遗传性球形红细胞增多症患者外周血红细胞形态的扫描电镜观察

The Application of Scanning Electron Microscopy on Study of Hereditary Spherocytosis

目的 :为探讨遗传性球形红细胞增多症异形红细胞的形态分类、发生演变、诊断和鉴别 ,本文运用扫描电镜技术对遗传性球形红细胞增多症患者外周血红细胞进行研究。方法 :7例遗传性球形红细胞增多症患者及 2例家系成员的静脉血置于扫描电镜下观察。结果 :在观察红细胞从盘形到口形 ,最终至球形的过程中 ,作者对各型红细胞直径和中央凹陷直径及细胞厚度的变化作了测量 ,并结合细胞表面形态和测量结果将病变红细胞分成 5个亚型 ,即 :盘口型 -碗口型 -球口型 -口球型 -典型球形 ,其他少量出现的异常红细胞 (棘状和靶状红细胞 )则归于畸变类。结论 :上述分型对于判断异形红细胞类型和诊断本病很有帮助。

Objective:In order to study the erythrocyte morphorlogical classification,development evolution,and diagnosis of hereditary spherocytosis(HS).Method:The blood samples of 7 cases of HS and 2 cases of their family members was observed under scanning electron microscope.Result:The erythrocytes of HS were divided into 5 subtypes which were dish-like stomatocyte type,bowl-like stomatocyte type,ball-like stomaocyte type,mouth-like spherocyte type and typical spherocyte (include teardrop-like type).The other abnormal erythrocytes which were rarely seen such as acanthocyte,target-like cell were not classified because they might be malformed cells.Discussion:1.Development evolution of spherocytes:The way of development evolution of spherocytes is as follows:dish-like type (normal red blood cell)→dish-like stomatocyte type→bowl-like stomatocyte type→ball-like stomaocyte type→mouth-like spherocyte type→typical spherocyte.2.Diagnosis:When the spherocytes of blood exceed in number by 20% (the stomatocytes are not included),the diagnosis of HS should be considered.Conclusions:The erythrocytes classifications of HS was very useful to diagnose HS.The disease which needs to be differentiated is hereditary stomatocytosis.