Kise Takayasu, Yokogawa Naoto, Miyoshi Yuji, Utsunomiya Masako, Nagai Yoshiki, Shimada Kota
Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
Mod Rheumatol. 2024 Mar 28;34(3):646-648. doi: 10.1093/mr/road060.
To validate the gout analyzer as a clinical method of synovial fluid crystal analysis.
Thirty knee synovial fluid samples with suspected calcium pyrophosphate (CPP) crystals were analyzed. Within 48 hours after collection, each non-centrifuged sample was examined blindly and independently by one or more rheumatologists in the following order: 1) with an optical microscope under ordinary light, 2) with the same microscope under compensated polarization provided by a gout analyzer, and 3) with a fully equipped compensated polarized microscope with a rotating stage as the gold standard. As a reference, laboratory technicians analyzed fresh, centrifuged synovial fluid using a gout analyzer.
Of the 30 samples analyzed, CPP and monosodium urate (MSU) crystals were detected in 11 and four, non-centrifuged samples, respectively, using a fully equipped compensated polarized microscope. The rheumatologists' detection rate of crystals in the non-centrifuged synovial fluid under ordinary light and with a gout analyzer was 73.3% and 80%, respectively. The laboratory technicians' detection rate in fresh centrifuged synovial fluid using a gout analyzer was 100%.
A gout analyzer may be used to diagnose gout and calcium pyrophosphate deposition disease definitively if a fully equipped compensated polarized microscope is unavailable.
验证痛风分析仪作为一种分析滑液晶体的临床方法。
对30份疑似焦磷酸钙（CPP）晶体的膝关节滑液样本进行分析。在样本采集后48小时内，由一名或多名风湿病学家按以下顺序对每份未离心的样本进行独立盲检：1）在普通光线下用光学显微镜检查；2）在痛风分析仪提供的补偿偏振光下用同一显微镜检查；3）以配备旋转载物台的全功能补偿偏振显微镜作为金标准进行检查。作为对照，实验室技术人员使用痛风分析仪对新鲜离心后的滑液进行分析。
使用全功能补偿偏振显微镜分析的30份样本中，分别在11份和4份未离心样本中检测到CPP和尿酸钠（MSU）晶体。风湿病学家在普通光线下和使用痛风分析仪对未离心滑液中晶体的检出率分别为73.3%和80%。实验室技术人员使用痛风分析仪对新鲜离心滑液的检出率为100%。
如果没有全功能补偿偏振显微镜，痛风分析仪可用于明确诊断痛风和焦磷酸钙沉积病。
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