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Complete blood test with formula. Deciphering the blood test norm

Description

Determination method See description

Material under study See description

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Blood is a liquid tissue that performs various functions, including transporting oxygen and nutrients to organs and tissues and removing waste products from them. Consists of plasma and formed elements: red blood cells, leukocytes and platelets.

A general blood test in the INVITRO laboratory includes determination of hemoglobin concentration, number of red blood cells, white blood cells and platelets, hematocrit value and erythrocyte indices (MCV, RDW, MCH, MCHC). General analysis - , Leukocyte formula - , ESR - .

The leukocyte formula is the percentage of different types of leukocytes (neutrophils, lymphocytes, eosinophils, monocytes, basophils).

The leukocyte formula in the INVITRO Independent Laboratory includes the determination (in%) of neutrophils, lymphocytes, eosinophils, basophils, and monocytes. General analysis - , Leukocyte formula - , ESR - .

Erythrocyte sedimentation rate (ESR) is a nonspecific indicator of inflammation. ESR is an indicator of the rate of separation of blood in a test tube with an added anticoagulant into 2 layers: upper (transparent plasma) and lower (settled red blood cells). The erythrocyte sedimentation rate is estimated by the height of the formed plasma layer (in mm) per 1 hour. The specific gravity of erythrocytes is higher than the specific gravity of plasma, therefore, in a test tube, in the presence of an anticoagulant (sodium citrate), under the influence of gravity, erythrocytes settle to the bottom.

The process of erythrocyte sedimentation can be divided into 3 phases, which occur at different rates. At first, red blood cells slowly settle into individual cells. Then they form aggregates - “coin columns”, and subsidence occurs faster. In the third phase, a lot of red blood cell aggregates are formed, their sedimentation first slows down and then gradually stops.

The ESR indicator varies depending on many physiological and pathological factors. ESR values in women are slightly higher than in men. Changes in the protein composition of the blood during pregnancy lead to an increase in ESR during this period.

A decrease in the content of erythrocytes (anemia) in the blood leads to an acceleration of ESR and, on the contrary, an increase in the content of erythrocytes in the blood slows down the sedimentation rate. During the day, fluctuations in values are possible; the maximum level is observed in the daytime. The main factor influencing the formation of “coin columns” during erythrocyte sedimentation is the protein composition of the blood plasma. Acute-phase proteins, adsorbed on the surface of erythrocytes, reduce their charge and repulsion from each other, contribute to the formation of “coin columns” and accelerated sedimentation of erythrocytes.

An increase in acute phase proteins, for example, C-reactive protein, haptoglobin, alpha-1-antitrypsin, during acute inflammation leads to an increase in ESR. In acute inflammatory and infectious processes, a change in the erythrocyte sedimentation rate is observed 24 hours after an increase in temperature and an increase in the number of leukocytes. In chronic inflammation, an increase in ESR is caused by an increase in the concentration of fibrinogen and immunoglobulins.

Dynamic determination of ESR, in combination with other tests, is used to monitor the effectiveness of treatment of inflammatory and infectious diseases. General analysis - , Leukocyte formula - , ESR - .

Biomaterial - 2 tubes:

Whole blood with EDTA

Whole blood with citrate

Please note that when performing a clinical blood test () and counting the leukocyte formula (), if significant deviations are detected in the samples and the result requires manual microscopy, INVITRO additionally carries out a free manual count of the leukocyte formula with the counting of young forms of neutrophils (including accurate counting band neutrophils) and quantitative assessment of all pathological forms of leukocytes (if present).

Preparation

It is preferable to take blood in the morning on an empty stomach, after 8-14 hours of overnight fasting (you can drink water), it is acceptable in the afternoon 4 hours after a light meal.

On the eve of the study, it is necessary to exclude increased psycho-emotional and physical stress (sports training), and alcohol intake.

Indications for use

A general blood test together with a leukocyte formula is widely used as one of the most important examination methods for most diseases. The changes occurring in the peripheral blood are nonspecific, but at the same time reflect changes occurring in the whole organism. The study of the leukocyte formula is of great importance in the diagnosis of hematological, infectious, inflammatory diseases, as well as in assessing the severity of the condition and the effectiveness of the therapy. At the same time, changes in the leukocyte formula are not specific - they may have a similar nature in different diseases or, on the contrary, dissimilar changes may occur with the same pathology in different patients. The leukocyte formula has age-related characteristics, so its changes should be assessed from the perspective of the age norm (this is especially important when examining children).

An extensive study of the qualitative and quantitative composition of blood, during which the characteristics of red blood cells and their specific indicators (MCV, MCH, MCHC, RDW), leukocytes and their varieties in percentage (leukocyte formula) and platelets are given, and the erythrocyte sedimentation rate (ESR) is determined ) . Used to diagnose and monitor the treatment of many diseases.

SynonymsEnglish

Complete blood count (CBC) with differential, Erythrocyte Sedimentation Rate (ESR).

Research method

SLS (sodium lauryl sulfate) is a method of capillary photometry (venous blood).

Units of measurement

*10^9/l – 10 per st. 9/l;

*10^12/l – 10 per st. 12/l;

g/l – grams per liter;

fL – femtoliter;

pg – picogram;

% - percent;

mm/h. – millimeter per hour.

What biomaterial can be used for research?

Venous, capillary blood.

How to properly prepare for research?

Eliminate alcohol from your diet 24 hours before the test.
Do not eat for 8 hours before the test; you can drink clean still water.
Avoid physical and emotional stress for 30 minutes before the test.
Do not smoke for 30 minutes before the test.

General information about the study

A clinical blood test with leukocyte count and ESR is one of the most frequently performed tests in medical practice. Today, this study is automated and allows you to obtain detailed information about the quantity and quality of blood cells: red blood cells, leukocytes and platelets. From a practical point of view, the doctor should primarily focus on the following parameters of this analysis:

Hb (hemoglobin) – hemoglobin;
MCV (mean corpuscular volume) – average volume of an erythrocyte;
RDW (RBCdistributionwidth) – distribution of red blood cells by volume;
Total number of red blood cells;
Total platelet count;
Total number of leukocytes;
Leukocyte formula - the percentage of different leukocytes: neutrophils, lymphocytes, monocytes, eosinophils and basophils;
Erythrocyte sedimentation rate, ESR. The ESR indicator depends on the ratio of protein fractions in the blood and the number of red blood cells.

Determining these parameters makes it possible to diagnose conditions such as anemia/polycythemia, thrombocytopenia/thrombocytosis and leukopenia/leukocytosis, which can either be symptoms of a disease or act as independent pathologies.

When interpreting the analysis, the following features should be taken into account:

In 5% of healthy people, blood test results deviate from the accepted reference values. On the other hand, the patient may show a significant deviation from his usual indicators, which at the same time remain within the accepted norms. For this reason, test results must be interpreted in the context of each individual's individual normal performance.
Blood counts vary by race and gender. Thus, in women the number and quality characteristics of red blood cells are lower, and the number of platelets is higher than in men. For comparison: men – Hb 12.7-17.0 g/dl, erythrocytes 4.0-5.6×10 12 /l, platelets 143-332×10 9 /l, women – Hb 11.6-15, 6 g/dl, red blood cells 3.8-5.2×10 12 /l, platelets 169-358×10 9 /l. In addition, hemoglobin, neutrophils and platelets are lower in dark-skinned people than in white people.

What is the research used for?

For diagnosis and control of treatment of many diseases.

When is the study scheduled?

During a preventive examination;
if the patient has complaints or symptoms of any disease.

What do the results mean?

Reference values

Leukocytes

Red blood cells

	Age	Reference values
	Less than 1 year	4.1 - 5.3 *10^12/l
		4 - 4.4 *10^12/l
		4.1 - 4.5 *10^12/l
		4 - 4.4 *10^12/l
		4.2 - 4.6 *10^12/l
		4.1 - 4.5 *10^12/l
		4.2 - 4.6 *10^12/l
		4.4 - 4.8 *10^12/l
		3.5 - 5 *10^12/l
	More than 19 years	3.5 - 5.2 *10^12/l
		3.9 - 5.6 *10^12/l
	More than 19 years	4.2 - 5.3 *10^12/l

Hemoglobin

Age		Reference values
Less than 2 weeks		134 – 198 g/l
2 weeks – 2 months		124 - 166 g/l
2-12 months		110 – 131 g/l
		110 – 132 g/l
		111 – 133 g/l
		112 - 134 g/l
		114 - 134 g/l
		113 - 135 g/l
		115 - 135 g/l
		116 - 138 g/l
		115 - 137 g/l
		118 - 138 g/l
		114 - 140 g/l
		118 - 142 g/l
		117 - 143 g/l
		121 - 145 g/l
		120 – 144 g/l
		130 – 168 g/l
		130 – 168 g/l
		120 – 148 g/l
		132 - 173 g/l
		117 - 155 g/l
		131 - 172 g/l
		117 - 160 g/l
More than 65 years		126 - 174 g/l
		117 - 161 g/l

Hematocrit

	Age	Reference values
	Less than 1 year








	More than 65 years




	More than 65 years

Mean erythrocyte volume (MCV)

	Age	Reference values
	Less than 1 year







	More than 65 years




	More than 65 years

Average hemoglobin content in erythrocytes (MCH)

Mean erythrocyte hemoglobin concentration (MCHC)

Platelets

RDW-SD (red blood cell distribution by volume, standard deviation): 37 — 54.

RDW-CV (red blood cell distribution by volume, coefficient of variation): 11,5 — 14,5.

Platelet distribution by volume (PDW): 10 - 20 fL.

Mean Platelet Volume (MPV): 9.4 - 12.4 fL.

Large Platelet Ratio (P-LCR): 13 — 43 %.

Neutrophils (NE)

Lymphocytes (LY)

Monocytes (MO)

Eosinophils (EO)

Basophils (BA): 0 - 0.08 *10^9/l.

Neutrophils, % (NE%)

Lymphocytes,% (LY%)

Monocytes, % (MO%)

Eosinophils,% (EO%)

Basophils,% (BA%): 0-1.2%.

Erythrocyte sedimentation rate (photometry)

Interpretation of the analysis:

1. Anemia

A decrease in hemoglobin and/or red blood cells indicates the presence of anemia. Using the MCV indicator, you can perform a primary differential diagnosis of anemia:

MCV less than 80 fl (microcytic anemia). Reasons:
1. iron deficiency anemia,
2. thalassemia,
3. anemia of chronic disease,
4. sideroblastic anemia.

Given that the most common cause of microcytic anemia is iron deficiency, when identifying microcytic anemia, it is recommended to determine the concentration of ferritin, as well as serum iron and total serum iron-binding capacity. It is recommended to pay attention to the RDW indicator (increased only in iron deficiency anemia) and platelet count (often increased in iron deficiency anemia).

MCV 80-100 fl (normocytic anemia). Reasons:
1. bleeding,
2. anemia in chronic renal failure,
3. hemolysis,
4. anemia due to iron or vitamin B12 deficiency.
MCV more than 100 fl (macrocytic anemia). Reasons:
1. medications (hydroxyurea, zidovudine),
2. deficiency of vitamin B 12 and folic acid.

Marked macrocytosis (MCV greater than 110 fl) usually indicates a primary bone marrow disease.

With anemia, regardless of its type, the ESR is usually increased.

2. Thrombocytopenia

thrombocytopenic purpura/hemolytic-uremic syndrome;
DIC syndrome (disseminated intravascular coagulation);
drug thrombocytopenia (co-trimoxazole, procainamide, thiazide diuretics, heparin);
hypersplenism;
idiopathic thrombocytopenic purpura.

It should be remembered that in pregnant women, platelets can normally decrease to 75-150 × 10 9 / l.

3. Leukopenia

For the differential diagnosis of leukopenia, both the absolute number of each of the 5 main lineages of leukocytes and their percentage (leukocyte formula) are important.

Neutropenia. A decrease in neutrophils of less than 0.5×10 9 /l is severe neutropenia. Reasons:

Congenital agranulocytosis (Kostmann syndrome);
Drug-induced neutropenia (carbamazepine, penicillins, clozapine and others);
Infections (sepsis, viral infection);
Autoimmune neutropenia (SLE, Felty's syndrome).

Lymphopenia. Reasons:

Congenital lymphopenia (Bruton agammaglobulinemia, severe combined immunodeficiency, DiGeorge syndrome);
Acquired variable immunodeficiency;
Drug-induced lymphopenia (glucocorticosteroids, monoclonal antibodies);
Viral infection (HIV);
Autoimmune lymphopenia (SLE, rheumatoid arthritis, sarcoidosis);
Tuberculosis.

4. Polycythemia

An increase in the concentration of Hb and/or Ht and/or the number of red blood cells can be observed with:

Polycythemia vera is a myeloproliferative disease. In the blood test, in addition to erythrocytosis, thrombocytosis and leukocytosis are observed.
Relative polycythemia (bone marrow compensatory response to hypoxia in COPD or ischemic heart disease; excess erythropoietin in renal cell carcinoma).

For the differential diagnosis of polycythemia, a study of erythropoietin levels is recommended.

Thrombocytosis

Primary thrombocytosis (malignant disease of the myeloid lineage of the bone marrow, including essential thrombocytosis and chronic myeloid leukemia);
Secondary thrombocytosis after removal of the spleen, during an infectious process, iron deficiency anemia, hemolysis, trauma and malignant diseases (reactive thrombocytosis).

An increase in Hb, MCV, or total leukocyte count suggests primary thrombocytosis.

Leukocytosis

The first step in interpreting leukocytosis is to evaluate the leukocyte count. Leukocytosis can be caused by an excess of immature leukocytes (blasts) in acute leukemia or mature, differentiated leukocytes (granulocytosis, monocytosis, lymphocytosis).

Granulocytosis - neutrophilia. Reasons:

Leukemoid reaction (reactive neutrophilia in the presence of infection, inflammation, use of certain medications);
Myeloproliferative disease (eg, chronic myeloid leukemia).

An increase in band neutrophils of more than 6% indicates the presence of infection, but can also be observed in chronic myeloid leukemia and other myeloproliferative diseases.

Also an indirect sign of an infectious process is an increase in ESR, which, however, can also be observed in many malignant diseases.

Granulocytosis - eosinophilia. Reasons:

Granulocytosis - basophilia. Reasons:

Chronic basophilic leukemia.

Monocytosis. Reasons:

Myeloproliferative disease, such as CML;
Reactive monocytosis (chronic infections, granulomatous inflammation, radiation therapy, lymphoma).

Lymphocytosis. Reasons:

Reactive lymphocytosis (viral infection). Virus-specific laboratory tests are recommended.
Lymphocytic leukemia (acute and chronic).

A clinical blood test with leukocyte count and ESR is a screening method that can be used to suspect or exclude many diseases. This analysis, however, does not always make it possible to establish the cause of the changes, the identification of which, as a rule, requires additional laboratory tests, including pathomorphological and histochemical studies. The most accurate information can be obtained by dynamic monitoring of changes in blood parameters.

What can influence the result?

age;
race;
pregnancy;
presence of concomitant diseases;
use of medicines.

Important Notes

Test results must be interpreted in the context of each individual's individual normal performance;
the most accurate information can be obtained by dynamic monitoring of changes in blood parameters;
test results should be interpreted taking into account all anamnestic, clinical and other laboratory data.

Clinical and biochemical blood test - main indicators

Who orders the study?

Therapist, surgeon, gynecologist, pediatrician, general practitioner.

Literature

Jolobe OM. How to interpret and pursue an abnormal complete blood cell count in adults. Mayo Clin Proc. 2005 Oct;80(10):1389-90; author reply 1390, 1392.
McPhee S.J., Papadakis M. CURRENT Medical Diagnosis and Treatment / S. J. McPhee, M. Papadakis; 49 ed. – McGraw-Hill Medical, 2009.

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 white blood cells 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 is 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. A healthy person does not have them 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 chemicals released 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. Main job of 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 the chemical elements that eosinophils secrete that 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. The pathogenic microbe is absorbed by the 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

In each laboratory, different values can be accepted as normal, 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 is the analysis carried out?

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 in different ways can vary even within one person. 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 in a short time. But in controversial cases, preference is given to viewing under a microscope by a laboratory assistant. A person can detect minor differences in the appearance of cells, which 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 immature cells in the 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 when conducting clinical studies, 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:

Severe 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 types of 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 when 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 has no diagnostic value. It is 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 for 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

White blood cells form an important part in the body, protecting it from harmful bacteria and substances. They ingest and disarm foreign particles. Consequently, the behavior of these cells can indicate the presence of an inflammation process, because the composition of the blood shows the state of human health. Therefore, for diagnostics that provide results, a special test is prescribed, which is used in medicine called the leukocyte blood count. Judging by its results, you can find out about the type of disease, predict its course and predict the further outcome. What can the leukocyte formula show?

Indicators

Alerts about changes in certain types of leukocytes. Often such a study is prescribed with general tests during routine medical examinations, infectious diseases, during monitoring of various diseases.

These are cells of the immune system that are responsible for protecting the human body. Their goal is to form a certain boundary beyond which harmful substances, toxins, and foreign bodies should not fall.
There are several types of leukocyte cells that perform a specific task. Basophils, monocytes, neutrophils, eosinophils, lymphocytes constitute the body's defense group. What functions do these cells perform?

This species is responsible for ensuring security. They recognize, capture and destroy viruses or bacteria. They are divided into:

myelocytes (seeds) and metamyelocytes (derived from myelocytes). Basically, they are not in the blood of a healthy person, but in case of severe illness they appear.
stick-shaped (young) - in case of infections or diseases that are bacterial in nature, their number increases if the segmented ones are not able to neutralize the infection.
segmented (mature) - are found in the greatest quantity, as they constitute the body’s defense in a normal state.

Lymphocytes. They create antiviral immunity, as they are able to remember antigens, and also participate in the synthesis of antibodies.

Their functions are similar to neutrophils, but they differ in that they are capable of not only capturing and destroying harmful bacteria, but also absorbing dying cells. In this way they cleanse the blood, giving the ability to regenerate tissues.

Basophils. They appear when allergic processes occur that prevent harmful microorganisms and toxins from spreading throughout the blood.

The leukocyte blood count shows the condition of a sick person, the severity of his disease, the causes and its outcome. In addition to the leukocytogram, there are leukocyte indices, which show the level of protein bodies in the blood.

An example of this is the leukocyte index of intoxication, which determines the severity of the inflammation process. As well as other types of indices, for example, immunoreactivity, allergization. They help assess the level of body resistance, the capabilities of the immune system, and the patient’s condition.

And finally, the leukoformula is used to determine the balance of these bodies in the blood.

Carrying out analysis

Before taking the leukocyte formula, you need to undergo simple preparation. You just need to refuse food 3-4 hours in advance, and also not be subjected to physical and emotional stress.

The material is blood from a vein. Next, it is placed on a special glass plate under a microscope. The laboratory technician fishes out several hundred cells to determine the number and level of white blood cells. The next step is to distribute the blood over the entire glass surface, but not evenly. The heavy bodies are located at the edges, and the light ones in the center. The heavy ones include: monocytes, basophils and eosinophils, and the light ones include lymphocytes.

When counting white bodies in the blood, two options are used:

Schilling method. Counting occurs conditionally in 4 areas of the smear.
Filipchenko's method. The laboratory technician divides the smear into 3 parts and determines the quantity along a straight transverse line.

However, there are clinics equipped with new equipment and the counting of leukocytes is done by a special device - an analyzer. And if the result deviates sharply from the norm, then a person intervenes. It should be noted that the quantity error error exists in any case. Factors include errors in blood collection, smear preparation, and others.

Ready in a few days. The attending physician analyzes the obtained values.

A specially trained specialist is responsible for deciphering the leukocyte formula of blood. However, you can also compare the result with the norms. To do this, you need to know what indicators are the maximum permissible for a healthy person in accordance with his age.

There are leukocyte blood formula standards for adults:

neutrophils - 55%;
lymphocytes - 35%;
monocytes - 5%;
eosinophils - 2.5%;
basophils - 0.5%.

Leukocyte formula norms by age:

hemoglobin- a protein found in red blood cells. It is needed to transport oxygen throughout the body, as well as carbon dioxide. For men: 130 - 160 g/l, for women: 120 - 140 g/l, for children from 0 to 6: 100 - 140 g/l, and up to 12: 120 - 150 g/l.

If the indicators in the leukocyte formula deviate, for example, in a decreasing direction, a possible development of leukemia is detected. If increased, it indicates the presence of diabetes, dehydration or diseases of the hematopoietic system.

red blood cells. The norm for men is 4.0-5.0 × 1012/l, for women: 3.6 - 4.6 × l, for children from 0 - 6 years: 5 - 15.5 × l, for children from 0 - 6 years: 5.0-15.5×l, up to 12 years – 4.0 - 13.5×l.

Possible for drug allergies, sinusitis, bronchitis, leukemia. If the indicators are less than normal, then this indicates the initial stage of inflammation, the development of viral or infectious diseases.

neutrophils. The normal amount of segmented neutrophils for adults is from 50 to 70%, for children from 0 to 6: 28 - 55%, up to 12 years: 43 - 60%. As for stab diseases, in adults it is 1-3%, and in children under 16 it is 1-5%. A deviation from the norm shows that not everything is in order in the body. So, if the amount is exceeded, then this is mainly during bronchitis, sinusitis, and inflammation of the organs. Reduces this indicator of diseases that are infectious or blood diseases.

In the transcript of the analysis for the leukocyte formula, there is such a term as leukocyte formula shift. It characterizes the content of rod and segmented cells in ba. If the shift is to the right, then there are fewer band neutrophils to a greater or lesser extent, which is reflected in the state of human segmented neutrophils. Then the person’s condition is associated with impaired functioning of the liver, kidneys or the presence of megaloblastic anemia. If there is a shift to the left, then band cells increase and metamyelocytes and myelocytes appear. Then the following diseases emerge: acidosis or acute infections. Also during physical stress.

eosinophils. For newborns and infants up to 2 weeks, the norm is 1 - 5%, for infants 1 - 6%, from 1 to 2 years this figure is 1 - 7%, from 2 to 5 it is 1 - 6%, and then the norm remains unchanged 1 - 5%. A high level of eosinophils occurs with allergic sensitization, infectious diseases, tumors or diseases of the hematopoietic system. A decrease occurs under stress, purulent infections, injuries and burns, and intoxication.
monocytes are responsible for recognizing foreign bodies. For newborns, the norm is 3 - 12%, then for a 2-week-old baby the indicator increases from 5 to 15%, for infants 4 - 10%, for children under 2 years old 3 - 10%, and then the indicator does not change. occurs with fungal and viral infections, rheumatic diseases, diseases of the hematopoietic system. And also possible during the recovery period. A decrease is observed during childbirth, shock, and when taking glucocorticoids. Also for aplastic anemia or hairy cell leukemia.
basophils. The norm is 0 - 0.5% for everyone. An increase in basophils is observed in the following diseases: chicken pox, myxedema, chronic myeloid leukemia. For other diseases: Hodgkin's disease, ulcerative colitis, chronic anemia, nephrosis. A decrease in basophils occurs during pregnancy, ovulation, pneumonia, hyperthyroidism, and also with pathologies in the bone marrow.
lymphocytes. Throughout life, this indicator changes. For newborns 15 - 35%, for infants up to 2 weeks 22 - 55%, for infants 45 - 70%, for children up to 2 years 37 - 60%, up to 5 years 33 - 55%, up to 8 years 30 - 50%, up to 15 years this figure is 30 - 45%, and then without changes 20 - 40%. An increase in lymphocytes indicates acute respiratory viral infections, viral infections, blood diseases, and poisoning. A decrease in lymphocytes is observed in acute infections and diseases, miliary tuberculosis, aplastic anemia, renal failure, and HIV infections.

The leukocyte blood count in children contains some differences depending on age.

For a newborn baby, the blood shape ratio is stable. However, the number increases by the 6th day to 49 - 60%, and neutrophils decrease to 35 - 48%.

In the first months of life, the child develops a leukoformula, which will persist for a whole year. Indicators for infants have some differences in lability; they can easily be disrupted by the child’s indignation or anxiety, illness, or climate change. Up to 6 years, the number of neutrophils and lymphocytes increases. Closer to 15 years, the leukogram becomes similar to an adult.

And so, it turned out that the leukocyte blood count in children will naturally change due to their age. The number of neutrophils in the blood of a newborn ranges from 51 to 71%, gradually increases in the first days of life, and then begins to decline sharply. At this time, the baby fluctuates from 15 to 35%, by the end of the second week it reaches 55%. When the baby is 6-7 days old, the curves of lymphocytes and neurophils converge. This intersection is called the first intersection.

As for basophilic ones, they are almost absent in newborns. The number of monocytes in the blood ranges from 6.5 to 11%, and at the end of the first week from 8.4 to 14.1%. Plasma cells are quite small from 6.4 to 11.2%. In babies up to a week, there is a clear shift to the left according to Schilling, which is balanced until the end of the week.

Within a month of life, the baby’s leukogram is drawn, which will be present throughout the first year. In it, lymphocytes have an advantage; there is always a shift of neutrophils to the left side, balanced monocytosis and the presence of plasma cells. Differential white blood cell counts in infants vary widely.

When a child already goes to school, their number decreases, and neutrophils increase. The number of monocytes also decreases slightly, and plasma cells cease to be present. At the age of 15, the leukogram becomes closer to adults. An accurate assessment of the ratios of various forms of leukocytes in the blood is of great importance in diseases.

How to determine the type of infection

The leukoformula in children and adults provides answers to many questions regarding diseases of an infectious nature. But how to distinguish between viral and bacterial?
When taking a smear, blood is smeared onto a glass. After this, the laboratory doctor takes a microscope, puts it down and looks, observing the behavior of leukocytes. When he saw it, he determined by its appearance what type it was and wrote down the quantity of each type. He does this until he gets 100.

The relationship of different blood cells shows the type of infection. If a large percentage of lymphocytes predominates, then it is a viral infection; if it is neutrophils, then it is bacterial.

The main fighter against infections and bacteria is the segmented neutrophil. It is the most popular cell in the blood. In other words, she is mature and ready to cope with all foreign bodies in the body. If there are a lot of them, then the body is protected from all bacteria.

However, in order for a segmented neutrophil to become mature, it must undergo a series of transformations. First, he is born in the form of another neutrophil - a band neutrophil. And when the human body is attacked by any disease, information is sent to the bone marrow so that the production of young stab cells begins. And if there are a lot of them, this means that there is an acute bacterial infection.

To educate and protect yourself and, first of all, your baby, in our time it is possible to undergo many examinations and diagnostics. Especially on the content of leukocytes in the baby’s blood. After all, this is very important information about your child’s health.

Test indications

There are a number of necessary cases for taking a blood test:

It is necessary to be examined by a doctor once a year
for complications in diseases
when tired.

Analysis of ESR allows you to estimate a certain rate of sedimentation and separation of blood into plasma and erythrocytes. This method is very effective and reliable since in the 21st century technology does not stand still and medicine needs high-quality diagnosis of any type of disease or epidemic problem, etc. The popularity of this analysis has increased, since it is technically simple and accessible, and the results are reliable. But if everything is normal with the indicators, can we assume that the person is not sick? And what if it's the other way around?

Good erythrocyte sedimentation rate results do not mean that the human body is not affected by bacteria or infections. Referring to the data, most patients have ESR less than 20 mm/hour. And in some places, even with an elevated ESR of 100 mm/hour, it is not possible to find out about the signs of the disease.

Indicators of ESR norm according to Westergren

Therefore, an increase in ESR in the blood in most cases occurs when:

infections, since infectious processes increase ESR
malignant diseases (solitary tumors, etc.)
rheumatological
kidney pathology.

For this method, a Panchenkov apparatus is used, which consists of 100 mm pipettes and a tripod. The analysis is performed on the basis of blood from a vein or from a capillary into which a substance is placed that prevents it from clotting. In this case, the smear is placed in a thin test tube and watched for about an hour. The test tube is made of glass or plastic. During this time, the separation into red blood cells and plasma occurs separately. The ESR is calculated based on the dimensions from the edge at the top of the plasma to the red blood cells. The normal indicator is a slow sedimentation of erythrocytes, behind which there is a remainder of pure plasma.

There is another “stopped flow” method, which involves stirring the sample to disaggregate the red blood cells. This process must be carried out efficiently, otherwise microclots can change the result. Measurements range from 2 to 120mm/hour. The results are highly accurate.

When protein levels are high, red blood cells stick together. Therefore, they drop very quickly, and the ESR in the blood increases its level. As a result, acute or chronic illness can lead to an increase in ESR. Women have a higher ESR than men, since there are fewer of them.

The ESR norm for adolescents under 15 years of age: 2-20 mm/hour, from 15 to 50: 2-15 mm/hour, and after 50: 2-20 mm/hour. For women, permissible values up to 50 range from 2 to 20 mm/hour, and after 50 from 2 to 30 mm/hour.

What is the need

This is necessary for diagnosing acute or chronic diseases, cancer infections. However, this type of analysis is carried out in combination with others, since it does not give an accurate answer to the type of origin of the disease, its development and outcome.

Indicated for monitoring infectious, oncological and autoimmune diseases. And also in combination with a leukocyte blood count or a general blood test.

A clinical blood test can provide many answers to complex diagnoses and diseases, as well as describe a person’s condition. However, decoding should be done by an experienced specialist who can give an accurate description and correct the treatment process.