFE genotypes also had increased mean erythrocyte parameters (other than red blood cell count). Peripheral blood smears prepared before therapeutic phlebotomy revealed that erythrocytes in many probands had increased diameters and were well filled with hemoglobin. Erythrocyte parameters were similar in C282Y/C282Y probands with and without hepatomegaly, elevated serum concentrations of hepatic enzymes, hepatic cirrhosis, diabetes mellitus, arthropathy, or hypogonadism. Among C282Y/C282Y probands, significantly greater values of MCV (but not other erythrocyte parameters) occurred among those who had transferrin saturation values of 75% or greater or iron overload at diagnosis. After iron depletion, the mean MCV, MCH, and MCHC values of C282Y/C282Y probands decreased but remained significantly greater than values in wild-type control subjects. Mean values of prephlebotomy MCH and MCHC concentrations were lower in HLA-A3-positive than in HLA-A3-negative C282Y/C282Y probands. We conclude that increased values of mean hemoglobin, hematocrit, MCV, MCH, and MCHC in hemochromatosis probands are caused primarily by increased iron uptake and hemoglobin synthesis by immature erythroid cells. Mechanisms of iron uptake by erythrocytes that could explain these results are discussed.     

Glucose-6-phosphate dehydrogenase deficiency and other erythrocyte enzyme abnormalities

Normal values of glucose-6-phosphate dehydrogenase (G6PD), 6-phosphogluconate dehydrogenase (6PGD), glutathione reductase (GR), glucosephosphate isomerase (GPI), pyruvate kinase (PK) and pyrimidine 5'-nucleotidase (P5N) have been determined in normocytes, reticulocytes, newborn cord erythrocytes, and leucocytes. Metabolic and clinical aspects of G6PD and the classification of its genetic variants are reviewed. Enzyme determinations and their variation in drug-induced haemolysis are critically presented. Extensive tables are published listing the drugs and compounds that can cause haemolysis in G6PD-deficient patients, as well as those preparations which may, probably, be administered safely. Clinical and biochemical data in patients with the inherited enzyme defects GR, GPI, PK, and P5N, as well as acquired deficiency of the last-mentioned in chronic lead intoxication, are reviewed in the light of our personal experience in this field.     

红细胞参数在儿童地中海贫血筛查中的价值探讨

目的探讨红细胞参数在地中海贫血(简称地贫)患儿筛查中的价值。方法对2009年6月17日至7月24日在云南省西双版纳州的2781名7岁以下儿童进行了血液学的检测分析,红细胞参数检测应用SysmexKX-21N血液分析仪,红细胞渗透脆性试验采用简易一管半定量法(自配试剂),血红蛋白电泳应用Helena公司pH8.6缓冲液醋酸纤维薄膜做电泳及配套电泳扫描仪扫描电泳结果。结果 6项红细胞参数中,地贫的红细胞体积分布宽度(RDW-CV)的升高最明显,红细胞平均体积(MCV)、平均红细胞血红蛋白含量(MCH)的降低也明显,与健康人的差距较大,基本上不存在重叠,其余指标则与正常参考值相重叠。MCV、MCH初筛与电泳诊断在地贫筛查中无差异。结论红细胞参数MCV、MCH、RDW-CV可以作为地贫的初步筛查试验,对三者结果均异常者,有条件时进一步做血红蛋白电泳或基因分析确诊,协助临床诊断地贫,是简单、方便、经济的筛查方法 ,尤其适合地贫高发地区。     

Assessment and monitoring of flow limitation and other parameters from flow/volume loops

Flow/volume (F/V) spirometry is routinely used for assessing the type and severity of lung disease. Forced vital capacity (FVC) and timed vital capacity (FEV₁) provide the best estimates of airflow obstruction in patients with asthma, chronic obstructive pulmonary disease (COPD) and emphysema. Computerized spirometers are now available for early home recognition of asthma exacerbation in high risk patients with severe persistent disease, and for recognition of either infection or rejection in lung transplant patients. Patients with severe COPD may exhibit expiratory flow limitation (EFL) on tidal volume (VT) expiratory F/V (VTF/V) curves, either with or without applying negative expiratory pressure (NEP). EFL results in dynamic hyperinflation and persistently raised alveolar pressure or intrinsic PEEP (PEEP_i). Hyperinflation and raised PEEP_i greatly enhance dyspnea with exertion through the added work of the threshold load needed to overcome raised pleural pressure. Esophageal (pleural) pressure monitoring may be added to VTF/V loops for assessing the severity of PEEP_i: 1) to optimize assisted ventilation by mask or via endotracheal tube with high inspiratory flow rates to lower I : E ratio, and 2) to assess the efficacy of either pressure support ventilation (PSV) or low level extrinsic PEEP in reducing the threshold load of PEEP_i. Intraoperative tidal volume F/V loops can also be used to document the efficacy of emphysema lung volume reduction surgery (LVRS) via disappearance of EFL. Finally, the mechanism of ventilatory constraint can be identified with the use of exercise tidal volume F/V loops referenced to maximum F/V loops and static lung volumes. Patients with severe COPD show inspiratory F/V loops approaching 95% of total lung capacity, and flow limitation over the entire expiratory F/V curve during light levels of exercise. Surprisingly, patients with a history of congestive heart failure may lower lung volume towards residual volume during exercise, thereby reducing airway diameter and inducing expiratory flow limitation. This revised version was published online in July 2006 with corrections to the Cover Date.     

651例血尿红细胞参数检测结果分析

目的探讨全自动尿沉渣分析仪UF-100判剐血尿来源的可信性。方法采用全自动尿沉渣分析仪UF-100与显微镜同时检测651例血尿中红细胞形态,并对检测结果进行比较分析。结果全自动尿沉瀣分析仪UF-100检测651例血尿中393例显示红细胞来源信息,与显微镜检测结果比较符合率为：肾小球性血尿为85．5％,非肾小球性血屎为100％。结论用全自动尿沉渣分析仪UF-100检测血尿来源可信度高,简便快速。但仪器提示肾小球性血尿的小红细胞最好用显微镜验证。仪器提示未分类红细胞的必须用显微镜分类确诊,以减少误诊,减少医疗纠纷。     

Storage effects on the Cole-Cole parameters of erythrocyte suspensions

Chemical alterations of red blood cells (RBCs) during storage eventually affect the electrical properties of blood. In this study, the physiological parameters such as extracellular (SAGM + CPD + residual plasma) Na(+), K(+), Cl(-), pH, 2,3-DPG and ATP together with the Cole-Cole parameters were measured using erythrocyte suspensions from 51 male donors (31 donors form the training set and 20 donors are used for testing), on the 0th, 10th, 21st, 35th and 42nd days of storage. During storage, while the surrounding fluid resistance (R(e)) and the effective cell membrane capacitance (C(m)) increased progressively with time, the intracellular fluid resistance (R(i)) has decreased. Storage of RBCs resulted in a rise in K(+) and a fall in Na(+), Cl(-), pH, 2,3-DPG and ATP. Accordingly, electrical parameters were all correlated with Na(+), K(+), Cl(-), pH and ATP at varying levels. By applying multi-regression analysis, it is concluded that R(i), R(e) and C(m) are appropriate for modeling Na(+), K(+), Cl(-), pH and ATP during storage.     

非贫血性地中海贫血患者红细胞和网织红细胞参数的分析

目的 探讨非贫血性地中海贫血患者红细胞及网织红细胞参数的变化及临床意义.方法 应用Beckman Coulter公司的LH-750型全自动血细胞分析仪,检测100例非贫血性地中海贫血患者和100例健康成人的红细胞和网织红细胞参数,对所得数据进行统计学分析.结果 非贫血性地中海贫血患者红细胞、红细胞体积分布宽度、网织红细胞绝对值、高光散网织红细胞绝对值增高,血红蛋白、平均红细胞体积、平均红细胞血红蛋白量、平均网织红细胞体积、平均球形细胞体积显著降低,网织红细胞百分率、高光散网织红细胞百分率、未成熟网织红细胞指数变化不大.结论 血常规筛查出非贫血性地中海贫血患者对临床和优生优育有重要的意义.     

非贫血性地中海贫血患者红细胞和网织红细胞参数的分析

目的探讨非贫血性地中海贫血患者红细胞及网织红细胞参数的变化及临床意义。方法应用Beckman Coulter公司的LH～750型全自动血细胞分析仪,检测100例非贫血性地中海贫血患者和100例健康成人的红细胞和网织红细胞参数,对所得数据进行统计学分析。结果非贫血性地中海贫血患者红细胞、红细胞体积分布宽度、网织红细胞绝对值、高光散网织红细胞绝对值增高,血红蛋白、平均红细胞体积、平均红细胞血红蛋白量、平均网织红细胞体积、平均球形细胞体积显著降低,网织红细胞百分率、高光散网织红细胞百分率、未成熟网织红细胞指数变化不大。结论血常规筛查出非贫血性地中海贫血患者对临床和优生优育有重要的意义。     

珠蛋白生成障碍性贫血基因型与红细胞参数的关系研究

目的：探讨珠蛋白生成障碍性贫血（地贫）基因型与红细胞参数之间的相关性。方法选取2012年2月至2013年6月佛山市第二人民医院315例成年α地贫基因携带者,根据其缺失α基因个数分3组,缺失1个基因者为 A 组;缺失2个基因者为 B 组;缺失3个基因者为 C 组。选取中国人群最常见的4种β-地贫基因突变型的基因携带者165例,分为 CD41-42组,IVS2nt654组,-28组,CD17组,及αβ复合型地贫组,选取同期100名健康体检者做对照组,回顾性分析各组红细胞（RBC）参数,采用方差分析及 SNK 检验比较上述各组间红细胞参数的差异。结果α基因缺失个数与 RBC 及红细胞分布宽度变异系数（RDW-CV）呈正相关（r ＝0．872,0．561;P＜0．05）;与血红蛋白（Hb）,平均红细胞体积（MCV ）,平均血红蛋白含量（MCH ）,平均血红蛋白浓度（MCHC ）呈负相关（r ＝-0．708,-0．901,-0．826,-0．735,P ＜0．05）。β地贫基因型及αβ复合型地贫统计学分析比较显示,RBC 、MCHC 、RDW-CV 在各组间比较,差异无统计学意义（P＞0．05）;而 Hb 、MCV 、MCH 在各组间比较,差异有统计学意义（P＜0．05）。结论α地贫的贫血程度与缺失α珠蛋白基因的个数密切相关。而对于中国人群最常见的4种β-地贫基因突变来说,所引起的血液学表型相差不大。     

非贫血性地中海贫血患者红细胞和网织红细胞参数的分析

目的 探讨非贫血性地中海贫血患者红细胞及网织红细胞参数的变化及临床意义.方法 应用Beckman Coulter公司的LH-750型全自动血细胞分析仪,检测100例非贫血性地中海贫血患者和100例健康成人的红细胞和网织红细胞参数,对所得数据进行统计学分析.结果 非贫血性地中海贫血患者红细胞、红细胞体积分布宽度、网织红细胞绝对值、高光散网织红细胞绝对值增高,血红蛋白、平均红细胞体积、平均红细胞血红蛋白量、平均网织红细胞体积、平均球形细胞体积显著降低,网织红细胞百分率、高光散网织红细胞百分率、未成熟网织红细胞指数变化不大.结论 血常规筛查出非贫血性地中海贫血患者对临床和优生优育有重要的意义.     

红细胞参数在危重病患者液体管理中的作用

目的 探讨红细胞参数与中心静脉压(CVP)及血容量的关系,以期指导重症患者的液体管理.方法 ①试验1:持续观察1例重症患者38 d,记录其每日早晨的CVP和红细胞参数[红细胞计数(RBC)、血红蛋白(Hb)、红细胞比容(HCT)]等;将所测CVP值(cm H2O,1 cm H2O=0.098 kPa)分为3组(＜8组、8～10组、＞10组),比较各组的红细胞参数,分析其与CVP的相关性.同时获取其“最佳”CVP(即血容量最合适的情况下)及与之对应的“最佳”红细胞参数(血液既未被稀释,也未被浓缩).②试验2:观察另1例重症患者,分析其“最佳”CVP,确定其“最佳”红细胞参数值.在怀疑其血容量可能不足或过度的情况下,立即检测其红细胞参数,如果所测数值与“最佳”红细胞参数差异较大,予以扩充血容量或利尿,否则寻找其他原因或继续观察.分别比较扩容或利尿治疗前后的CVP.结果 ①试验1:CVP＞ 10组的RBC(×109/L)、Hb(g/L)、HCT均较CVP＜8组和CVP 8 ～ 10组显著降低(RBC:3.05±0.32比3.59±0.25、3.42±0.24,Hb:85.3±6.8比104.2±3.6、97.5±4.9,HCT:0.271±0.023比0.321±0.015、0.309±0.019,均P＜0.01);CVP 8 ～ 10组的Hb也显著低于CVP＜8组(97.5±4.9比104.2 ± 3.6,P＜ 0.01).CVP与RBC、Hb、HCT均呈负相关,相关系数(r值)分别为-0.735、-0.903、-0.822(均P＜0.01);RBC、Hb、HCT之间呈高度正相关,r值分别为0.804、0.931、0.863(均P＜0.01).患者CVP为8 ～ 10 cm H2O时生命体征较为平稳,故将此值定为“最佳”CVP;据此确定的“最佳”红细胞参数RBC为3.43×109/L、Hb为97.4 g/L、HCT为0.310.②试验2:该患者的“最佳”CVP也为8～ 10 cm H2O,对应的“最佳”红细胞参数Hb为105 g/L.在Hb较“最佳”Hb显著升高组中,经过扩容后其CVP明显升高(8.29±1.80比5.86±1.57,P＜0.05);在Hb较“最佳”Hb显著降低组中,经过利尿后其CVP显著降低(8.80±2.39比12.20±1.92,P＜0.05).结论 红细胞各参数与CVP呈显著负相关,“最佳”CVP对应的“最佳”红细胞参数值可能具有指导危重病患者液体管理的作用.     

非贫血性地中海贫血患者红细胞和网织红细胞参数的分析

目的 探讨非贫血性地中海贫血患者红细胞及网织红细胞参数的变化及临床意义.方法 应用Beckman Coulter公司的LH-750型全自动血细胞分析仪,检测100例非贫血性地中海贫血患者和100例健康成人的红细胞和网织红细胞参数,对所得数据进行统计学分析.结果 非贫血性地中海贫血患者红细胞、红细胞体积分布宽度、网织红细胞绝对值、高光散网织红细胞绝对值增高,血红蛋白、平均红细胞体积、平均红细胞血红蛋白量、平均网织红细胞体积、平均球形细胞体积显著降低,网织红细胞百分率、高光散网织红细胞百分率、未成熟网织红细胞指数变化不大.结论 血常规筛查出非贫血性地中海贫血患者对临床和优生优育有重要的意义.     

非贫血性地中海贫血患者红细胞和网织红细胞参数的分析

目的 探讨非贫血性地中海贫血患者红细胞及网织红细胞参数的变化及临床意义.方法 应用Beckman Coulter公司的LH-750型全自动血细胞分析仪,检测100例非贫血性地中海贫血患者和100例健康成人的红细胞和网织红细胞参数,对所得数据进行统计学分析.结果 非贫血性地中海贫血患者红细胞、红细胞体积分布宽度、网织红细胞绝对值、高光散网织红细胞绝对值增高,血红蛋白、平均红细胞体积、平均红细胞血红蛋白量、平均网织红细胞体积、平均球形细胞体积显著降低,网织红细胞百分率、高光散网织红细胞百分率、未成熟网织红细胞指数变化不大.结论 血常规筛查出非贫血性地中海贫血患者对临床和优生优育有重要的意义.     

非贫血性地中海贫血患者红细胞和网织红细胞参数的分析

目的 探讨非贫血性地中海贫血患者红细胞及网织红细胞参数的变化及临床意义.方法 应用Beckman Coulter公司的LH-750型全自动血细胞分析仪,检测100例非贫血性地中海贫血患者和100例健康成人的红细胞和网织红细胞参数,对所得数据进行统计学分析.结果 非贫血性地中海贫血患者红细胞、红细胞体积分布宽度、网织红细胞绝对值、高光散网织红细胞绝对值增高,血红蛋白、平均红细胞体积、平均红细胞血红蛋白量、平均网织红细胞体积、平均球形细胞体积显著降低,网织红细胞百分率、高光散网织红细胞百分率、未成熟网织红细胞指数变化不大.结论 血常规筛查出非贫血性地中海贫血患者对临床和优生优育有重要的意义.     

非贫血性地中海贫血患者红细胞和网织红细胞参数的分析

目的 探讨非贫血性地中海贫血患者红细胞及网织红细胞参数的变化及临床意义.方法 应用Beckman Coulter公司的LH-750型全自动血细胞分析仪,检测100例非贫血性地中海贫血患者和100例健康成人的红细胞和网织红细胞参数,对所得数据进行统计学分析.结果 非贫血性地中海贫血患者红细胞、红细胞体积分布宽度、网织红细胞绝对值、高光散网织红细胞绝对值增高,血红蛋白、平均红细胞体积、平均红细胞血红蛋白量、平均网织红细胞体积、平均球形细胞体积显著降低,网织红细胞百分率、高光散网织红细胞百分率、未成熟网织红细胞指数变化不大.结论 血常规筛查出非贫血性地中海贫血患者对临床和优生优育有重要的意义.     

非贫血性地中海贫血患者红细胞和网织红细胞参数的分析

目的 探讨非贫血性地中海贫血患者红细胞及网织红细胞参数的变化及临床意义.方法 应用Beckman Coulter公司的LH-750型全自动血细胞分析仪,检测100例非贫血性地中海贫血患者和100例健康成人的红细胞和网织红细胞参数,对所得数据进行统计学分析.结果 非贫血性地中海贫血患者红细胞、红细胞体积分布宽度、网织红细胞绝对值、高光散网织红细胞绝对值增高,血红蛋白、平均红细胞体积、平均红细胞血红蛋白量、平均网织红细胞体积、平均球形细胞体积显著降低,网织红细胞百分率、高光散网织红细胞百分率、未成熟网织红细胞指数变化不大.结论 血常规筛查出非贫血性地中海贫血患者对临床和优生优育有重要的意义.