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泼尼松试验在中性粒细胞减少症鉴别诊断中的价值评估

Assessment of the value of prednisone test in differential diagnosis of neutropenic state.

作者信息

Jedrzejczak W W

出版信息

Blut. 1975 Aug;31(2):69-76. doi: 10.1007/BF01633722.

Abstract

The prednisone test revealed normal bone marrow reserve of neutrophils (BMR) in subjects with innocent neutropenias e.g. neutropenias not associated with any other disturbances in haemopoiesis or with increased incidence of infections, assumed to be an individual anomaly of the subject. On the other hand, diminution or absence of MBR in chronic hypoplastic neutropenias, transient post-chemotherapeutic neutropenias and neutropenias with increased destruction of neutrophils were observed. The magnitude of that diminution was not dependent of the cause of neutropenia. It is suggested, that the prednisone test (and probably tests with other BMR mobilizing agents) may serve as screening tests for exclusion (or confirmation) of relative granulopoietic insufficiency as the cause of neutropenia. Only after confirmation of reduced BMR another explanations of neutropenia should be sought using other method as muramidase level, adrenaline test or granulocyte kinetics with DF32P, 3HDFP, or 51Cr.

摘要

泼尼松试验显示,在患有良性中性粒细胞减少症的受试者中,中性粒细胞的骨髓储备(BMR)正常,例如与造血过程中的任何其他紊乱或感染发生率增加无关的中性粒细胞减少症,被认为是受试者的个体异常。另一方面,在慢性再生障碍性中性粒细胞减少症、化疗后短暂性中性粒细胞减少症和中性粒细胞破坏增加的中性粒细胞减少症中,观察到MBR降低或缺失。这种降低的程度与中性粒细胞减少症的病因无关。有人提出,泼尼松试验(可能还有其他BMR动员剂试验)可作为筛查试验,用于排除(或确认)相对粒细胞生成不足作为中性粒细胞减少症的病因。只有在确认BMR降低后,才应使用其他方法,如溶菌酶水平、肾上腺素试验或用DF32P、3HDFP或51Cr进行粒细胞动力学研究,来寻找中性粒细胞减少症的其他解释。

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