Institute of Laboratory Medicine and Pathobiochemistry, Charité Universitätsmedizin Berlin, Berlin, Germany.
Clin Chem Lab Med. 2011 Jul;49(7):1193-8. doi: 10.1515/CCLM.2011.188. Epub 2011 May 17.
When certain inflammatory processes occur, toxic granulation neutrophils (TGNs) appear in the blood showing prominent cytoplasmic granules. Currently, the granularity of TGNs is analyzed by manual microscopy of blood smears. The SYSMEX XE-5000 is an automated hematology analyzer, which can measure toxic granulation of TGNs by calculating the Granularity (GI) Index. In this study we investigated if the GI-Index is suitable as a parameter for the TGN granularity in inflammatory diseases.
An evaluation of the toxic granulation neutrophil (TGN) granularity by manual microscopy, the GI-Index and the C-reactive protein (CRP) concentrations of 158 patients were determined. Blood samples from 40 healthy individuals were incubated with lipopolysaccharide (LPS) for in vitro kinetic measurements of the GI-Index. Furthermore, time course measurements of the GI-Index and CRP concentrations of 100 intensive care unit patients were performed.
The GI-Index correlated with the microscopic rating of TGNs (n=158; r(s)=0.839; p<0.0001). When incubating the blood samples with LPS, the neutrophils displayed hypogranulation 30 min after incubation and a hypergranulation after 90 min. In vivo, the GI-Index indicated changes of the bacterial infection status 1 day earlier than the CRP concentration. The correlation of CRP and GI-Index varied between the patient cohorts (n=158; r(s)=0.836) (n=100; r=0.177), depending on the cause and extent of inflammation.
The GI-Index is suited to quantify the granularity of TGNs. The GI-Index is an automated, standardized parameter available on a 24 h basis. We suggest that it replace the time-consuming, subjective and semiquantitative microscopic procedure.
当发生某些炎症过程时，血液中会出现有毒颗粒的中性粒细胞（TGN），表现为细胞质颗粒明显。目前，TGN 的颗粒度通过血液涂片的手动显微镜分析来分析。SYSMEX XE-5000 是一种自动化血液分析仪，它可以通过计算颗粒度（GI）指数来测量 TGN 的有毒颗粒。在这项研究中，我们研究了 GI 指数是否适合作为炎症性疾病中 TGN 颗粒度的参数。
评估了 158 名患者的手动显微镜毒性颗粒中性粒细胞（TGN）颗粒度、GI 指数和 C 反应蛋白（CRP）浓度。将 40 名健康个体的血液样本与脂多糖（LPS）孵育，以进行 GI 指数的体外动力学测量。此外，对 100 名重症监护病房患者的 GI 指数和 CRP 浓度进行了时间过程测量。
GI 指数与 TGN 的显微镜评分相关（n=158；r(s)=0.839；p<0.0001）。将血液样本与 LPS 孵育时，中性粒细胞在孵育 30 分钟后表现出颗粒减少，90 分钟后表现出颗粒增多。在体内，GI 指数比 CRP 浓度更早地指示细菌感染状态的变化。CRP 和 GI 指数的相关性在患者队列之间有所不同（n=158；r(s)=0.836）（n=100；r=0.177），这取决于炎症的原因和程度。
GI 指数适合量化 TGN 的颗粒度。GI 指数是一种自动化、标准化的参数，可在 24 小时内提供。我们建议它取代耗时、主观和半定量的显微镜程序。
