Afzal A, Noor H A, Gill S A, Brawner C, Stein P D
Henry Ford Heart and Vascular Institute, Detroit, MI, USA.
Chest. 1999 May;115(5):1329-32. doi: 10.1378/chest.115.5.1329.
The purpose of this investigation is to assess the level of leukocytosis in acute pulmonary embolism (PE).
Limited data exist regarding leukocytosis in acute PE. One reason that the prevalence of leukocytosis in acute PE is unknown, despite an extensive number of investigations of PE, may relate to the fact that acute PE is usually associated with other conditions that themselves may cause leukocytosis.
Hospital records of 386 patients with a diagnosis of acute PE were reviewed retrospectively. Patients with no other possible or definite cause of leukocytosis were analyzed separately. A diagnosis of PE was made by a high-probability interpretation of the ventilation/perfusion lung scan or pulmonary angiogram.
Among patients with PE in whom other possible or defined causes for leukocytosis were eliminated, 52 of 266 (20%) had a WBC count > 10,000/mm3. None had a WBC count that was > or = 20,000/mm3. Patients with the pulmonary hemorrhage/infarction syndrome had an increased WBC count in 32 of 183 (17%) vs 20 of 83 (24%) in patients who did not have pulmonary hemorrhage/infarction syndrome (not significant).
A modest leukocytosis may accompany (and possibly be caused by) PE. Its presence should not dissuade the clinician from objectively pursuing the diagnosis of PE.
本研究旨在评估急性肺栓塞（PE）患者的白细胞增多水平。
关于急性PE患者白细胞增多的数据有限。尽管对PE进行了大量研究，但急性PE患者白细胞增多的患病率仍不清楚，原因之一可能是急性PE通常与其他本身可能导致白细胞增多的疾病相关。
回顾性分析386例诊断为急性PE患者的医院记录。对无其他可能或明确白细胞增多原因的患者进行单独分析。通过通气/灌注肺扫描或肺血管造影的高概率解读来诊断PE。
在排除其他可能或明确白细胞增多原因的PE患者中，266例中有52例（20%）白细胞计数>10,000/mm³。无一例白细胞计数≥20,000/mm³。有肺出血/梗死综合征的患者中，183例中有32例（17%）白细胞计数升高，而无肺出血/梗死综合征的患者中，83例中有20例（24%）白细胞计数升高（无显著性差异）。
PE可能伴有轻度白细胞增多（也可能由其引起）。其存在不应阻碍临床医生客观地进行PE的诊断。
