436例关节液检查白细胞分类结果分析及临床意义

Analysis and its clinical application of leukocyte differential count in 436 patients′ synovia

目的关节液中白细胞分类结果检查可协助临床诊断、治疗骨关节病。方法将关节液离心、沉淀、涂片、染色,油镜下作白细胞分类计数。结果化脓性关节炎中性粒细胞值为72%-97%;类风湿性关节炎中性粒细胞值为20%~81%;痛风性关节炎中性粒细胞为55%-82%;结核性关节炎中性粒细胞为20%-71%;骨性关节炎中性粒细胞为19%-50%;强直性脊柱炎中性粒细胞为13%-18%;假痛风中性粒细胞为25%-55%;创伤性骨关节病中性粒细胞为35%-45%;骨关节肿瘤中性粒细胞为20%-30%;其他病因不明的骨关节病中性粒细胞为11%-63%之间,淋巴细胞为20%-69%。结论关节液的中性粒细胞分类是区分炎性或非炎性关节液的重要指标,化脓性关节炎中性粒细胞分类很高,在72%-97%之间,最高可达到97%以上,平均为93%。当中性粒细胞分类介于50%-72%时,一般来说是非化脓性的炎性感染。

Objective To observe leukocyte differential count in synovia and analyze the clinical diagnosis value for osteoarticular disease.Methods The synovia was centrifuged,precipitated,smeared and stained successively.The stained samples were determined for leukocyte differential count under light microscope.Results The percentages of neutrophilic granulocyte in pyogenic arthritis,rheumatoid arthritis,arthrolithiasis,tuberculous arthritis,osteoarthritis,rhachitis,pseudogout,traumatic osteoarthrosis and bone tumor were 72%-97%,20%-81%,55%-82%,20%-71%,19%-50%,13%-18%,25%-55%,35%-45% and 20%-30% respectively.The percentage of neutrophilic granulocyte in other osteoarthrosis which had not definite etiological factor was 11%-63%,and the percentage of lymphocyte was 20%-69%.Conclusions The percentage of neutrophilic granulocyte in synovia is an important parameter to discriminate the inflammatory synovia.It can rise to 72%-97% in pyogenic arthritis,and the average percentage is 93%.It is not inflammatory when the percentage of neutrophilic granulocyte is between 50%-72%.