Use of reticulocyte cellular indices in the diagnosis and treatment of hematological disorders.

C Brugnara
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引用次数: 103

Abstract

Automated counting of reticulocytes has markedly increased the precision and accuracy of this assay compared with the traditional manual counts. In addition, several new reticulocyte parameters are now available to clinicians and pathologists. This review examines the potential role of these parameters in the diagnosis and management of anemias. Reticulocyte maturity can now be assessed based on the staining intensity of reticulocytes, which is proportional to their RNA content. However, the clinical value of the numerical estimate of the immature reticulocyte fraction has not been yet demonstrated. In the bone marrow transplant setting, there is no clear evidence that the use of this index results in improved care of these patients, and many studies have failed to show its superiority compared with the traditional white cell count, especially for autologous transplants. Direct measurement of reticulocyte volume, hemoglobin concentration, and hemoglobin content are now available. Studies have shown that these parameters, and hemoglobin content in particular, allow a real-time assessment of the functional state of the erythroid marrow. In the setting of recombinant human erythropoietin therapy, studies of hemoglobin content have shown that this index allows an early detection of functional iron deficiency. Preliminary studies have also shown that this index may be helpful in the diagnosis of iron deficiency and in the monitoring of iron replacement therapy.

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网织红细胞指标在血液病诊断和治疗中的应用。
与传统的人工计数相比,网织红细胞的自动计数显着提高了该分析的精度和准确性。此外,临床医生和病理学家现在可以使用一些新的网状红细胞参数。这篇综述探讨了这些参数在贫血的诊断和治疗中的潜在作用。现在可以根据网织红细胞的染色强度来评估网织红细胞的成熟度,这与它们的RNA含量成正比。然而,未成熟网状细胞分数的数值估计的临床价值尚未得到证实。在骨髓移植中,没有明确的证据表明该指标的使用改善了这些患者的护理,并且许多研究未能显示其与传统白细胞计数相比的优势,特别是在自体移植中。直接测量网织红细胞体积,血红蛋白浓度和血红蛋白含量现在是可用的。研究表明,这些参数,特别是血红蛋白含量,可以实时评估红细胞骨髓的功能状态。在重组人促红细胞生成素治疗的设置中,血红蛋白含量的研究表明,该指标可以早期发现功能性缺铁。初步研究还表明,该指标可能有助于铁缺乏症的诊断和铁替代治疗的监测。
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