Sauter D, Spiekermann K, Feuring-Buske M, Braess J
Labor für Leukämiediagnostik, Medizinische Klinik III Klinikum der Universität München Grosshadern.
MMW Fortschr Med. 2007 Apr 12;149(15):29-32; quiz 33.
Leukocytosis is a condition often met with in the clinical and ambulatory setting. Although it is usually caused by an increase in the numbers of neutrophilic granulocytes, an increase in other leukocytes populations may also account for leukocytosis. Etiologically, both primary pathological conditions affecting the white blood cells, such as various forms of leukemia and lymphomas, and also rare genetic disorders must be considered. Decidedly more common, however, are reactive changes caused by infections, cigarette smoking, chronic inflammation, necrotic tissue or certain drugs. Although moderate leukocytosis in the absence of a clinical correlate and/or an apparent trigger, requires no diagnostic clarification, it should be kept under observation. If the etiology is uncertain, or a treatment-requiring disorder is suspected, the differential blood count is at the focus of the further diagnostic work-up. Depending upon the findings, this is supplemented by additional laboratory parameters, bone marrow examination, microbiological investigations and imaging procedures. Leukostasis resulting from vasoocclusion in the presence of very high numbers of leukocytes represents an emergency situation, and is an indication for leukapheresis.
白细胞增多是临床和门诊中常见的一种情况。虽然它通常是由嗜中性粒细胞数量增加引起的，但其他白细胞群体数量的增加也可能导致白细胞增多。从病因学角度来看，必须考虑影响白细胞的原发性病理状况，如各种形式的白血病和淋巴瘤，以及罕见的遗传疾病。然而，更常见的是由感染、吸烟、慢性炎症、坏死组织或某些药物引起的反应性变化。虽然在没有临床相关表现和/或明显诱因的情况下，中度白细胞增多不需要进行诊断性澄清，但应予以观察。如果病因不确定，或者怀疑存在需要治疗的疾病，血常规分类检查是进一步诊断检查的重点。根据检查结果，可通过其他实验室参数、骨髓检查、微生物学检查和影像学检查来补充诊断。在白细胞数量非常高的情况下，血管阻塞导致的白细胞淤滞是一种紧急情况，是进行白细胞单采术的指征。
