脓毒症患者外周血红细胞膜磷脂酰丝氨酸的外露

Phosphatidylserine exposure in red blood cell in sepsis patients

目的研究脓毒症患者外周血红细胞的形态改变及红细胞膜表面磷脂酰丝氨酸（PS）的外露情况。方法采用配对设计随机分组方法，分别对正常对照组（n=30）和脓毒症患者组（n=30）进行静脉采血，行瑞氏染色血涂片观察和测定红细胞聚集指数，并采用对Ps有高度亲和力的磷脂结合蛋白AnnexinV检测技术，利用流式细胞仪对红细胞进行荧光测定。结果显微镜下观察脓毒症患者外周血红细胞形态发生明显异常改变，呈棘形、泪滴形、球形、缗线形等变化，细胞明显聚集；同时红细胞聚集指数测定结果显示脓毒症组较正常对照组也明显升高，其差异有统计学意义（P〈0．05）。脓毒症组Ps外露的红细胞比例明显高于正常对照组，其差异有统计学意义（P〈0．001）。结论脓毒症患者外周血红细胞表面Ps的外露表达明显增加，同时红细胞形态发生明显异常变化。

Objective To investigate the morphologic change and phosphatidylserine （PS） exposure of erythrocytes in sepsis patients. Methods 30 healthy volunteers （control group）and 30 sepsis patients were enrolled in this study and were collected venous sampling. Monitoring included Wright＇s staining blood smear test, erythrocyte aggregation index and the ratio of PS exposure of erythrocytes. A flow-cytometric assay based on FITC- Annexin V was used to measure the PS exposure of erythrocytes. Results The morphological changes of red blood cells included acanthocyte, lachrymiform, rouleaux, spherocyte in sepsis patients, and the peripheral blood erythrocyte aggregation and aggregation index were significantly higher than that of the healthy control group （P〈0.05）. The percentage of PS exposure of erythrocytes in sepsis patients were significantly higher than that of healthy volunteers （P〈0.001）. Conclusion The PS exposure of erythrocytes were significantly higher in sepsis patients, and the morphology of red blood cells is obvious abnormal.