Antonsen S, Pedersen F B, Wang P
Department of Clinical Chemistry, Odense University Hospital, Denmark.
Perit Dial Int. 1991;11(1):43-7.
The concentration of leukocytes and the fraction of neutrophil granulocytes are two important criteria in the diagnosis of peritonitis in continuous ambulatory peritoneal dialysis (CAPD). We have found that leukocytes are unstable in dialysis effluents, resulting in false low leukocyte concentrations if not counted immediately. At 25 degrees C the leukocyte count decreases 25%-30% in 4-6 hours. Sampling in tubes containing EDTA and storage at 4 degrees C make the leukocyte concentration stable for 6 hours, while the combination of EDTA and storage at 4 degrees C ensures stability for 24 hours. When samples are handled accordingly, concentrations as high as 2 x 10(8)/L are observed without any clinical signs of peritonitis, especially within the first months of CAPD-treatment. Thus, we suggest a leukocyte-concentration of 2 x 10(8)/L as the diagnostic limit for peritonitis. Concerning fraction of neutrophils a diagnostic limit of 0.50 still seems relevant.
白细胞浓度和中性粒细胞比例是持续性非卧床腹膜透析（CAPD）患者腹膜炎诊断中的两个重要标准。我们发现透析废液中的白细胞不稳定，如果不立即计数会导致白细胞浓度假性降低。在25摄氏度时，白细胞计数在4至6小时内会降低25%至30%。在含有乙二胺四乙酸（EDTA）的试管中采样并在4摄氏度下保存可使白细胞浓度在6小时内保持稳定，而EDTA与4摄氏度保存相结合可确保24小时的稳定性。当样本按此方式处理时，会观察到白细胞浓度高达2×10⁸/L，而无任何腹膜炎的临床体征，尤其是在CAPD治疗的最初几个月内。因此，我们建议将2×10⁸/L的白细胞浓度作为腹膜炎的诊断界限。关于中性粒细胞比例，0.50的诊断界限似乎仍然适用。
