系统性红斑狼疮合并自身免疫性溶血性贫血患者血常规中的红细胞聚集现象分析  

Analysis of erythrocyte aggregation in blood of patients with systemic lupus erythematosus complicated by autoimmune hemolytic anemia

作　　者：陈允国 李绵绵[1] 陈小剑[1] 叶映月[1] 方佩佩[1] 余玲玲[1] CHEN Yun-guo;LI Mian-mian;CHEN Xiao-jian;YE Ying-yue;FANG Pei-pei;YU Ling-ling(Department of Medical Laboratory,the Second Affiliated Hospital（Yuying Children＇s Hospital）of Wenzhou Medical University,Wenzhou,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院育英儿童医院医学检验中心,浙江温州325027

出　　处：《中国卫生检验杂志》2018年第19期2373-2375,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的通过对系统性红斑狼疮(SLE)合并自身免疫性溶血性贫血(AIHA)患者血常规中的红细胞(RBC)聚集现象进行分析,进一步探讨其可能的发生机制及纠正措施。方法采用SYSMEX-XE5000全自动血细胞分析仪对SLE合并AIHA患者血常规标本进行检测,将镜下发生RBC聚集标本置37℃水浴,分别在水浴30 min、60 min、120 min、24 h后,重新上机检测,同时采用对水浴前全血作5倍稀释(预稀释模式)进行测定,并进行涂片和瑞氏染色,观察RBC多项参数变化及显微镜下观察RBC解聚情况。结果全血在水浴前,水浴30 min、60 min、120 min、24 h后,RBC计数明显低于正常参考范围,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)明显高于正常参考范围,显微镜下观察血涂片,RBC均存在聚集现象;而预稀释处理后,RBC计数值显著上升,MCV、MCH均接近于正常参考范围,MCHC在正常参考范围内,观察血涂片,RBC呈散在分布。结论此类患者全血在水浴箱37℃长时间水浴后,RBC仍不能解聚,只有预稀释处理后,才能得到较满意的检测结果。Objective To investigate the possible mechanism of erythrocyte（RBC） aggregation in the blood of patients with systemic lupus erythematosus（SLE） complicated by autoimmune hemolytic anemia（AIHA） and to get corrective measures.Methods The blood samples of SLE with AIHA were detected by SYSMEX-XE5000 automatic hematology analyzer. Specimens with aggregated RBC were placed in the 37℃ water bath for 30 min,60 min,120 min and 24 h respectively,and then detected again,meanwhile,the whole blood before water bath was diluted 5 times（pre-dilution mode）,and smear and Wright＇s staining were performed. The changes of RBC parameters and the disaggregation of RBC under the microscope were observed.Results The RBC count of the whole blood was significantly lower than that of the normal reference range after water bath for30 min,60 min,120 min,24 h. The mean corpuscular volume（MCV）,mean corpuscular hemoglobin（MCH）,mean corpuscular hemoglobin concentration（MCHC） were significantly higher than the normal reference range,microscopic observation of blood smears,RBC aggregated phenomena; and pre-dilution treatment,RBC count increased significantly,MCV,MCH were close to the normal reference range,MCHC was within the normal reference range,blood smear was observed,and RBC was of scattered distribution. Conclusion The RBC could not be depolymerized even after the whole blood was washed in a water bath at 37 ℃ for a long time. Only the pre-dilution treatment could obtain satisfactory results.

关 键 词：系统性红斑狼疮 自身免疫性溶血性贫血 红细胞聚集 

分 类 号：R593.241[医药卫生—内科学]