2例急性放射病患者网织红细胞变化分析

Changes in reticulocyte in 2 patients with acute radiation sickness

目的:分析2例急性放射病(ARS)患者的外周血细胞和网织红细胞等参数的变化,探讨其在ARS救治中的临床价值。方法:用Sysm ex-2000 i型自动血细胞分析仪连续测定2例ARS患者的白细胞计数(WBC),红细胞计数(RBC),血小板计数(Plt)等血象指标,以及网织红细胞计数(RET)、网织红细胞绝对数、未成熟网织红细胞指数(IRF)、高荧光网织红细胞比率(HFR)、中荧光网织红细胞比率(MFR)、低荧光网织红细胞比率(LFR)6项网织红细胞参数。结果:2例ARS患者WBC在受照后初期一过性升高,淋巴细胞计数明显下降,RET和RET绝对数降低,HFR和IRF均为0。造血干细胞移植后HFR和IRF最早恢复,先于WBC升高1d,先于RET、RET绝对数升高2d,先于Plt升高3 d。结论:受照初期WBC、淋巴细胞计数以及RET和RET绝对数等与受照剂量有关。WBC升高结合HFR、IRF值的变化可以用于早期判断ARS患者造血干细胞移植是否成功。

Objective：To assess the clinical value of routine blood and reticulocyte parameters in acute radiation sickneas（ABS）. Methods： Two patients with ARS were analyzed. White blood cell count（WBC）, red blood cell count （RBC）, platelet count （Pit） , reticulocyte count （BET）, absolute reticulocyte count, immature reticulocyte fraction （IRF）, high fluorescence reticulocytes （HFR）, middle fluorescence reticulocytes （MFR） , and low fluorescence reticulocytes （LFR） were measured using Sysmex XT-2000i automatic hematology analyzer. Results： During early days after exposure,an increase in WBC,decrease in lymphocyte count, BET and absolute BET were observed, HFR and IRF were zero. After hematopoietic stem cell transplantation, HFR and IRF recovered at first, 1 day before the rise in WBC, 2 days before the rise in RET and absolute BET, and 3 days before the rise in Pit. Conclusion： Durin8 early days, WBC, lymphocyte count, BET and absolute BET are related to radiation dose. The rises of WBC, HFR and IRF can reflect marrow recovery after hematopoietic stem cell transplantation in ARS.