内源性一氧化碳呼气试验检测高原红细胞增多症患者红细胞寿命

Red blood cell lifespan detected by endogenous carbon monoxide breath test in patients with high altitude polycythemia

目的评估高原红细胞增多症(HAPC)患者的红细胞寿命,探讨其影响因素。方法回顾性分析2020年4—9月在日喀则市人民医院血液科初次诊断的50例HAPC患者,以同期10例健康志愿者作为正常对照。采用内源性一氧化碳呼气试验检测红细胞寿命,行Pearson相关性分析评估其影响因素。结果HAPC患者红细胞寿命为(69.4±34.5)d,较正常对照组[(101.5±14.9)d]显著缩短(P=0.001);其中,汉族患者的红细胞寿命[(114.6±31.9)d]与正常对照组的差异无统计学意义(P=0.255),藏族患者的红细胞寿命[(58.1±24.5)d]较正常对照组显著缩短(P=0.001)。接受红细胞单采术后,HAPC患者平均红细胞寿命为(80.3±28.1)d,较治疗前显著延长(P<0.05);其中,藏族患者的红细胞寿命[(74.6±27.1)d]较治疗前显著延长(P=0.005),汉族患者的红细胞寿命[(103.0±19.5)d]与治疗前的差异无统计学意义(P=0.340)。相关性分析显示,红细胞寿命与血清维生素B 12水平呈负相关(r=-0.325,P=0.021)。结论HAPC患者红细胞寿命较健康者缩短约1/3,其中藏族患者红细胞寿命显著缩短,汉族患者红细胞寿命与健康者相似;红细胞寿命与血清维生素B 12水平呈负相关。

Objective To detect the red blood cell lifespan in patients with high altitude polycythemia(HAPC),and explore its influencing factors.Methods Fifty patients newly diagnosed as HAPC in the Shigatse People’s Hospital from April 2020 to September 2020 and 10 normal controls were recruited in this study.Red blood cell lifespan was detected by endogenous carbon monoxide(CO)breath test.The related factors were analyzed by pearson correlation analysis.Results The red blood cell lifespan of HAPC patients was(69.4±34.5)d,which was significantly shorter than that of the normal controls([101.5±14.9]d,P=0.001).There was no significant difference in the red blood cell lifespan between the Han patients([114.6±31.9]d)and the normal control group(P=0.255),and that of the Tibetan patients([58.1±24.5]d)were significantly shorter than that of the normal control group(P=0.001).The red blood cell lifespan of HAPC patients was(80.3±28.1)d after therapeutic erythrocytapheresis,which was significantly longer than that before treatment(P<0.05).In Tibetan patients,the red blood cell lifespan was significantly different before and after treatment([74.6±27.1]d,P=0.005),while in Han patientsthere was no significantl difference([103.0±19.5]d,P=0.340).Correlation analysis showed that the level of serum vitamin B 12 was negatively correlated with red blood cell lifespan(r=-0.325,P=0.021).Conclusion The lifespan of red blood cells in patients with HAPC is about one third shorter than the normal level,especially in Tibetan patients.The red blood cell lifespan of Han HAPC patients is similar to that of healthy people.The lifespan of red blood cells is also related to serum vitamin B 12 level.