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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 analyze the changes of peripheral blood cells and reticulocytes in 2 patients with acute radiation sickness (ARS) and discuss their clinical value in the treatment of ARS. Methods: The WBC, RBC and Plt were measured in two ARS patients continuously with Sysm ex-2000 automatic hematology analyzer, and the reticulocyte count (RET) The number of reticulocytes, immature reticulocyte index (IRF), high fluorescence reticulocyte ratio (HFR), medium fluorescence reticulocyte ratio (MFR), low fluorescence reticulocyte ratio (LFR) parameter. Results: The WBC in two ARS patients increased transiently in the early stage after irradiation, the lymphocyte count decreased obviously, the absolute numbers of RET and RET decreased, and the HFR and IRF were zero. HFR and IRF recovered after hematopoietic stem cell transplantation, and increased 1 day before WBC. Before RET, the absolute number of RET increased 2d, and increased 3 days before Plt. Conclusion: The initial WBC, lymphocyte count and the absolute numbers of RET and RET are related to the dose of irradiation. WBC increased combined with HFR, IRF value changes can be used to determine the early ARS patients with hematopoietic stem cell transplantation was successful.