One of the components of a blood test is the leukocyte formula. Doctors recommend its determination for any pathology, since it is sensitive to many pathologies. In the article we will analyze all possible changes in the number of leukocytes and what they mean.
Types of leukocytes
A general blood test consists of several indicators. All of them are reflected in their own units of measurement, with designations in Latin letters.
Therefore, when receiving a blood test (leukogram), deciphering the values will be useful to any person:
The leukocyte formula is recorded separately. It reflects the ratio of white blood cells to each other. This is important for clinical diagnosis, since all leukocytes are not the same.
There are several varieties of them, which differ in their functions in the human body:
- Neutrophils;
- Lymphocytes;
- Monocytes;
- Eosinophils;
- Basophils.
Neutrophils
One of the most versatile cells. Activated by any inflammation, no matter bacterial or viral. Neutrophils destroy any substances foreign to the body, releasing chemical components that attract other inflammatory cells. Therefore any inflammatory reaction essentially triggered by neutrophils.
Neutrophil cells are also divided according to their degree of maturity:
- Myelocytes and metamyelocytes- very young, juvenile cells that do not perform any functions. U healthy person they do not exist in the blood.
- Rod- maturing cells that are always found in the blood. Their number increases sharply during the onset of infection.
- Segmented- the oldest, most mature cells. They perform all the functions of protecting the body inherent in neutrophils. Segmented neutrophils are the very last stage of myelocyte development.
Lymphocytes
These are the cells that carry out the second stage of the immune response. They come to the site of inflammation, reacting to chemical substances secreted by neutrophils.
There are several types of lymphocytes:
- B lymphocytes– create antibodies to viral and bacterial infections.
- Helper and killer T lymphocytes– trigger the work of B-lymphocytes and independently destroy viral cells.
- Natural killer cells– capable of destroying cells that have been infected by a virus or that have undergone tumor changes.
Monocytes
Similar in function to neutrophils. Home work monocytes– destroy foreign material. They perform their task using phagocytosis.
This is the process of engulfing a bacterium, virus or any other pathogen by a monocyte. Inside the cell, this element dies, giving monocytes information about its structure. In the future, this will help B-lymphocytes produce antibodies specifically to this pathogen.
Eosinophils and basophils
These are the cells involved in allergic reactions. Their number increases sharply if the human body develops an allergy to any substance.
It is due to chemical elements, which eosinophils secrete, a person develops symptoms of an acute allergic reaction:
- The face swells;
- A cough or runny nose appears;
- The skin turns red;
- A rash appears.
Functions of leukocytes
It’s not for nothing that the leukoformula consists of several components. Each of these cells is important in providing the body with healthy immunity. It all starts with the entry of a bacteria or virus into the human body. Pathogenic microbe is absorbed by a neutrophil, which digests it - phagocytosis.
After phagocytosis, the neutrophil retains the microbial particle, showing it to lymphocytes. T lymphocytes and B lymphocytes work together to organize an attack on the pathogen. B cells create a host of antibodies that are ideally suited to this bacterium. Only such joint actions provide an immune response to any infection. That is why the ratio of leukogram cells is so important.
Normal leukogram values
Can be accepted as normal in every laboratory different meanings, depending on the technology and reagent used by laboratory technicians. Therefore, follow-up analysis must be performed in one laboratory. This will allow you to maintain the correctness of the values and clearly trace the dynamics.
But there are average criteria that can be used if the laboratory has not provided its data.
The normal number of cells depends greatly on the gender and age of the person.
| Age | Neutrophils, % | Lymphocytes, % | Monocytes, % | Eosinophils, % | Basophils, % |
|---|---|---|---|---|---|
| Newborns up to 28 days | 50-82 | 15-35 | 43071 | 42887 | 0-1 |
| Up to 1 year | 17-50 | 45-71 | 43012 | 42887 | 0-1 |
| From one to two years | 30-52 | 37-61 | 42981 | 42887 | 0-1 |
| Up to 5 years | 35-62 | 33-56 | 42981 | 42856 | 0-1 |
| Up to 10 years | 45-67 | 30-46 | 42981 | 42856 | 0-1 |
| Up to 15 years | 45-67 | 25-41 | 43011 | 42856 | 0-0,5 |
| Over 16 years old and adults | 45-75 | 25-40 | 43011 | 42795 | 0-0,5 |
How does the analysis work?
Blood can be collected in two ways to determine the number of leukocytes:
- Capillary- from a finger.
- Venous– from a peripheral vein.
Analysis indicators taken different ways, can vary even from one person to another. But usually these changes do not exceed normal values. The method of counting has always previously been to view the blood under a microscope. It is carried out by a laboratory assistant, counting the number of cells in the fields of view under a microscope.
The calculation is carried out for 100 cells, so it is convenient to display the final result as a percentage. Before counting neutrophils or other cells, the field of view is mentally divided into 3 sections from one edge to the other.
Today, many laboratories use an automatic analyzer. This is a device that counts all possible cells that it encounters.
When using a hematology analyzer, you can view more cells per short term. But in controversial cases, preference is given to viewing under a microscope by a laboratory assistant. A person can detect minor differences in appearance cells that may indicate pathology.
Why is the leukoformula determined?
A large number of leukoformula indicators allows it to respond to many diseases. A well-calculated analysis in normal and pathological conditions will be of great help to the doctor.
When a doctor refers you to determine the number of leukocytes, he has several goals:
- Help in making a diagnosis;
- Determination of the severity or activity of the process;
- Dynamics of recovery;
- Reaction or lack thereof to medications;
- Early detection of complications.
Changes in quantity and ratio in the leukogram
When calculating the percentage of neutrophil cells, the ratio of mature and young forms of leukocytes is necessarily displayed. This allows you to understand the severity of the process and its severity.
With an increase in the number of band and young cells in the analysis, they speak of a shift in the leukocyte formula to the left, since these cells are located on the left in the form. This indicates an active immune response. In some cases, the appearance of the most mature cells in peripheral blood may indicate cancer.
Table of the ratio of neutrophil forms as a percentage of the total number of white blood cells.
In controversial cases or during clinical trials The determination of the leukocyte intoxication index (LII) can be used. This is the ratio of immature forms of neutrophils that appear during acute inflammation to other cells - lymphocytes, monocytes, eosinophils.
Index values are calculated depending on age and gender. The approximate index number is 0.6.
Causes of increase or decrease in leukocytes
An increase in the number of neutrophils occurs when:
- Bacterial infections– sore throat, pyelonephritis, pneumonia;
- Intoxication of any nature;
- Taking glucocorticosteroids– prednisolone;
- Burn disease;
- Gangrene, heart attack.
A decrease in the number of neutrophils accompanies:
- Heavy bacterial infections – brucellosis, tuberculosis;
- Viral infections– measles, rubella;
- Effects of toxins on the bone marrow;
- Radiation sickness;
- Autoimmune diseases.
The main reason for the change in the number of lymphocyte cells – various kinds infections. B lymphocytes mature in the bone marrow, and T lymphocytes mature in the thymus. This difference emphasizes that their functions are different. But in the analyzes it does not matter which fraction is elevated. The laboratory examines the total lymphocyte count.
Lymphocytosis, or an increased number of lymphocytes, occurs when:
- Chronic bacterial infections– tuberculosis, syphilis, brucellosis;
- Acute viral diseases – flu, chickenpox, measles;
- Tumors of the blood system– lymphomas;
- Hormonal dysfunctions– hypothyroidism;
- Macrocytic anemias– folate deficiency;
- Autoimmune pathologies– systemic lupus erythematosus.
A reduced number of lymphocytes or lymphocypenia accompanies:
- Primary immunodeficiencies– DiGeorge syndrome;
- Secondary immunodeficiencies- HIV infection;
- Taking glucocorticosteroids– prednisolone;
- Acute bacterial infections– streptococcal pneumonia;
- Toxic effects on bone marrow– irradiation, heavy metals.
Monocytes have virtually no clinical significance, if they are considered individually. Therefore, their changes are usually assessed in combination with other leukocyte parameters.
Monocytes usually increase when:
A decrease in the number of monocytes practically does not occur without general leukocytopenia. Therefore it does not have diagnostic value. Worth mentioning infectious mononucleosis. This is a viral infection, the main criterion of which is the detection of mononuclear cells in the blood.
These are cells similar to monocytes, but are pathological. In a healthy person, detection of mononuclear cells in the blood is unacceptable.
Eosinophils and basophils are criteria allergic reactions and some infectious diseases. Estimation of their number also strongly depends on the total number of leukocytes in the blood test.
Low eosinophils accompany:
- Taking corticosteroid medications;
- Some severe infections such as typhoid fever.
Video: Decoding a blood test
To determine an accurate diagnosis and evaluate the effectiveness of treatment, the doctor usually prescribes a blood test, which examines the leukocyte formula. Let's figure out what it means this concept, what indicators are considered normal, and what may certain deviations indicate?
Functions of leukocytes
So, what is the leukocyte formula, and how can it be determined? The leukocyte formula of blood shows the percentage various types leukocytes in human blood plasma. Each of existing species cells react in a certain way to the penetration of viruses or pathogenic bacteria into the body and the development of diseases.
Therefore, decoding the leukocyte formula, showing the composition of the blood, allows the doctor to diagnose the type of disease, judge its severity, and monitor the progress of treatment of the disease.
- The leukocyte blood formula considers the composition of two main groups of leukocytes in the blood:
- Granulocytes, which in turn are divided into:
- Basophils.
- Eosinophils.
- Neutrophils.
- Agranulocytes, which include:
- Monocytes.
Lymphocytes of various types.
Granulocytes have a large granular structure with a nucleus divided into segments.
Their varieties are divided according to their ability to be painted with certain types of dyes. Eosinophils at laboratory research
- The doctor may prescribe blood with a leukocyte formula in the following cases:
- to determine the cause of the disease,
- to identify the severity of the disease, the presence of complications,
- to monitor the course of the disease and evaluate the effectiveness of treatment,
- to assess further forecasts, when conducting preventive examinations
or planning pregnancy to identify existing pathologies.
- In order to ensure that the transcript does not contain distorted indicators when analyzing the leukocyte formula of blood, you should properly prepare for the study. To do this, you need to follow these recommendations:
- 24 hours before the test, do not drink alcohol-containing drinks or medications,
- do not smoke for at least 30 minutes before collecting a sample for testing,
- Avoid strong physical or emotional stress 30-40 minutes before blood collection.
To determine the leukocyte formula, venous or capillary blood is taken. It is treated with special reagents that stain the cells in one color or another, which makes it possible to count their number.
Cell counting is carried out by a laboratory assistant using a microscope or an automatic analyzer.
A modern leukocyte count counter significantly increases the reliability of the results obtained, since it makes it possible to analyze more than 2 thousand cells. In comparison, microscopic examination can evaluate the types of approximately 200 cells.
The following factors can affect the reliability of the result:
- gender and age, race of the patient,
- use of medicines,
- pregnancy.
For this reason, the results obtained should be interpreted taking into account individual characteristics patient. If there are deviations from the norm in the leukocyte formula, you should do reanalysis. Sometimes incorrect calculation of the leukocyte formula is caused by errors in blood sampling, improper preparation of the smear, the quality of the reagents and other factors.
Norms
Only a qualified specialist can correctly decipher the leukocyte formula of blood. Because to make a diagnosis, you should pay attention not only to the relative content of leukocytes, but also to their absolute values, as well as the levels of other blood parameters.
For adults, the following leukocyte standards are accepted:
Deviations
A shift in the leukocyte formula is a change in the ratio of those found in the blood different types these cells. There are shifts to the left or to the right.
Shift left
It is curious that the overwhelming majority of all leukocytes are represented by mature neutrophils. Their number, as already mentioned, reaches 70-72%. But young neutrophils with a rod-shaped nucleus make up no more than 5% of the total number of leukocytes.
The reason for this is that immature cells are in the blood for a very short period of time, since they mature quite quickly and turn into mature neutrophils with a segmented nucleus.
Segmented particles are the main fighters against infections and viruses. Therefore, when the body is attacked by any pathogens, a command is sent to the bone marrow to produce new cells. In other words, the disease is a stimulus for the intensive reproduction of new (young) neutrophils. Accordingly, a sharp change in their number above the normative 5% may be a sign of the following pathologies:
- acute diseases – pyelonephritis, prostatitis,
- necrosis, purulent infections,
- acidosis,
- severe bleeding
- severe intoxication,
- leukemia,
- malignant neoplasms,
- significant physical activity.
Shift right
In the case when a blood test shows the presence of exclusively mature neutrophils. In this case, young cells with a rod-shaped nucleus are reduced or absent altogether. In this situation, we are talking about shifting the formula to the right. Such insufficient reproduction of new blood cells is typical for the following pathologies:
- liver and kidney diseases,
- radiation sickness,
- megaloblastic anemia,
- conditions after blood transfusion,
- vitamin B12 deficiency or folic acid deficiency.
The degree of formula shift determines the leukocyte index, which reflects the ratio of jointly counted young and juvenile neutrophils to the number of mature cells with a segmented nucleus. Acceptable standards for such an index are in the range of 0.05-0.1.
In addition to neutrophils, deviations from the norm in the analysis can also be observed for other leukocytes.
The cause of an increased number of lymphocytes may be:
- Infectious mononucleosis,
- various viral infections, for example, rubella, chickenpox, hepatitis,
- heavy bacterial diseases, such as tuberculosis, brucellosis, toxoplasmosis, syphilis, whooping cough,
- chronic lymphocytic leukemia, lymphosarcoma, in which the number of lymphocytes can reach 50-100 Gg/l,
- hyperthyroidism,
- some types of anemia.
A decrease in the level of lymphocytes is typical for:
- lymphogranulomatosis,
- renal failure,
- autoimmune diseases,
- acute infections,
- radiation sickness,
- taking corticosteroid drugs.
An increase in the number of eosinophils above the normative values is relatively rare. Typically this situation occurs when:
A decrease in the level of these cells is typical for:
- conditions after severe stress,
- taking adenocorticotropic hormonal drugs,
- Cushing's syndrome.
ESR
Often, for diagnosis, the doctor prescribes general analysis blood with leukocyte formula and ESR. This CBC is often used as a screening test for:
- infectious diseases,
- rheumatological diseases,
- renal pathology,
- the presence of malignant neoplasms.
Principle this study lies in the fact that the erythrocyte has a density slightly greater than the density of blood plasma. Because of this, such cells settle at a certain speed to the bottom of the test tube with a blood sample that is deprived of the ability to clot.
Under the influence of various processes, for example, when tumor cells When infection penetrates, lymphocytes begin to intensively produce certain protein compounds. Under their influence, the aggregation of erythrocytes (sticking together) increases, which leads to an increase in their density and accelerates the settling of particles to the bottom of the test tube.
The normal level of ESR for men is 1-10 mm/hour; for women it is slightly higher and ranges from 2-15 mm/hour.
The erythrocyte sedimentation rate increases significantly in the case of inflammatory processes, infectious and autoimmune diseases, in the presence of anemia, tumors, rheumatism and other pathologies. The results of the analysis must be deciphered by a qualified specialist, taking into account the presence clinical symptoms and data from other surveys.
Studying the ratio of leukocytes contained in the blood is very important element diagnosing diseases and monitoring the effectiveness of treatment. The leukocyte balance determined during the study will allow the doctor to promptly identify hidden pathologies, assess the prognosis of the disease and prescribe the correct therapy.
In contact with
A general blood test is one of the routine tests of any clinical laboratory - this is the first test that a person takes when undergoing medical examination or when he becomes ill. In laboratory work, CBC is classified as a general clinical research method (clinical blood test).
Even people far from all laboratory wisdom, replete with a mass of difficult-to-pronounce terms, had a good grasp of the norms, meanings, names and other parameters as long as the answer form included leukocyte cells (leukocyte formula), red blood cells and hemoglobin with a color indicator. Widespread settlement medical institutions all kinds of equipment did not escape the laboratory service, many experienced patients found themselves at a dead end: some incomprehensible abbreviation of Latin letters, a lot of all sorts of numbers, various characteristics of red blood cells and platelets...
Do-it-yourself decryption
The difficulty for patients is a general blood test performed by an automatic analyzer and scrupulously copied into a form by the responsible laboratory assistant. By the way, the “gold standard” of clinical research (microscope and doctor’s eyes) has not been canceled, therefore any analysis performed for diagnosis must be applied to glass, stained and examined in order to identify morphological changes in blood cells. In the event of a significant decrease or increase in a certain population of cells, the device may not be able to cope and “protest” (refuse to work), no matter how good it is.
Sometimes people try to find differences between a general and clinical blood test, but there is no need to look for them, because a clinical analysis implies the same study, which for convenience is called a general test (it’s shorter and clearer), but the essence does not change.
A general (detailed) blood test includes:
- Determination of the content of cellular elements of blood: - red blood cells containing the pigment hemoglobin, which determines the color of blood, and which do not contain this pigment, therefore are called white blood cells (neutrophils, eosinophils, basophils, lymphocytes, monocytes);
- Level ;
- (in a hematology analyzer, although it can be approximately determined by eye after the red blood cells spontaneously settle to the bottom);
- , calculated according to the formula, if the study was carried out manually, without the participation of laboratory equipment;
- , which used to be called reaction (ROE).
A general blood test shows the reaction of this valuable biological fluid to any processes occurring in the body. How many red blood cells and hemoglobin it contains, which perform the function of respiration (transferring oxygen to tissues and removing carbon dioxide from them), leukocytes that protect the body from infection, participate in the coagulation process, how the body reacts to pathological processes, in a word, the CBC reflects the state of the body itself V different periods life. The concept of “complete blood count” means that, in addition to the main indicators (leukocytes, hemoglobin, red blood cells), the leukocyte formula (and cells of the agranulocyte series) is studied in detail.
It is better to entrust the interpretation of the blood test to the doctor, but if there is a special desire, the patient can try to independently study the result issued in the clinical laboratory, and we will help him with this by combining the usual names with the abbreviation of the automatic analyzer.
The table is easier to understand
As a rule, the results of the study are recorded on a special form, which is sent to the doctor or given to the patient. To make it easier to navigate, let’s try to present a detailed analysis in the form of a table in which we will enter the norm of blood parameters. The reader will also see cells in the table such as . They are not among the mandatory indicators of a general blood test and are young forms of red blood cells, that is, they are the precursors of red blood cells. Reticulocytes are examined to identify the cause of anemia. There are very few of them in the peripheral blood of an adult healthy person (the norm is shown in the table); in newborn children there can be 10 times more of these cells.
| No. | Indicators | Norm |
|---|---|---|
| 1 | Red blood cells (RBC), 10 cells to the 12th power per liter of blood (10 12 /l, tera/liter) men women | 4,4 - 5,0 3,8 - 4,5 |
| 2 | Hemoglobin (HBG, Hb), grams per liter of blood (g/l) men women | 130 - 160 120 - 140 |
| 3 | Hematocrit (HCT), % men women | 39 - 49 35 - 45 |
| 4 | Color Index (CPU) | 0,8 - 1,0 |
| 5 | Average erythrocyte volume (MCV), femtoliter (fl) | 80 - 100 |
| 6 | Average hemoglobin content in an erythrocyte (MCH), picograms (pg) | 26 - 34 |
| 7 | Mean erythrocyte hemoglobin concentration (MCHC), grams per deciliter (g/dL) | 3,0 - 37,0 |
| 8 | Anisocytosis of erythrocytes (RDW), % | 11,5 - 14,5 |
| 9 | Reticulocytes (RET) % ‰ | 0,2 - 1,2 2,0 - 12,0 |
| 10 | White blood cells (WBC), 10 cells to the 9th power per liter of blood (10 9 /l, giga/liter) | 4,0 - 9,0 |
| 11 | Basophils (BASO), % | 0 - 1 |
| 12 | Basophils (BASO), 10 9 /l (absolute values) | 0 - 0,065 |
| 13 | Eosinophils (EO), % | 0,5 - 5 |
| 14 | Eosinophils (EO), 10 9 /l | 0,02 - 0,3 |
| 15 | Neutrophils (NEUT), % myelocytes, % young, % Band neutrophils, % Segmented neutrophils, % | 47 - 72 0 0 1 - 6 47 – 67 |
| 16 | Lymphocytes (LYM), % | 19 - 37 |
| 17 | Lymphocytes (LYM), 10 9 /l | 1,2 - 3,0 |
| 18 | Monocytes (MON), % | 3 - 11 |
| 19 | Monocytes (MON), 10 9 /l | 0,09 - 0,6 |
| 20 | Platelets (PLT), 10 9 /l | 180,0 - 320,0 |
| 21 | Average platelet volume (MPV), fl or µm 3 | 7 - 10 |
| 22 | Platelet anisocytosis (PDW), % | 15 - 17 |
| 23 | Thrombocrit (PCT), % | 0,1 - 0,4 |
| 24 | men women | 1 - 10 2 -15 |
And a separate table for children
Adaptation to new living conditions of all body systems of newborns, their further development in children after one year and final formation in adolescence makes blood counts different from those in adults. It should not be surprising that the norms of a small child and a person who has crossed the age of majority can sometimes differ noticeably, so for children there is their own table of normal values.
| No. | Index | Norm |
|---|---|---|
| 1 | Red blood cells (RBC), 10 12 /l first days of life up to a year 16 years 6 - 12 years 12 - 16 years old | 4,4 - 6,6 3,6 - 4,9 3,5 - 4,5 3,5 - 4,7 3,6 - 5,1 |
| 2 | Hemoglobin (HBG, Hb), g/l first days of life (due to fetal Hb) up to a year 16 years 6 - 16 years | 140 - 220 100 - 140 110 - 145 115 - 150 |
| 3 | Reticulocytes (RET), ‰ up to a year 16 years 6 - 12 12 - 16 | 3 - 15 3 - 12 2 - 12 2 - 11 |
| 4 | Basophils (BASO), % for all | 0 - 1 |
| 5 | Eosinophils (EO), % up to a year 1 - 12 years over 12 | 2 - 7 1 - 6 1 - 5 |
| 6 | Neutrophils (NEUT), % up to a year 1-6 years 6 - 12 years 12 – 16 years old | 15 - 45 25 - 60 35 - 65 40 - 65 |
| 7 | Lymphocytes (LYM), % up to a year 16 years 6 - 12 years 12 - 16 years old | 38 - 72 26 - 60 24 - 54 25 - 50 |
| 8 | Monocytes (MON), % up to a year 1 - 16 years | 2 -12 2 - 10 |
| 9 | Platelets10 9 cells/l up to a year 16 years 6 - 12 years 12 - 16 years old | 180 - 400 180 - 400 160 - 380 160 - 390 |
| 10 | Erythrocyte sedimentation rate (ESR), mm/hour up to 1 month up to a year 1 - 16 years | 0 - 2 2 - 12 2 - 10 |
It should be noted that the normal values may differ in different medical sources and in different laboratories. This is not due to the fact that someone does not know how many certain cells should be or what normal level hemoglobin. Just, using various analytical systems and techniques, each laboratory has its own reference values. However, these subtleties are unlikely to be of interest to the reader...
Red blood cells in a general blood test and their characteristics
Or red blood cells (Er, Er) - the most numerous group of cellular elements of the blood, represented by nuclear-free biconcave disks ( the norm for women and men is different and is 3.8 – 4.5 x 10 12 / l and 4.4 – 5.0 x 10 12 / l, respectively). Red blood cells top the general blood count. Having numerous functions (tissue respiration, regulation of water-salt balance, transfer of antibodies and immunocomplexes on their surfaces, participation in the coagulation process, etc.), these cells have the ability to penetrate the most inaccessible places (narrow and convoluted capillaries). To carry out these tasks, red blood cells must have certain qualities: size, shape and high plasticity. Any changes in these parameters that go beyond the norm are shown by a general blood test (examination of the red part).
Red blood cells contain an important component for the body, consisting of protein and iron. This is a red blood pigment called. A decrease in red blood cells usually entails a drop in Hb levels, although there is another picture: there are enough red blood cells, but many of them are empty, then the CBC will have a low content of red pigment. In order to find out and evaluate all these indicators, there are special formulas that doctors used before the advent of automatic analyzers. Now equipment deals with such matters, and additional columns with an incomprehensible abbreviation and new units of measurement have appeared in the general blood test form:
An indicator of many diseases - ESR
Considered an indicator (non-specific) of a wide variety of pathological changes in the body, so this test is almost never ignored in diagnostic searches. ESR norm depends on gender and age - absolutely healthy women it can be 1.5 times higher than this figure in children and adult men.
As a rule, an indicator such as ESR is written down at the bottom of the form, that is, it kind of completes the general blood test. In most cases, ESR is measured in 60 minutes (1 hour) in a Panchenkov stand, which is still indispensable to this day. However, in our high-tech times there are devices that can reduce the determination time, but not all laboratories have them.
determination of ESR
Leukocyte formula
Leukocytes (Le) are a “motley” group of cells representing “white” blood. The number of white blood cells is not as high as the content of red blood cells (erythrocytes), their normal value in an adult it varies within 4.0 – 9.0 x 10 9 /l.
In the CBC, these cells are presented in the form of two populations:
- Granulocyte cells (granular leukocytes), containing granules that are filled with biologically active substances (BAS): (rods, segments, young, myelocytes), ;
- Representatives of the agranulocytic series, which, however, can also have granules, but of a different origin and purpose: immunocompetent cells () and the “orderlies” of the body - (macrophages).
The most common reason increase in leukocytes in the blood () – infectious-inflammatory process:
- In the acute phase, the neutrophil pool is activated and, accordingly, increases (up to the release of young forms);
- A little later, monocytes (macrophages) are included in the process;
- The stage of recovery can be determined by the increased number of eosinophils and lymphocytes.
The calculation of the leukocyte formula, as mentioned above, is not completely trusted even by the most high-tech equipment, although it cannot be suspected of errors - the devices work well and accurately, and provide a large amount of information, significantly exceeding that when working manually. However, there is one tiny nuance - the machine cannot yet fully see morphological changes in the cytoplasm and nuclear apparatus of the leukocyte cell and replace the doctor's eyes. In this regard, identification of pathological forms is still carried out visually, and the analyzer is allowed to count the total number of white blood cells and divide leukocytes into 5 parameters (neutrophils, basophils, eosinophils, monocytes and lymphocytes), if the laboratory has a high-precision class 3 analytical system at its disposal .
Through the eyes of man and machine
Hematology analyzers latest generation not only are they able to carry out a complex analysis of granulocyte representatives, but also to differentiate cells of the agranulocytic series (lymphocytes) within a population (subpopulations of T cells, B lymphocytes). Doctors successfully use their services, but, unfortunately, such equipment is still the privilege of specialized clinics and large medical centers. In the absence of any hematological analyzer, the number of leukocytes can be counted using the old old-fashioned method (in Goryaev’s chamber). Meanwhile, the reader should not think that one or another method (manual or automatic) is necessarily better; doctors working in the laboratory monitor this, monitoring themselves and the machine, and at the slightest doubt they will ask the patient to repeat the study. So, leukocytes:
Platelet link
The next abbreviation in a general blood test refers to cells called platelets or. Studying platelets without a hematology analyzer is quite labor-intensive; the cells require a special approach to staining, so without an analytical system this test is performed as needed and is not a default analysis.
The analyzer, distributing cells like red blood cells, calculates the total number of blood platelets and platelet indices (MPV, PDW, PCT):
- PLT– an indicator indicating the number of blood platelets (platelets). An increase in platelet content in the blood is called, a reduced level is qualified as thrombocytopenia.
- MPV– average volume of blood platelets, uniformity of platelet population sizes, expressed in femtoliters;
- PDW– width of distribution of these cells by volume – %, quantitatively – degree of platelet anisocytosis;
- PCT() is an analogue of hematocrit, expressed as a percentage and denotes the proportion of platelets in whole blood.
Elevated platelet count And change in one direction or another platelet indices may indicate the presence of a rather serious pathology: myeloproliferative diseases, inflammatory processes of an infectious nature, localized in various organs, as well as about the development malignant neoplasm. Meanwhile, the number of platelets can increase: physical activity, childbirth, surgical interventions.
Decline the content of these cells is observed in autoimmune processes, angiopathy, infections, and massive transfusions. A slight drop in platelet levels is observed before menstruation and during pregnancy, however a decrease in their number to 140.0 x 10 9 /l and below should already be a cause for concern.
Does everyone know how to prepare for analysis?
It is known that many indicators (especially leukocytes and erythrocytes) vary depending on previous circumstances:
- Psycho-emotional stress;
- Food (digestive leukocytosis);
- Bad habits such as smoking or thoughtless drinking of strong drinks;
- Use of certain medications;
- Solar radiation (it is not advisable to go to the beach before taking tests).
Nobody wants to get unreliable results, in this regard, you need to go for analysis on an empty stomach, sober and without a morning cigarette, calm down within 30 minutes, do not run or jump. People should be aware that in the afternoon, after exposure to the sun and during heavy physical labor, some leukocytosis will be observed in the blood.
The female sex has even more restrictions, so representatives of the fair half need to remember that:
- The ovulation phase increases the total number of leukocytes, but decreases the level of eosinophils;
- Neutrophilia is observed during pregnancy (before childbirth and during its course);
- Pain associated with menstruation and the menstruation itself can also cause certain changes in the test results - you will have to donate blood again.
Blood for a detailed blood test, provided it is carried out in a hematological analyzer, is now in most cases taken from a vein, simultaneously with other tests (biochemistry), but in a separate tube (a vacutainer with an anticoagulant placed in it - EDTA). There are also small microcontainers (with EDTA) designed for collecting blood from a finger (earlobe, heel), which are often used to take tests from children.
The indicators of blood from a vein are somewhat different from the results obtained from the study of capillary blood - in venous blood there is higher hemoglobin and more red blood cells. Meanwhile, it is believed that it is better to take OAC from a vein: the cells are less injured, contact with skin
In addition, many people (by the way, most often adults), without reacting at all to venipuncture, are panicky afraid of the scarifier that is used to pierce the finger, and sometimes the fingers are blue and cold - it is difficult to obtain blood. The analytical system that performs a detailed blood analysis “knows” how to work with venous and capillary blood; it is programmed to different variants, so he can easily “figure out” what’s what. Well, if the device fails, it will be replaced by a highly qualified specialist who will check, double-check and make a decision, relying not only on the capabilities of the machine, but also on his own eyes.
Video: clinical blood test - Dr. Komarovsky
Blood indicators characterize a person’s health status and can greatly facilitate diagnosis. By determining the leukocyte formula, one can guess the type of disease, judge its course, the presence of complications, and even predict its outcome. And deciphering the leukogram will help you understand the changes occurring in the body.
What does the leukocyte blood count show?
The leukocyte formula of blood is the ratio of different types of leukocytes, usually expressed as a percentage. The study is carried out as part of a general blood test.
Leukocytes are white blood cells that represent the body's immune system. Their main functions are:
- protection against microorganisms that can cause health problems;
- participation in processes that occur in the body under the influence of various pathogenic factors and causing disturbances in normal life (various diseases, exposure to harmful substances, stress).
The following types of leukocytes are distinguished:
Interpretation of LYM (lymphocyte) indicators in a blood test:
Plasma cells (plasmocytes) participate in the formation of antibodies and are normally present in very low quantities only in the blood of children; in adults they are absent and can appear only in the case of pathologies.
The study of the qualitative and quantitative characteristics of leukocytes can help in making a diagnosis, since with any changes in the body, the percentage of some types of blood cells increases or decreases due to an increase or decrease to one degree or another in others.
The doctor prescribes this analysis in order to:
- get an idea of the severity of the patient’s condition, judge the course of the disease, or pathological process, find out about the presence of complications;
- establish the cause of the disease;
- evaluate the effectiveness of the prescribed treatment;
- predict the outcome of the disease;
- in some cases, to evaluate the clinical diagnosis.
Technique, calculation and interpretation of analysis
To calculate the leukocyte formula, certain manipulations are performed on a blood smear, dried, treated with special dyes and examined under a microscope. The laboratory technician marks those blood cells that fall into his field of vision, and does this until a total of 100 (sometimes 200) cells are collected.
The distribution of leukocytes over the surface of the smear is uneven: the heavier ones (eosinophils, basophils and monocytes) are located closer to the edges, and the lighter ones (lymphocytes) are closer to the center.
When calculating, 2 methods can be used:
- Schilling method. It consists of determining the number of leukocytes in four areas of the smear.
- Filipchenko's method. In this case, the smear is mentally divided into 3 parts and counted along a straight transverse line from one edge to the other.
The quantity is noted on a piece of paper in the appropriate columns. After this, each type of leukocyte is counted - how many of which cells were found.
It should be borne in mind that counting cells in a blood smear when determining the leukocyte formula is a very inaccurate method, since there are many difficult to eliminate factors that introduce error: errors in drawing blood, preparing and staining the smear, human subjectivity in interpreting cells. The peculiarity of some types of cells (monocytes, basophils, eosinophils) is that they are distributed unevenly in the smear.
If necessary, leukocyte indices are calculated, which is the ratio of those contained in the patient’s blood various forms leukocytes, the ESR (erythrocyte sedimentation rate) indicator is also sometimes used in the formula.
| Age | Eosinophils, % | Neutrophils segmented, % | Neutrophils stabs, % | Lymphocytes, % | Monocytes, % | Basophils, % |
| Newborns | 1–6 | 47–70 | 3–12 | 15–35 | 3–12 | 0–0,5 |
| Infants up to 2 weeks | 1–6 | 30–50 | 1–5 | 22–55 | 5–15 | 0–0,5 |
| Infants | 1–5 | 16–45 | 1–5 | 45–70 | 4–10 | 0–0,5 |
| 1–2 years | 1–7 | 28–48 | 1–5 | 37–60 | 3–10 | 0–0,5 |
| 2–5 years | 1–6 | 32–55 | 1–5 | 33–55 | 3–9 | 0–0,5 |
| 6–7 years | 1–5 | 38–58 | 1–5 | 30–50 | 3–9 | 0–0,5 |
| 8 years | 1–5 | 41–60 | 1–5 | 30–50 | 3–9 | 0–0,5 |
| 9–11 years | 1–5 | 43–60 | 1–5 | 30–46 | 3–9 | 0–0,5 |
| 12–15 years | 1–5 | 45–60 | 1–5 | 30–45 | 3–9 | 0–0,5 |
| People over 16 years old | 1–5 | 50–70 | 1–3 | 20–40 | 3–9 | 0–0,5 |
The norms of the leukocyte formula depend on the age of the person. In women, the difference is also that indicators can change during ovulation, after or during menstruation, during pregnancy, after childbirth.
That is why in cases of deviations you should consult a gynecologist.
Possible deviations from the norm in the leukogram
An increase or decrease in the level of certain types of leukocytes indicates pathological changes occurring in the body.
Reasons for changes in the number of leukocytes in the blood - table
In medicine, there are concepts of a shift in the leukocyte formula, indicating deviations in the health status of patients.
Shift of leukocyte formula left and right - table
| Shift left | Shift right | |
| Changes in the blood formula |
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| What health problems does it indicate? |
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To obtain data on the patient's condition, based on the results of the leukocyte formula, the shift index is taken into account. It is determined by the formula: IS = M (myelocytes) + MM (metamyelocytes) + P (band neutrophils)/C (segmented neutrophils). The norm for the leukocyte formula shift index in an adult is 0.06.
In some cases, there may be a phenomenon such as a significant content of young cells in the blood - metamyelocytes, myelocytes, promyelocytes, myeloblasts, erythroblasts. This usually indicates diseases of a tumor nature, oncology and metastasis (formation of secondary tumor foci).
Cross leukocyte formula
Leukocyte crossover is a concept that arises when analyzing a child’s blood. If in an adult, changes in the blood are caused by diseases or significant effects on the body harmful factors, then in young children changes occur in connection with the formation immune system. This phenomenon is not a pathology, but is considered absolutely normal. The non-standard nature of the numbers is determined only by the development of immunity.
First cross leukocyte formula usually occurs towards the end of the baby's first week of life. At this time, the number of neutrophils and lymphocytes in the blood equalizes (they become approximately 45%), after which the number of lymphocytes continues to increase, and the number of neutrophils decreases. This is considered a normal physiological process.
The second cross-section of the leukocyte formula occurs at 5–6 years of age, and only by the age of ten do blood counts approach the normal level of an adult.
How to determine the nature of the inflammatory process using a blood test - video
The leukocyte formula can provide many answers to difficulties in diagnosing the disease and prescribing therapy, as well as characterize the patient’s condition. However, it is better to entrust the interpretation of the blood test to an experienced specialist. The doctor can give detailed explanations and adjust the treatment.
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Clinical blood test
Clinical blood test (HOW) (complete blood count, complete blood count (CBC)) - a medical or nursing analysis that allows you to evaluate the hemoglobin content in the red blood system, the number of red blood cells, color index, the number of leukocytes, platelets. A clinical blood test allows you to examine the leukogram and erythrocyte sedimentation rate (ESR).
Using this analysis, it is possible to identify anemia (decrease in hemoglobin - leukocyte formula), inflammatory processes (leukocytes, leukocyte formula), etc.
Blood counts
Currently, most indicators are performed on automatic hematology analyzers, which are able to simultaneously determine from 5 to 24 parameters. Of these, the main ones are the number of leukocytes, hemoglobin concentration, hematocrit, number of red blood cells, average volume erythrocyte, average hemoglobin concentration in an erythrocyte, average hemoglobin content in an erythrocyte, half-width of erythrocyte size distribution, platelet count, average platelet volume.
- WBC(white blood cells - white blood cells) - absolute content of leukocytes (norm 4-9 10 9 (\displaystyle 10^(9)) cells/l) - shaped elements blood - responsible for recognizing and neutralizing foreign components, immune protection the body from viruses and bacteria, eliminating dying cells of one’s own body.
- R.B.C.(red blood cells - red blood cells) - absolute content of erythrocytes (normal 4.3-5.5 cells/l) - formed elements of blood - containing hemoglobin, transporting oxygen and carbon dioxide.
- HGB(Hb, hemoglobin) - hemoglobin concentration in whole blood (normal 120-140 g/l). For analysis, a cyanide complex or cyanide-free reagents are used (as a replacement for toxic cyanide). It is measured in moles or grams per liter or deciliter.
- HCT(hematocrit) - hematocrit (norm 0.39-0.49), part (% = l/l) of total volume blood attributable to the formed elements of blood. Blood consists of 40-45% formed elements (erythrocytes, platelets, leukocytes) and 60-55% plasma. Hematocrit is the ratio of the volume of formed elements to blood plasma. It is believed that hematocrit reflects the ratio of the volume of red blood cells to the volume of blood plasma, since red blood cells mainly make up the volume of blood cells. Hematocrit depends on the number of RBCs and the MCV value and corresponds to the product RBC*MCV.
- PLT(platelets - blood platelets) - the absolute content of platelets (the norm is 150-400 10 9 (\displaystyle 10^(9)) cells/l) - the formed elements of blood - involved in hemostasis.
Red blood cell indices (MCV, MCH, MCHC):
- MCV- the average volume of an erythrocyte in cubic micrometers (µm) or femtoliters (fl) (the norm is 80-95 fl). Old tests indicated: microcytosis, normocytosis, macrocytosis.
- MCH- the average hemoglobin content in an individual erythrocyte in absolute units (norm 27-31 pg), proportional to the ratio “hemoglobin/number of erythrocytes”. Color indicator of blood in old tests. CPU=MCH*0.03
- MCHC- the average concentration of hemoglobin in the erythrocyte mass, and not in whole blood (see above HGB) (the norm is 300-380 g/l, reflects the degree of saturation of the erythrocyte with hemoglobin. A decrease in MCHC is observed in diseases with impaired hemoglobin synthesis. However, this is the most stable hematological indicator. Any inaccuracy associated with the determination of hemoglobin, hematocrit, MCV leads to an increase in MCHC, therefore this parameter is used as an indicator of instrument error or error made in preparing the sample for research.
Platelet indices (MPV, PDW, PCT):
- MPV(mean platelet volume) - average platelet volume (normal 7-10 fl).
- PDW- relative width of platelet distribution by volume, an indicator of platelet heterogeneity.
- PCT(platelet crit) - thrombocrit (norm 0.108-0.282), the proportion (%) of the volume of whole blood occupied by platelets.
Leukocyte indices:
- LYM% (LY%)(lymphocyte) - relative (%) content (normal 25-40%) of lymphocytes.
- LYM# (LY#)(lymphocyte) - absolute content (norm 1.2-3.0 x 10 9 (\displaystyle 10^(9)) / l (or 1.2-3.0 x 10 3 (\displaystyle 10^(3)) / µl)) lymphocytes.
- MXD% (MID%)- relative (%) content of the mixture (norm 5-10%) of monocytes, basophils and eosinophils.
- MXD# (MID#)- absolute content of the mixture (norm 0.2-0.8 x 10 9 (\displaystyle 10^(9)) / l) of monocytes, basophils and eosinophils.
- NEUT% (NE%)(neutrophils) - relative (%) content of neutrophils.
- NEUT# (NE#)(neutrophils) - absolute content of neutrophils.
- MON% (MO%)(monocyte) - relative (%) content of monocytes (normal 4-11%).
- MON# (MO#)(monocyte) - absolute content of monocytes (norm 0.1-0.6 10 9 (\displaystyle 10^(9)) cells/l).
- EO%- relative (%) content of eosinophils.
- EO#- absolute content of eosinophils.
- BA%- relative (%) content of basophils.
- BA#- absolute content of basophils.
- IMM%- relative (%) content of immature granulocytes.
- IMM#- absolute content of immature granulocytes.
- ATL%- relative (%) content of atypical lymphocytes.
- ATL#- absolute content of atypical lymphocytes.
- GR% (GRAN%)- relative (%) content (normal 47-72%) of granulocytes.
- GR# (GRAN#)- absolute content (norm 1.2-6.8 x 10 9 (\displaystyle 10^(9)) / l (or 1.2-6.8 x 10 3 (\displaystyle 10^(3)) / µl) ) granulocytes.
Erythrocyte indices:
- HCT/RBC- average volume of red blood cells.
- HGB/RBC- average hemoglobin content in an erythrocyte.
- HGB/HCT- the average concentration of hemoglobin in the erythrocyte.
- RDW- Red cell Distribution Width - “width of distribution of erythrocytes”, the so-called “anisocytosis of erythrocytes” - an indicator of the heterogeneity of erythrocytes, calculated as the coefficient of variation of the average volume of erythrocytes.
- RDW-SD- relative width of the distribution of erythrocytes by volume, standard deviation.
- RDW-CV- relative width of distribution of erythrocytes by volume, coefficient of variation.
- P-LCR- coefficient of large platelets.
- ESR (ESR) (erythrocyte sedimentation rate) - nonspecific indicator pathological condition body.
As a rule, automatic hematology analyzers also build histograms for red blood cells, platelets and white blood cells.
Hemoglobin
Hemoglobin(Hb, Hgb) in a blood test is the main component of red blood cells that transports oxygen to organs and tissues. For analysis, a cyanide complex or cyanide-free reagents are used (as a replacement for toxic cyanide). It is measured in moles or grams per liter or deciliter. Its definition has not only diagnostic, but also prognostic significance, since pathological conditions leading to a decrease in hemoglobin content lead to oxygen starvation fabrics
- men - 135-160 g/l (gigamoles per liter);
- women - 120-140 g/l.
An increase in hemoglobin is observed when:
- primary and secondary erythremia;
- dehydration (false effect due to hemoconcentration);
- excessive smoking (formation of functionally inactive HbCO).
A decrease in hemoglobin is detected when:
- anemia;
- overhydration (a false effect due to hemodilution - “dilution” of the blood, increasing the volume of plasma relative to the volume of the totality of formed elements).
Red blood cells
Red blood cells(E) in a blood test - red blood cells, which are involved in the transport of oxygen to tissues and support biological oxidation processes in the body.
- men - (4.0-5.15) x 10 12 (\displaystyle 10^(12))/l
- women - (3.7-4.7) x 10 12 (\displaystyle 10^(12))/l
- children - (3.80-4.90) x 10 12 (\displaystyle 10^(12))/l
An increase (erythrocytosis) in the number of red blood cells occurs when:
- neoplasms;
- hydrocele of the renal pelvis;
- the influence of corticosteroids;
- Cushing's disease and syndrome;
- Polycythemia vera disease;
- treatment with steroids.
A slight relative increase in the number of red blood cells may be associated with blood thickening due to a burn, diarrhea, or taking diuretics.
A decrease in the content of red blood cells in the blood is observed when:
- blood loss;
- anemia;
- pregnancy;
- hydremia (intravenous administration of large amounts of fluid, that is, infusion therapy)
- during outflow tissue fluid into the bloodstream to reduce edema (therapy with diuretics).
- reducing the intensity of red blood cell formation in the bone marrow;
- accelerated destruction of red blood cells;
Leukocytes
Leukocytes(L) - blood cells formed in the bone marrow and lymph nodes. There are 5 types of leukocytes: granulocytes (neutrophils, eosinophils, basophils), monocytes and lymphocytes. The main function of leukocytes is to protect the body from foreign antigens (including microorganisms, tumor cells; the effect also manifests itself in the direction of transplant cells).
An increase (leukocytosis) occurs when:
- acute inflammatory processes;
- purulent processes, sepsis;
- many infectious diseases of viral, bacterial, fungal and other etiologies;
- malignant neoplasms;
- tissue injuries;
- myocardial infarction;
- during pregnancy (last trimester);
- after childbirth - during the period of feeding the baby with breast milk;
- after heavy physical exertion (physiological leukocytosis).
The decrease (leukopenia) is caused by:
- aplasia, hypoplasia bone marrow;
- impact ionizing radiation, radiation sickness;
- typhoid fever;
- viral diseases;
- anaphylactic shock;
- Addison-Beermer disease;
- collagenoses;
- under the influence of certain medications (sulfonamides and some antibiotics, non-steroidal anti-inflammatory drugs, thyreostatics, antiepileptic drugs, antispasmodic oral drugs);
- bone marrow damage chemicals, medications;
- hypersplenism (primary, secondary);
- acute leukemia;
- myelofibrosis;
- myelodysplastic syndromes;
- plasmacytoma;
- metastases of neoplasms to the bone marrow;
- pernicious anemia;
- typhus and paratyphoid;
- collagenoses.
Leukocyte formula
Leukocyte formula (leukogram) is the percentage of different types of leukocytes, determined by counting them in a stained blood smear under a microscope.
In addition to the leukocyte indices listed above, leukocyte, or hematological, indices are also proposed, calculated as the ratio of the percentage of different types of leukocytes, for example, the index of the ratio of lymphocytes and monocytes, the index of the ratio of eosinophils and lymphocytes, etc.
Color index
Main article: Blood color index
Color Index (CPU)- degree of saturation of erythrocytes with hemoglobin:
- 0.85-1.05 is normal;
- less than 0.80 - hypochromic anemia;
- 0.80-1.05 - red blood cells are considered normochromic;
- more than 1.10 - hyperchromic anemia.
In pathological conditions, there is a parallel and approximately equal decrease in both the number of red blood cells and hemoglobin.
A decrease in CPU (0.50-0.70) occurs when:
- iron deficiency anemia;
- anemia caused by lead intoxication.
An increase in CPU (1.10 or more) occurs when:
- deficiency of vitamin B12 in the body;
- folic acid deficiency;
- cancer;
- polyposis of the stomach.
For a correct assessment color index It is necessary to take into account not only the number of red blood cells, but also their volume.
ESR
(ESR) is a nonspecific indicator of the pathological state of the body. Fine:
- newborns - 0-2 mm/h;
- children under 6 years old - 12-17 mm/h;
- men under 60 years old - up to 8 mm/h;
- women under 60 years old - up to 12 mm/h;
- men over 60 years old - up to 15 mm/h;
- women over 60 years old - up to 20 mm/h.
An increase in ESR occurs when:
- infectious and inflammatory disease;
- collagenosis;
- damage to the kidneys, liver, endocrine disorders;
- pregnancy, in postpartum period, menstruation;
- bone fractures;
- surgical interventions;
- anemia;
- oncological diseases.
It can also increase with such physiological conditions, such as food intake (up to 25 mm/h), pregnancy (up to 45 mm/h).
A decrease in ESR occurs when:
- hyperbilirubinemia;
- increased levels of bile acids;
- chronic circulatory failure;
- erythremia;
- hypofibrinogenemia.
Comparison of the results of general analysis of capillary and venous blood
Venous blood tests are the recognized “gold standard” laboratory diagnostics for many indicators. However, capillary blood is a frequently used type of biomaterial for performing a general blood test. In this regard, the question arises about the equivalence of the results obtained from the study of capillary (C) and venous (V) blood.
Comparative assessment of 25 general blood test indicators for different types biomaterial is presented in the table as the average analysis value:
| Indicator, units | n | Blood | Difference | Significance differences |
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| V, units | K, units | (K-V), units. | (K-V), % of V | |||
| WBC, *10 9 /l | 52 | 6,347 | 5,845 | -0,502
[-0,639; -0,353] |
-7,901 | W=1312
R M.C.<0,001 |
| RBC, *10 12 /l | 52 | 4,684 | 4,647 | -0,5 | -0,792 | W=670
R MC =0.951 |
| HGB, g/l | 52 | 135,346 | 136,154 | 0,808 | 0,597 | W=850,5
R MC =0.017 |
| HCT, % | 52 | 41,215 | 39,763 | -1,452 | -3,522 | W=1254
p M.C.<0,001 |
| MCV, fl | 52 | 88,115 | 85,663 | -2,452 | -2,782 | W=1378
p M.C.<0,001 |
| MCH, pg | 52 | 28,911 | 29,306 | 0,394 | 1,363 | W=997
p M.C.<0,001 |
| MCHC, g/l | 52 | 328,038 | 342,154 | 14,115 | 4,303 | W=1378
R M.C.<0,001 |
| PLT, *10 9 /l | 52 | 259,385 | 208,442 | -50,942 | -19,639 | W=1314
R M.C.<0,001 |
| BA, *10 9 /l | 52 | 0,041 | 0,026 | -0,015 | -37,089 | W=861
R M.C.<0,001 |
| BA, % | 52 | 0,654 | 0,446 | -0,207 | -31,764 | W=865,5
R M.C.<0,001 |
| P-LCR, % | 52 | 31,627 | 36,109 | 4,482 | 14,172 | W=1221
R M.C.<0,001 |
| LY, *10 9 /l | 52 | 2,270 | 2,049 | -0,221 | -9,757 | W=1203
p M.C.<0,001 |
| LY, % | 52 | 35,836 | 35,12 | -0,715 | -1,996 | W=987,5
R MC =0.002 |
| MO, *10 9 /l | 52 | 0,519 | 0,521 | 0,002 | 0,333 | W=668,5
R MC =0.583 |
| MO, % | 52 | 8,402 | 9,119 | 0,717 | 8,537 | W=1244
R M.C.<0,001 |
| NE, *10 9 /l | 52 | 3,378 | 3,118 | -0,259 | -7,680 | W=1264
R M.C.<0,001 |
| NE, % | 52 | 52,925 | 52,981 | 0,056 | 0,105 | W=743
R MC =0.456 |
| PDW | 52 | 12,968 | 14,549 | 1,580 | 12,186 | W=1315
R M.C.<0,001 |
| RDW-CV | 52 | 12,731 | 13,185 | 0,454 | 3,565 | W=1378
R M.C.<0,001 |
| RDW-SD | 52 | 40,967 | 40,471 | -0,496 | -1,211 | W=979
R M.C.<0,001 |
| MPV, fl | 52 | 10,819 | 11,431 | 0,612 | 5,654 | W=1159
R M.C.<0,001 |
| PCT, % | 52 | 0,283 | 0,240 | -0,042 | -14,966 | W=245
R M.C.<0,001 |
| EO, *10 9 /l | 52 | 0,139 | 0,131 | -0,007 | -5,263 | W=475
R MC =0.235 |
| EO, % | 52 | 2,183 | 2,275 | 0,092 | 4,229 | W=621,5
R MC =0.074 |
| ESR, mm/hour | 52 | 7,529 | 7,117 | -0,412 | -5,469 | W=156,5
R MC =0.339 |
All 25 parameters studied are divided into 3 groups: (1) statistically significantly decreasing in capillary blood relative to venous blood, (2) significantly increasing, and (3) not changing:
1) There are eleven indicators in this group, 4 of which are within -5% (HCT, MCV, LY%, RDW-SD) - their CIs are within the bias boundaries of -5% and 0%, but do not cross them. CIs for WBC, LY, NE and PCT were not included within the -5% bias limits. The PLT (-19.64%), BA (-37.09%) and BA% (-31.77%) indicators decrease the most.
2) There are 7 indicators in this group. For MO%, P-LCR, PDW and MPV, the bias is more than 5%, but the 95% CI of MPV includes a bias value of 5%. The deviations of the remaining 3 indicators of this group (MCH, MCHC, RDW-CV) are less than 5%.
3) There are 7 indicators in this group: RBC, HGB, MO, NE%, EO, EO%, ESR. No statistically significant differences were found for them.
When comparing the results of capillary and venous blood, it is necessary to take into account a significant decrease in the number of basophils and platelets in capillary blood (leading to an increase in the coefficient of large platelets, distribution of platelets by volume, average platelet volume and a significant decrease in thrombocrit), as well as a less significant decrease in the number of leukocytes, lymphocytes and neutrophils, which causes a slight increase in the relative number of monocytes.
Indicators of the third group (RBC, HGB, MO, NE%, EO, EO%, ESR), along with blood parameters of the first and second groups, whose 95% CI included no more than 5% deviation (HCT, MCV, LY%, RDW -SD, MCH, MCHC, RDW-CV), can be determined in capillary blood with strict adherence to preanalytical rules without any compromise in the accuracy of clinical assessment.
General blood test norms
| Analysis indicator | Norm |
| Hemoglobin | Men: 130-170 g/l |
| Women: 120-150 g/l | |
| Red blood cell count | Men: 4.0-5.0 10 12 /l |
| Women: 3.5-4.7 10 12 /l | |
| White blood cell count | Within 4.0-9.0x10 9 /l |
| Hematocrit (the ratio of the volume of plasma and cellular elements of blood) | Men: 42-50% |
| Women: 38-47% | |
| Average red blood cell volume | Within 86-98 microns 3 |
| Leukocyte formula | Neutrophils:
Monocytes: 3-11% Eosinophils: 0.5-5% Basophils: 0-1% |
| Platelet count | Within 180-320 10 9 /l |
| Erythrocyte sedimentation rate (ESR) | Men: 3 - 10 mm/h |
| Women: 5 - 15 mm/h |
General blood test norms for children under 1 year of age
| Index | Age | |||
| newborn | 7-30 days | 1 – 6 months | 6 -12 months | |
| Hemoglobin | 180-240 | 107 - 171 | 103-141 | 113-140 |
| Red blood cells | 3,9-5,5 | 3,6-6,2 | 2,7-4,5 | 3,7-5,3 |
| Color index | 0,85-1,15 | 0,85-1,15 | 0,85-1,15 | 0,85-1,15 |
| Reticulocytes | 3-15 | 3-15 | 3-12 | 3-12 |
| Leukocytes | 8,5-24,5 | 6,5 -13,8 | 5,5 – 12,5 | 6-12 |
| Rod | 1-17 | 0,5- 4 | 0,5- 5 | 0,5- 5 |
| Segmented | 45-80 | 16-45 | 16-45 | 16-45 |
| Eosinophils | 1 - 6 | 1 - 5 | 1 - 5 | 1 - 5 |
| Basophils | 0 - 1 | 0 - 1 | 0 - 1 | 0 - 1 |
| Lymphocytes | 15 - 35 | 45 - 70 | 45 - 70 | 45 - 70 |
| Platelets | 180-490 | 180-400 | 180-400 | 160-390 |
| ESR | 2-4 | 4-10 | 4-10 | 4-12 |
General blood test norms for children aged 1 to 12 years
| Index | Age | ||||
| 1-2 years | 2-3 years | 3-6 years | 6-9 years | 9 -12 years | |
| Hemoglobin | 100 - 140 | 100 - 140 | 100 - 140 | 120 - 150 | 120 - 150 |
| Red blood cells | 3,7-5,3 | 3,9-5,3 | 3,9-5,3 | 4,0-5,2 | 4,0-5,2 |
| Color index | 0,75-0,96 | 0,8-1,0 | 0,8-1,0 | 0,8-1,0 | 0,8-1,0 |
| Reticulocytes | 0,3-1,2 | 0,3-1,2 | 0,3-1,2 | 0,3-1,2 | 0,3-1,2 |
| Leukocytes | 6,0 - 17,0 | 4,9-12,3 | 4,9-12,3 | 4,9-12,2 | 4,5-10 |
| Rod | 1 - 5 | 1 - 5 | 1 - 5 | 1 - 5 | 1 - 5 |
| Segmented | 28 - 48 | 32 - 55 | 32 - 55 | 38 - 58 | 43 - 60 |
| Eosinophils | 1 - 7 | 1 - 6 | 1 - 6 | 1 - 5 | 1 - 5 |
| Basophils | 0 - 1 | 0 - 1 | 0 - 1 | 0 - 1 | 0 - 1 |
| Lymphocytes | 37 - 60 | 33 - 55 | 33 - 55 | 30 - 50 | 30 - 46 |
| Platelets | 160-390 | 160-390 | 160-390 | 160-390 | 160-390 |
| ESR | 4-12 | 4-12 | 4-12 | 4-12 | 4-12 |
Hemoglobin
| Hemoglobin (Hb) is a protein containing an iron atom that is capable of attaching and transporting oxygen. Hemoglobin is found in red blood cells. The amount of hemoglobin is measured in grams/liter (g/l). Determining the amount of hemoglobin is very important, since when its level decreases, the tissues and organs of the entire body experience a lack of oxygen. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Reasons for increased hemoglobin
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Low hemoglobin - reasons
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Red blood cell count
| Red blood cells- These are small red blood cells. These are the most numerous blood cells. Their main function is the transfer of oxygen and its delivery to organs and tissues. Red blood cells are presented in the form of biconcave discs. Inside the red blood cell there is a large amount of hemoglobin - the main volume of the red disk is occupied by it. | ||||||||||||||||||||||||||||||||
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Causes of decreased red blood cell levelsA decrease in the number of red blood cells is called anemia. There are many reasons for the development of this condition, and they are not always associated with the hematopoietic system.
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Reasons for the increase in the number of red blood cells
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Total white blood cell count
| Leukocytes- these are living cells of our body circulating with the bloodstream. These cells carry out immune control. In the event of an infection or damage to the body by toxic or other foreign bodies or substances, these cells fight the damaging factors. The formation of leukocytes occurs in the red bone marrow and lymph nodes. Leukocytes are divided into several types: neutrophils, basophils, eosinophils, monocytes, lymphocytes. Different types of leukocytes differ in appearance and functions performed during the immune response. | |
Causes of increased leukocytesPhysiological increase in leukocyte levels
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Causes of decreased leukocytes
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Hematocrit
| Hematocrit- this is the percentage ratio of the volume of the blood being tested to the volume occupied by red blood cells in it. This indicator is calculated as a percentage. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Reasons for increased hematocrit
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Reasons for decreased hematocrit
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MCH, MCHC, MCV, color index (CPU)- norm
Color Index (CPU)- This is a classic method for determining the hemoglobin concentration in red blood cells. Currently, it is gradually being replaced by the MCH index in blood tests. These indices reflect the same thing, only expressed in different units.
Leukocyte formula
The leukocyte formula is an indicator of the percentage of different types of leukocytes in the blood and the total number of leukocytes in the blood (this indicator is discussed in the previous section of the article). The percentage of different types of leukocytes in infectious, blood diseases, and oncological processes will change. Thanks to this laboratory symptom, the doctor may suspect the cause of health problems.Types of leukocytes, normal
Neutrophils
| Neutrophils There can be two types - mature forms, which are also called segmented, and immature - rod-shaped. Normally, the number of band neutrophils is minimal (1-3% of the total number). With the “mobilization” of the immune system, there is a sharp increase (by several times) in the number of immature forms of neutrophils (band neutrophils). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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An increase in the level of neutrophils in the blood is a condition called neutrophilia. Reasons for increased neutrophil levels
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| Decreased neutrophil levels - a condition called neutropenia Reasons for decreased neutrophil levels
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What is a shift in the leukocyte formula to the left and to the right?Shift of the leukocyte formula to the left means that young, “immature” neutrophils appear in the blood, which are normally present only in the bone marrow, but not in the blood. A similar phenomenon is observed in mild and severe infectious and inflammatory processes (for example, tonsillitis, malaria, appendicitis), as well as in acute blood loss, diphtheria, pneumonia, scarlet fever, typhus, sepsis, intoxication.ESR erythrocyte sedimentation rateErythrocyte sedimentation rate(ESR) is a laboratory analysis that allows you to evaluate the rate of separation of blood into plasma and red blood cells.The essence of the study: red blood cells are heavier than plasma and white blood cells, so under the influence of gravity they sink to the bottom of the test tube. In healthy people, red blood cell membranes have a negative charge and repel each other, which slows down the rate of sedimentation. But during illness, a number of changes occur in the blood:
There are four groups of diseases that cause an increase in ESR:
The World Health Organization (WHO) recommends the Westergren technique. It is used by modern laboratories to determine ESR. But in municipal clinics and hospitals they traditionally use the Panchenkov method. Westergren method. Mix 2 ml of venous blood and 0.5 ml of sodium citrate, an anticoagulant that prevents blood clotting. The mixture is drawn into a thin cylindrical tube to a level of 200 mm. The test tube is placed vertically in a stand. After an hour, the distance from the upper boundary of the plasma to the level of red blood cells is measured in millimeters. Automatic ESR meters are often used. Unit of measurement of ESR - mm/hour. Panchenkov's method. Capillary blood from a finger is examined. In a glass pipette with a diameter of 1 mm, draw up a solution of sodium citrate to the 50 mm mark. It is blown into a test tube. After this, blood is drawn twice with a pipette and blown into a test tube with sodium citrate. Thus, a ratio of anticoagulant to blood of 1:4 is obtained. This mixture is drawn into a glass capillary to a level of 100 mm and placed in a vertical position. The results are assessed after an hour, just like with the Westergren method. The Westergren determination is considered a more sensitive method, so the ESR level is slightly higher than when examined by the Panchenkov method.
It must be remembered that uncomplicated viral infections do not cause an increase in ESR. This diagnostic sign helps determine that the disease is caused by bacteria. Therefore, when ESR increases, antibiotics are often prescribed. An erythrocyte sedimentation rate of 1-4 mm/h is considered slow. This reaction occurs when the level of fibrinogen, responsible for blood clotting, decreases. And also with an increase in the negative charge of red blood cells as a result of changes in the electrolyte balance of the blood. It should be noted that taking these drugs may cause a falsely low ESR result in bacterial infections and rheumatoid diseases. Biochemical blood test: interpretationSome normal values for adults are given in the table.
Blood test for sugar and cholesterol: interpretation and norm in the table
Total cholesterol
LDL
HDL
Blood test, decoding for adults, the norm in the table for sugar and cholesterol is as follows: For men For women The given transcript of a blood test for cholesterol in adults, the table, clearly shows the average lipid coefficient according to international calculations.
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