Bogar L L, Tarsoly P P
Department of Anaesthesiology and Critical Care, University of Pecs, Pecs, Hungary.
Clin Hemorheol Microcirc. 2006;34(3):439-45.
Leukocyte function tests are suitable for monitoring the severity of chronic inflammatory and acute infectious diseases. The tests usually require time consuming leukocyte separation techniques while the original character of leukocytes can substantially alter. In contrast, we noted that gravity sedimentation properties of leukocytes is simple to measure and it also reflects non-specific inflammatory reactions of leukocytes. Our novel test is named leukocyte antisedimentation rate (LAR) which is measured by leukocyte counting in the upper (U) and lower (L) half of the sedimentation blood column after one-hour gravity sedimentation of the whole blood. The formula LAR=100.(U-L)/(U+L) is used to calculate the percentage of leukocytes crosses the middle line of sedimentation blood column upward during one-hour sedimentation (normal range<15%, inter-assay coefficient of variation<5%). In this study we found that in vitro pre-treatment of septic patients' blood samples with protamine, lidocaine and prednisolone decreased leukocyte antisedimentation rate in a concentration dependent manner without effecting erythrocyte sedimentation rate. Leukocyte adherence was measured by the retention rate of leukocytes in a nylon fibre column. There was a significant positive correlation between leukocyte antisedimentation rate and leukocyte adherence (p<0.01), hematocrit (p<0.05), erythrocyte sedimentation rate (p<0.05) when blood samples of 35 healthy individuals were analysed. We concluded that leukocyte antisedimentation rate in septic patients is significantly elevated comparing to healthy controls and as a bedside test it can reflect leukocyte involvement in infections. In vitro protamine, lidocaine and prednisolone pre-treatment of septic patients' blood samples indicates that leukocyte antisedimentation process is partially independent from the ongoing erythrocyte sedimentation.
白细胞功能测试适用于监测慢性炎症和急性传染病的严重程度。这些测试通常需要耗时的白细胞分离技术，而白细胞的原始特性可能会发生显著改变。相比之下，我们注意到白细胞的重力沉降特性易于测量，并且它还反映了白细胞的非特异性炎症反应。我们的新型测试称为白细胞抗沉降率（LAR），它是通过对全血进行一小时重力沉降后，对沉降血柱上半部分（U）和下半部分（L）的白细胞进行计数来测量的。公式LAR = 100·(U - L)/(U + L)用于计算在一小时沉降过程中向上穿过沉降血柱中线的白细胞百分比（正常范围<15%，批间变异系数<5%）。在本研究中，我们发现用鱼精蛋白、利多卡因和泼尼松龙对脓毒症患者的血样进行体外预处理，可使白细胞抗沉降率呈浓度依赖性降低，而不影响红细胞沉降率。通过尼龙纤维柱中白细胞的保留率来测量白细胞黏附。对35名健康个体的血样进行分析时，白细胞抗沉降率与白细胞黏附（p<0.01）、血细胞比容（p<0.05）、红细胞沉降率（p<0.05）之间存在显著正相关。我们得出结论，与健康对照相比，脓毒症患者的白细胞抗沉降率显著升高，作为一种床旁测试，它可以反映白细胞在感染中的参与情况。对脓毒症患者的血样进行鱼精蛋白、利多卡因和泼尼松龙的体外预处理表明，白细胞抗沉降过程部分独立于正在进行的红细胞沉降。
