MECHANISM AND CLINICAL SIGNIFICANCE OE INCREASED OSMOTIC RESISTANCE OF ERYTHROCYTE IN CHOLESTASIS

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Osmotic resistance using CPC method, erythrocyte lipids and plasma lipoproteins in patients with hepatobiliary diseases were studied. In cholestasis with high concentration of plasma Lp-X, the osmotic resistance was increased intensively and marked elevation of both cholesterol and phospholipids in their erythrocyte were observed. On the other hand, in other hepatobiliary diseases, only cholesterol was increased in their erythrocyte in spite of the increased osmotic resistance.When cholestasis was removed by PTC drainage, the decrease of cholesterol and phospholipids in equal molar ratio was observed with the normalization of osmotic resistance. Lecithin was the primary phospholipid of increased phospholipids in erythrocyte with cholestasis, and it's fatty acid composition of acyl chain resembled with that of Lp-X.In conclusion, there are two kinds of mechanism that increase osmotic resistance in hepatobiliary diseases, one is the high cholesterol content of erythrocyte with decreased LCAT reaction, and the other is the high cholesterol and lecithin content of erythrocyte due to the fusion of Lp-X.The measurement of osmotic resistance facilitates the clinical evaluation of the degree of cholestasis and the evaluation of the treatment in cholestasis i.e. PTC drainage.
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