Matzner Y
Hematology Unit, Hadassah University Hospital, Jerusalem, Israel.
Transfus Med Rev. 1987 Dec;1(3):171-81. doi: 10.1016/s0887-7963(87)70019-4.
A complete evaluation of neutrophil function including: chemotaxis; adhesion; aggregation; phagocytosis; granule content and degranulation; respiratory burst activity; and bacterial killing; is expensive and requires the services of a specialized laboratory. However, preliminary screening of a patient with a predisposition toward infection, can be carried out using simple and inexpensive methods. These include examination of blood films, which may prove helpful in the diagnosis of Chediak-Higashi syndrome and specific granule deficiency; the Rebuck skin window test, which estimates chemotactic defects; the NBT test, which screens for chronic granulomatous disease patients; and peroxidase staining of the blood film in order to estimate the content of myeloperoxidase, when myeloperoxidase deficiency is suspected. For final diagnosis and determination of genetic transmission and radical treatment, ie, bone marrow transplantation, specific tests are indicated. Neutrophil function studies have also proved useful in detecting diseases in which defects in neutrophil function are secondary to the primary disorder. Indeed, increased neutrophil chemotaxis has been reported in the active phase of diseases such as: familial Mediterranean fever; psoriasis vulgaris, Behcet's syndrome and Sweet's syndrome. In these disorders the neutrophil chemotaxis assay has aided in the diagnosis and follow-up, particularly in evaluating the response to antiinflammatory agents, such as colchicine.
对中性粒细胞功能进行全面评估，包括趋化性、黏附性、聚集性、吞噬作用、颗粒内容物及脱颗粒、呼吸爆发活性和细菌杀伤能力，费用高昂且需要专业实验室的服务。然而，对于有感染易感性的患者，可以采用简单且廉价的方法进行初步筛查。这些方法包括检查血涂片，这可能有助于诊断切迪阿克-东综合征和特异性颗粒缺乏症；瑞巴克皮肤窗试验，用于评估趋化缺陷；硝基四氮唑蓝试验，用于筛查慢性肉芽肿病患者；以及当怀疑髓过氧化物酶缺乏时，对血涂片进行过氧化物酶染色以评估髓过氧化物酶的含量。对于最终诊断、确定遗传传递方式以及根治性治疗（即骨髓移植），则需要进行特定的检测。中性粒细胞功能研究在检测中性粒细胞功能缺陷继发于原发性疾病的病症中也已证明是有用的。实际上，在诸如家族性地中海热、寻常型银屑病、白塞病和斯威特综合征等疾病的活动期，已报道中性粒细胞趋化性增强。在这些病症中，中性粒细胞趋化性检测有助于诊断和随访，特别是在评估对秋水仙碱等抗炎药物的反应时。
