[Biochemical characteristics of compensation of posthemorrhagic anemia in patients presenting with nasal bleeding].

This work was designed to study the development of compensatory processes during posthemorrhagic anemia in 82 patients presenting with nasal bleeding (NB). The patients were allocated to three groups. Group 1 included patients with isolated episodes of NB, group 2 was comprised of patients in a moderately severe condition with recurring NB, group 3 was composed of patients in a severe condition with recurring NB. The general medical examination was supplemented by the evaluation of factors maintaining the oxygen-transporting function of the blood (hemoglobin affinity for oxygen, erythrocyte content of 2.3-diphosphoglyceric (2.3-DPG) acid as the principal modulator of hemoglobin affinity for oxygen) and indicators of energy (carbohydrate) metabolism in plasma and erythrocytes (glucose-6-phosphate dehydrogenase (G-6-PDH) activity, pyruvic acid (PA), lactate and lactate dehydrogenase (LDH) levels). Changes of biochemical parameters in patients presenting with incidental episodes of NB (group 1) suggested a compensatory increase in functional potential of the blood oxygen-transporting system. Patients of group 2 showed evidence of development of the modulation-type adaptive and compensatory mechanisms. Those of group 3 experienced a decrease of the 2.3-DPH level in erythrocytes and enhancement of hemoglobin affinity for oxygen which slowed down its uptake by the tissues. Tissue hypoxia and accompanying acidosis aggravated the impairment of gas-transporting function of the blood. In is concluded that patients of group 3 are at risk of uncompensated hypoxic hypoxia associated with the unfavourable changes in the oxygen-transporting function and the impairment of the functional potential of erythrocytes. Taken together, these untoward factors may be responsible for the severe clinical conditions of these patients.