Louthrenoo W, Sieck M, Clayburne G, Rothfuss S, Schumacher H R
Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.
J Rheumatol. 1991 Mar;18(3):409-13.
Leukocyte differential counts are rarely performed on synovial fluids (SF) with low leukocyte (WBC) counts as they have been difficult to do with standard Wright stains. We performed SF analysis including supravital (SV) stains for differential counts on 100 consecutive relatively noninflammatory synovial fluids defined as any SF with less than 2,000 cells/mm3. SV stains gave clear cellular morphology. Monocytes were the most prominent cells in all noninflammatory synovial fluids. Thirty-eight fluids were found to have crystals (monosodium urate (MSU) in 15, calcium pyrophosphate dihydrate (CPPD) in 5, CPPD plus apatite-like crystals in 9, apatite-like clumps alone in 8 and lipid liquid in 1). WBC counts, percentages of polymorphonuclear (PMN) and absolute PMN counts were greatest in fluids with MSU or CPPD crystals. Fluids with apatite-like clumps alone tended to have the lowest WBC counts. The presence of WBC over 500 cells/mm3, over 20% PMN and absolute PMN counts over 250 cells/mm3 should encourage a careful search for crystals, especially MSU, in noninflammatory synovial fluids.
对于白细胞（WBC）计数较低的滑液（SF），很少进行白细胞分类计数，因为使用标准瑞氏染色法很难进行此项操作。我们对100例连续的相对非炎性滑液进行了包括用于分类计数的活体染色（SV）在内的滑液分析，这些滑液被定义为细胞数少于2000个/mm³的任何滑液。活体染色给出了清晰的细胞形态。单核细胞是所有非炎性滑液中最突出的细胞。发现38例滑液中有晶体（15例为尿酸钠（MSU），5例为二水焦磷酸钙（CPPD），9例为CPPD加类磷灰石晶体，8例仅为类磷灰石团块，1例为脂质液）。在含有MSU或CPPD晶体的滑液中，白细胞计数、多形核白细胞（PMN）百分比和绝对PMN计数最高。仅含有类磷灰石团块的滑液往往白细胞计数最低。在非炎性滑液中，白细胞计数超过500个/mm³、PMN超过20%以及绝对PMN计数超过250个/mm³时，应促使仔细寻找晶体，尤其是MSU。
