Absolute and relative value. Relative and absolute changes in the leukocyte formula What are absolute blood values
Relative values are of four types: intensive, extensive, ratio indicators, and visual indicators.
Intensive indicators - show frequency phenomena in the environment. The environment is usually a certain set of objects (population, patients, cases), some of which experience some phenomenon. Calculated using the following formula:
I.p. = phenomenon/environment*coefficient.
The coefficient is used for the convenience of presenting the indicator; it represents various powers of the number 10 and usually takes the values 100, 1000, 10,000, 100,000. Its value depends on the frequency of occurrence of the phenomenon: the less often it occurs, the greater the coefficient. Thus, indicators of fertility, mortality, and general morbidity of the population are usually calculated per 1000 people. When calculating maternal mortality, as a much rarer event, a coefficient of 100,000 is used. On the contrary, the frequency of such a common phenomenon as a case of temporary disability is calculated per 100 workers.
An example of calculating an intensive indicator:
During the year, 360 surgical operations were performed at N.'s hospital. In 54 cases, various complications were observed in the postoperative period. Find the frequency of postoperative complications per 100 operations.
Solution: The incidence of postoperative complications is an intensive indicator that can be calculated as the ratio of the phenomenon to the environment. The medium is the totality of operations performed (360), of which in 54 cases, as follows from the conditions of the problem, a phenomenon occurred - postoperative complications were noted. Thus:
Rate of postoperative complications = (Number of cases of postoperative complications) / (Number of operations performed) * 100 = (54 / 360) * 100 = 15.
The value of the coefficient is taken to be 100, since the problem statement asks for a frequency calculated per 100 operations performed.
Answer: The rate of postoperative complications in N.'s hospital over the year was 15 cases per 100 operations performed.
Extensive indicators - characterize structure phenomena are measured as a percentage, less often - in ppm or fractions of a unit. Extensive quantities show what part a separate group of units makes up in the structure of the entire population. Calculated using the formula:
E.p. = part/whole*100%.
An example of calculating an extensive indicator:
A study of the effectiveness of treating pneumonia using a new antibiotic involved 200 patients, 90 of them men. It is necessary to determine the proportion of men among the subjects, and express the result in %.
Solution: Male patients represent a portion of the total population studied. Therefore, we must use the formula to calculate extensive indicators:
Proportion of male patients among all studied = (number of men) / (number of all patients) * 100% = (90 / 200) * 100% = 45%.
Answer: The share of patients in the study population is 45%.
Ratio indicators characterize the relationship between two unrelated populations. These aggregates can be measured in the same quantities, the main condition is that their changes must occur independently of each other. Typically, various indices, coefficients, and indicators are presented in this form. security population. Calculated using the following formula:
P.S. = (first set) / (second set)*coefficient
The coefficient usually takes the value 1 (for indices) or 10,000 (for indicators of population security).
Example of calculating the ratio indicator:
One of the regions of the Republic of Tatarstan has a population of 40,000. There are 384 inpatient beds in medical institutions in this area. What is the availability of beds for the population in the area?
Solution: We have two populations: population and inpatient beds. Changes in the population do not depend on changes in the number of inpatient beds and vice versa, and therefore we conclude that the presented populations are not related to each other. Let's calculate the indicator of the population's provision with inpatient beds:
Provision of population with beds = (number of beds) / (population) * 10,000 = (384 / 40,000) * 10,000 = 96.
Answer: The provision of inpatient beds to the population is 96 per 10,000 population.
Human blood consists of a large number of cells, which in turn are divided into groups. Each group performs an important function. One of them is leukocytes, or as they are also called, white blood cells. These cells are responsible for the body’s immunity and are divided into several subgroups, the basis of which are lymphocytes.
These bodies are formed in the bone marrow and thymus and, as a rule, are found in tissues of the lymphoid type. The main function of lymphocytes is to protect the body from viruses. They identify harmful cells and produce an antitoxin to fight them; carry out quality control of body cells and destroy defective ones.
To determine the number of lymphocytes, it is enough to do a general blood test. This simple procedure will help you find out the level of immune cells.
This study will reveal an increased level of white blood cells, which is one of the signals of the presence of an inflammatory process in the body. Therefore, it is necessary to have your blood tested twice a year.
Despite the fact that the procedure is quite primitive, for the most accurate result, certain preparation is required:
- at least 8 hours must pass between the last meal and the analysis itself;
- dinner on the eve of blood donation should be low in calories;
- Also, a day or two before the procedure, it is not recommended to consume fried and fatty foods, as well as alcoholic beverages;
- You should also not smoke at least a few hours before the procedure.
Previously, experts counted the number of cells independently, through a microscope. Nowadays, they use automatic analyzers that determine the quantity, color, shape and quality of blood cells in a matter of minutes.
Acceptable lymphocyte content
There is an upper and lower acceptable threshold for the content of lymphocytes in the blood, deviation from which is not normal and requires medical intervention.
Test results usually present two values: absolute - directly, the number of cells in the blood; and relative - the ratio of the number of lymphocytes to the number of leukocytes.
That is, the deviation can be either absolute or relative. The absolute indicator is usually presented in units per liter, and the relative indicator - in percentage.
The norm for adults is 19-37% of the total number of leukocytes or 1-4.8 * 109 / liter. For pregnant women, the norm remains the same, however, there is also a small number of lymphocytes and amounts to 16-18% of the total number of leukocytes, which is acceptable for this period.
For children, everything is not so simple; for them, the norm varies depending on age:
- Newborns - 15-35% or 0.8-9*109/l
- 1 year - 45-70% or 2-11*109/l;
- 1-2 years - 37-60% or 3-9.5*109/l;
- 2-4 years - 33-50% or 2-8*109/l;
- 4-10 years - 30-50% or 1.5-6.8*109/l;
- 10-16 years - 30-45% or 1.2-5.2*109/l.
Increased lymphocyte levels
When the number of lymphocytes is higher than normal, it is lymphocytosis. Like the level of immune cells, lymphocytosis can be absolute and relative.
It is also worth considering that if, in relative terms, neutrophils are reduced, while lymphocytes are increased, then this is not a cause for concern. Therefore, they often look at the absolute number of lymphocytes.
As a rule, an increase in the level of immune cells may not only indicate the presence of any disease, but may also be a reflection of certain physiological characteristics, for example, a woman's menstrual period or a common cold.
Causes of increased lymphocytes
The reasons for the deviation vary between adults and children.
In an adult:
- menstrual cycle;
- “reactive” type of immunity;
- fasting or strict diet;
- viral liver disease;
- tuberculosis;
- infections caused by bacteria (syphilis);
- infectious type mononucleosis;
- allergic reactions;
- decreased functioning of the thyroid gland;
- stressful period for smokers and people prone to alcoholism;
- autoimmune processes such as arthritis, scleroderma;
- benign blood tumors;
- intoxication with chemicals (arsenic, chlorine, etc.);
- plasma cell cancer;
- diseases related to the endocrine system;
- side effects from medications;
- turning points of some diseases.
The child has:
- anemia, especially vitamin B12 deficiency;
- infectious diseases: rubella, smallpox, measles, etc.;
- oncology;
- infectious lymphocytosis;
- asthma;
- problems with the endocrine system.
Symptoms of lymphocytosis
Exceeding the norm of lymphocytes in adults may or may not have symptoms, depending on the cause of the deviation. Often, the symptoms of lymphocytosis help to understand what triggered the increase in the number of immune cells.
If we talk about relative lymphocytosis, which is usually caused by viral infections, then it manifests itself as follows:
- runny nose;
- cough;
- headache;
- increased body temperature;
- sore throat.
With absolute lymphocytosis, along with the above symptoms, rashes may also be observed.
How to lower the level of immune cells in the blood
This deviation is not a disease as such, and therefore there is no specific treatment for this phenomenon. If there are no symptoms of a particular disease, the specialist will refer the patient for an X-ray, ultrasound, MRI, and may also prescribe additional tests. Based on the results obtained, the doctor prescribes treatment. Often this is taking antiviral, antipyretic, antiallergenic drugs and antibiotics. There are cases when chemotherapy, bone marrow transplantation and other radical measures necessary for a particular patient are prescribed against the disease.
You can also reduce the level of lymphocytes with the help of alternative medicine. A vodka infusion of a catharanthus tree leaf is considered an effective remedy for this disease. The tincture should be taken ten drops throughout the month, which will certainly lead to improved performance.
As you know, preventing a disease is much easier than treating it. In this case, you can also do without treatment by following basic preventive measures, such as: maintaining immunity, preventing various viral diseases.
Decreased lymphocyte count
Along with lymphocytosis, an increased level of lymphocytes, there is also the opposite disease, lymphopenia, a decreased level of lymphocytes.
More often you can find relative lymphopenia - with pneumonia, leukemic myelosis, etc. Relative lymphopenia is less common; this deviation usually occurs in people with infectious diseases, as well as those suffering from tuberculosis or sarcoma.
Often, low levels of immune cells indicate congenital or acquired immunodeficiency.
Causes of congenital lymphopenia:
- absence or poor development of stem cells responsible for the formation of lymphocytes;
- decrease in the number of T lymphocytes;
- Wiskott-Aldrich syndrome;
- thymoma.
Causes of acquired lymphopenia:
- infectious diseases;
- heart attack;
- poor nutrition;
- bad habits;
- consequences of certain therapies;
- systemic diseases that cause an allergic reaction to one’s own tissues.
Treatment of lymphopenia
The treatment process should combine prevention of the general manifestations of the disease and direct treatment of diseases that contributed to the decrease in immune cells.
Lymphopenia can manifest itself through:
- skin diseases;
- hair loss;
- damage to the oral cavity by ulcers;
- enlarged spleen and lymph nodes;
- reduced tonsils;
- recurrent infectious diseases.
A reduced level of lymphocytes indicates immunodeficiency, which increases the risk of developing cancer.
Thus, both of these deviations are a good enough reason to undergo additional examinations, since these are clear signs of problems with the immune system. However, it is worth remembering that this is only a symptom and not a diagnosis. It is necessary to contact a qualified specialist who will prescribe tests, on the basis of which a treatment algorithm for a particular patient will be built, depending on the reasons that led to certain deviations.
When receiving the results of a blood test, an ordinary person is unlikely to be able to tell much from them, even if he vaguely remembers his anatomy lessons in high school: blood consists of plasma and various cells - red blood cells, platelets and white blood cells. And their behavior in the test will tell the doctor a lot. For example, and, of course, the leukocyte blood count, one of the important indicators of the condition of the patient and his body.
Otherwise, this analysis is called a leukogram: it shows the percentage of types of white blood cells, that is, leukocytes. The total number of species is an absolute whole, an imaginable 100%, taking into account which a formula is drawn up: when the number of some leukocytes increases, others correspondingly decrease in the same quantity.
Kinds
The leukocyte formula of blood reflects, as a percentage, the presence of five forms of white cells, which are the main ones. They differ in the functions they perform, and according to their morphology they are divided into two groups: with or without granules that contribute to the perception of color:
- granulocytes (basophils; eosinophils; neutrophils).
- (B and T lymphocytes, monocytes).
In adults, the leukogram will normally contain different leukocytes in approximately the following percentages:
- the largest number 47-72% – ;
- then 19-37% - lymphocytes;
- 3-11% contains monocytes;
- the second type of neutrophils - stab (immature) - 1-6%;
- from 0.5% to 5% – eosinophils;
- and the lowest value is 0-1% basophils.
When diagnosing diseases in children, it is important to remember: the leukogram changes depending on the age of the patient.
The absolute values for white cells are also known, that is, how many of these or those are per unit in which the blood volume is calculated. This data is necessary to determine absolute changes in the leukogram: unlike relative ones, both percentage and numerical data are taken into account here.
Drawing up a leukogram
The leukocyte formula of blood is calculated under a microscope in the laboratory based on the amount (relative and absolute) per 100 cells of the material taken.
A hematological analyzer can also be used, which provides a more accurate result independent of the human factor, tested on a larger number than a microscope allows (2000 to 200).
If any deviations are found when deciphering the leukocyte formula, then to clarify the results, an additional study should be carried out - a smear, as well as a description of the morphology of the analyzed cells.
Why are white cells important?
Each type of white blood cell has its own specific function in the body, and they must perform it correctly. This is why the leukocyte formula is so important when examining a person: it will show failures and clarify the diagnosis.
The state of immunity, the presence of infection, allergies, leukemia, viral, bacterial diseases, the severity of the pathology - the doctor can obtain all this information by deciphering the leukogram.
- Lymphocytes "T-" stand in the way of one of the most serious diseases of our time - cancer, destroying its cells, as well as other microorganisms foreign to the human body. B lymphocytes, when working properly, produce antibodies.
- – direct participants in phagocytosis (the process of capturing and removing pathogens): they neutralize foreign material, control the immune system’s response to it and the restoration of damaged tissue.
- are important in that they control the movement of other leukocytes to the site of inflammation, and not a single allergy can exist without them.
- are responsible for bactericidal substances released in the body and absorb bodies foreign to the body.
- , like other cells involved in phagocytosis, control the release of histamine during inflammation and allergies.
Reasons for changes
There are many pathologies that lead to a quantitative increase in lymphocytes in the blood - lymphocytosis.
Infections lead to it:
- bacterial (tuberculosis, syphilis, brucellosis);
- viral (rubella, measles, chickenpox).
Leukocytosis in the blood may indicate that the patient has lymphoma, lymphocytic leukemia, or lymphosarcoma. An increase in lymphocytes can be a consequence of hypothyroidism, folate deficiency and other anemias, and disruption of the adrenal cortex.
If, therefore, lymphocytopenia is detected, then the doctor may suspect acute pathologies in the patient: radiation sickness, lupus erythematosus, infections. This also indicates possible kidney failure, lymphogranulomatosis or immunodeficiency.
In case of bleeding, necrosis, administration of corticosteroids, intoxication and acute bacterial pathologies, the leukogram will reflect an increased number of neutrophils compared to the norm - neutrophilia.
Its antipode - neutropenia - signals that the patient may have hepatitis, rubella, tularemia, typhoid fever, brucellosis, and autoimmune pathologies. It is also diagnosed with drug intoxication, hypersensitivity to drugs, and exposure to radiation. There is also hereditary neutropenia, it is hereditary and does not pose a threat.
If the number of monocytes in the blood test decreases, the assessment is carried out simultaneously with the analysis of the lymphocyte count, since they play an important role in determining pulmonary tuberculosis.
Myeloid leukemia (chronic) is reflected in the leukogram by a reduced level of basophils in the body (the doctor diagnoses basophilia).
When in the formula, this may indicate diseases and pathologies such as scarlet fever, eczema, leukemia, psoriasis, Leffler's endocarditis, allergic reactions. The number of eosinophils decreases with typhoid fever and adrenocorticosteroid activity.
Decoding
When deciphering changes in the leukocyte formula, taking into account the age norm, they speak of its shift:
- to the left, when the analysis revealed metamyelocytes (young) as well as myelocytes.
Such changes signal purulent infections, inflammatory processes (orchitis, pyelonephritis), bleeding in the acute stage, toxic poisoning, acidosis or too high stress on the body.
- to the left with rejuvenation (in addition to the forms found with a simple shift to the left, erythro- and myeloblasts, promyelocytes are present here).
Such a shift in the leukogram may indicate metastases, mylofibrosis, or a coma state.
- to the right (this conclusion is suggested by hypersegmented granulocytes that appear in the blood; immature band neutrophils are present in smaller numbers, and the level of mature, with 5-6 segments, neutrophils, on the contrary, is increased).
Such a leukogram may indicate that the patient has anemia (folate deficiency, megaloblastic), pathology of the kidneys, liver, radiation sickness, or may be a consequence of a lack of vitamin B12 or blood transfusion.
Changes in the leukogram also differ in the degree of development when using an index calculated by the formula: the total number of neutrophils present in the sample (myelocytes, band, meta- and promyelocytes of young) is divided by the number of mature neutrophils (segmented). For an adult, whose body is not susceptible to diseases and pathologies, this ratio should normally fall in the range of 0.05-0.1.
Only a qualified specialist can correctly and correctly decipher the leukocyte formula, who can, based on deciphering the leukogram, determine the direction of further studies that clarify the diagnosis and prescribe the correct effective therapy.
It should be remembered that absolute indicators of the content of blood cells (leukocytes of various types, reticulocytes and other blood cells) are not just more informative than relative indicators, but the only ones that allow one to obtain information about the state (inhibition or irritation) of a particular hematopoietic germ. Relative indicators have no independent meaning,
a are intermediate, “technological” indicators necessary to obtain absolute indicators.
Features of assessing the condition of neutrophils
Assessing the condition of neutrophils, in comparison with other leukocytes, has two features:
1. Quantitatively, the neutrophil content is assessed as the sum of neutrophil subpopulations, regardless of their degree of maturity. In this case, the limit of the relative norm of neutrophils is 50–70%. For example, the patient Ivanov I.I. leukocytes 10.00x109/l, myelocytes 2%, metamyelocytes 4%, band neutrophils 6%, segmented neutrophils 57%.
A) the relative number of neutrophils in total is equal to
2% + 4% + 9% + 67% = 82% (relative neutrophilia).
B) the absolute number of neutrophils is 82% of 10.00x109/l, i.e. (82% x 10.00x109/l) / 100 = 8.20x109/l (absolute neutrophilia).
2. In addition to quantitative assessment, neutrophils are assessed qualitatively according to their degree of maturity.
Assessment of the qualitative state of neutrophils is carried out using calculation nuclear shift index(IAS) or the Solovyov-Bobrov index.
INR is calculated as the ratio of the sum of the relative number of all immature forms of neutrophils present in a given patient to the relative number of mature neutrophils. By mature neutrophils we mean segmented neutrophils. By immature neutrophils we mean band neutrophils, metamyelocytes, myelocytes, promyelocytes and myeloblasts. For example, the patient Ivanov I.I. myelocytes 2%, metamyelocytes 4%, band neutrophils 9%, segmented neutrophils 67%. IAS = (2% + 4% + 9%) / 67% = 0.22.
Normally, the IAS fluctuates within 0,04–0,08 .
Decrease in IAS less than 0.04 called shift of the neutrophil formula to the right (hyporegenerative nuclear shift). A hyporegenerative nuclear shift is observed when neutrophil production in the bone marrow is suppressed and mature forms of neutrophils predominate in the peripheral blood.
Increasing INS above 0.08 called shift of the neutrophil formula to the left. This indicates rejuvenation of peripheral blood neutrophils as a result of increased myelopoiesis in the bone marrow.
There are three types of shift of the neutrophil formula to the left. If the IAS increases within 0,08–0,50 , nuclear shift is called regenerative. A regenerative nuclear shift indicates, on the one hand, the presence and sufficient severity of a pathological process in the body (usually of an inflammatory nature), on the other hand, an adequate protective-adaptive reaction of the body to this pathological process.
If the IAS increases within 0,50–1,00, shift is called hyperregenerative. The presence of such a shift indicates, on the one hand, the high severity of the pathological process, and on the other, an inadequate reaction of the body. With a nuclear shift of this type, overirritation of the bone marrow occurs, as a result of which most of the neutrophils are released from it into the blood in immature, functionally inactive forms. The protective potential of neutrophils does not increase, but decreases.
If IAS increases more than 1.00, a shift in the neutrophil formula is called degenerative. The appearance of a degenerative nuclear shift indicates a primary disruption of the processes of differentiation and maturation of neutrophils. This form of shift of the neutrophil formula to the left is observed most often in leukemia (myeloid leukemia).
Estimation of erythrocyte sedimentation rate
In addition to the actual number of blood cells, standard indicators of a general blood test include erythrocyte sedimentation rate (ESR). Normally, ESR fluctuates within 2–10 mm/hour for men and 5–15 mm/hour for women. In pathogenetic terms, ESR mainly depends on the ratio of gamma globulins and other protein fractions of blood plasma. ESR increases with an increase in the amount of gamma globulins in the blood plasma due to their overproduction against the background of inflammatory, infectious or other processes.
When assessing a general blood test (and other laboratory data), it should be remembered that its clinical and diagnostic interpretation is impossible without taking into account the entire set of clinical and laboratory data. Therefore, when interpreting the results of a separate blood test, one can talk not about the diagnosis as a whole, but only about the presence in a particular analysis of typical hematological symptoms characteristic of a particular pathology. Identifying these symptoms is important for making a preliminary diagnosis and developing a plan for further examination of the patient.
Examples of reading a blood test and interpreting the data obtained
Blood test No. 1
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Indicators |
Result | |
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Red blood cells |
3.50–5.00x1012/l |
|
|
Hemoglobin |
118.0–160.0 g/l |
|
|
Color index | ||
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Reticulocytes | ||
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Platelets |
180.0–320.0x10 9/l |
|
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Leukocytes |
4.00–9.00x10 9/l |
|
|
Basophils | ||
|
Eosinophils | ||
|
Myelocytes |
none |
|
|
Metamyelocytes | ||
|
Band neutrophils | ||
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Segmented neutrophils | ||
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Lymphocytes | ||
|
Monocytes | ||
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Plasma cells | ||
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Hematocrit: M | ||
|
1–16 mm/hour |
||
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Anisocytosis | ||
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Poikilocytosis | ||
|
Polychromatophily | ||
|
Normoblasts | ||
|
Megalocytes | ||
|
Megaloblasts | ||
|
Toxigenic granularity | ||
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The causative agent of malaria | ||
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A few years ago I wrote how they differ in general blood test, which cells become more and less numerous during various infections. The article has gained some popularity, but needs some clarification. Even at school they teach that white blood cell count should be between 4 to 9 billion(× 10 9) per liter of blood. Depending on their functions, leukocytes are divided into several types, therefore leukocyte formula(the ratio of different types of leukocytes) normally in an adult looks like this:
For example, a general blood test revealed 45% lymphocytes. Is it dangerous or not? Should we sound the alarm and look for a list of diseases in which the number of lymphocytes in the blood increases? We’ll talk about this today, because in some cases such deviations in blood tests are pathological, while in others they do not pose a danger. Stages of normal hematopoiesis Let's look at the results of a general (clinical) blood test guy 19 years old, sick The analysis was done in early February 2015 in the Invitro laboratory: Analysis, the indicators of which are discussed in this article In the analysis, indicators that differ from normal values are highlighted in red. Now in laboratory research the word “ norm" is used less frequently, it is replaced by " reference values" or " reference interval" This is done so as not to confuse people, because depending on what is used, the same value can be both normal and abnormal. Reference values are selected in such a way that the test results correspond to them 97-99% healthy people. Let's look at the analysis results highlighted in red. HematocritHematocrit - proportion of blood volume accounted for by formed blood elements(erythrocytes, platelets and platelets). Since red blood cells are much larger in number (for example, the number of red blood cells in a unit of blood exceeds the number of white blood cells in a thousand times), then in fact the hematocrit shows what part of the blood volume (in%) is occupied red blood cells. In this case, the hematocrit is at the lower limit of normal, and other indicators of red blood cells are normal, so a slightly reduced hematocrit can be considered variant of the norm. LymphocytesIn the above blood test 45.6% lymphocytes. This is slightly higher than normal values (18-40% or 19-37%) and is called relative lymphocytosis. It would seem that this is a pathology? But let's count how many lymphocytes are contained in a unit of blood and compare them with the normal absolute values of their number (cells). The number (absolute value) of lymphocytes in the blood is: (4.69 × 10 9 × 45.6%) / 100 = 2,14 × 10 9 /l. We see this figure at the bottom of the analysis; reference values are indicated nearby: 1,00-4,80 . Our result of 2.14 can be considered good, because it is almost in the middle between the minimum (1.00) and maximum (4.80) level. So, we have relative lymphocytosis (45.6% greater than 37% and 40%), but no absolute lymphocytosis (2.14 less than 4.8). In this case, relative lymphocytosis can be considered variant of the norm. NeutrophilsThe total number of neutrophils is calculated as the sum of young (normally 0%), band (1-6%) and segmented neutrophils (47-72%), their total 48-78% . Stages of granulocyte development In the blood test under consideration, the total number of neutrophils is equal to 42,5% . We see that the relative (%) content of neutrophils is below normal. Let's do the math absolute neutrophil count per unit of blood: There is some confusion regarding the proper absolute number of lymphocyte cells. 1) Data from the literature. 2) Reference values for the number of cells from the analysis of the Invitro laboratory(see blood test):
3) Since the above figures do not coincide (1.8 and 2.04), let’s try to calculate the limits of normal cell number values ourselves.
In patient analysis 1.99 × 10 9 neutrophils, which in principle corresponds to normal cell numbers. The level of neutrophils is clearly considered pathological below 1.5× 10 9 /l (called neutropenia). A level between 1.5 × 10 9 /L and 1.9 × 10 9 /L is considered intermediate between normal and pathological. Should we panic that the absolute number of neutrophils is near the lower limit of the absolute norm? No. At diabetes mellitus(and even with alcoholism) a slightly reduced level of neutrophils is quite possible. To make sure that fears are unfounded, you need to check the level of young forms: normal young neutrophils(metamyelocytes) - 0% and band neutrophils- from 1 to 6%. The commentary to the analysis (does not fit in the figure and is cropped to the right) states:
For the same person, the indicators of a general blood test are quite stable: if there are no serious health problems, then the results of tests done at intervals of six months to a year will be very similar. The subject had similar blood test results several months ago. Thus, the considered blood test, taking into account diabetes mellitus, stability of results, the absence of pathological forms of cells and the absence of an increased level of young forms of neutrophils, can be considered almost normal. But if in doubt, you need to observe the patient further and prescribe repeated general blood test (if an automatic hematology analyzer is not able to identify all types of pathological cells, then the analysis should be additionally examined manually under a microscope, just in case). In the most difficult cases, when the situation worsens, they take bone marrow puncture(usually from the sternum). Reference data for neutrophils and lymphocytesNeutrophils The main function of neutrophils is fight bacteria by phagocytosis(absorption) and subsequent digestion. Dead neutrophils make up a significant part pus with inflammation. Neutrophils are " ordinary soldiers» in the fight against infection:
Normal content neutrophils in the blood of an adult:
Leukocytes containing specific granules in the cytoplasm are classified as granulocytes. Granulocytes are neutrophils, eosinophils, basophils. Agranulocytosis- a sharp decrease in the number of granulocytes in the blood until they disappear (less than 1 × 10 9 / l leukocytes and less than 0.75 × 10 9 / l granulocytes). The concept of agranulocytosis is close to the concept neutropenia (decreased number of neutrophils- below 1.5 × 10 9 /l). Comparing the criteria for agranulocytosis and neutropenia, one can guess that only severe neutropenia will lead to agranulocytosis. To give a conclusion " agranulocytosis", a moderately reduced level of neutrophils is not enough. Causes decreased number of neutrophils ( neutropenia):
An increase in the number of neutrophils in the blood (above 78% or more than 5.8 × 10 9 / L) is called neutrophilia (neutrophilia, neutrophilic leukocytosis). 4 mechanisms of neutrophilia(neutrophilia):
For purulent bacterial infections characteristic:
Drawing from the site bono-esse.ru Lymphocytes Lymphocytes are the second most numerous leukocytes in the blood and come in different subtypes. Brief classification of lymphocytes Unlike neutrophils, the “soldiers,” lymphocytes can be classified as “officers.” Lymphocytes “train” longer (depending on the functions they perform, they are formed and multiply in the bone marrow, lymph nodes, spleen) and are highly specialized cells ( antigen recognition, initiation and implementation of cellular and humoral immunity, regulation of the formation and activity of cells of the immune system). Lymphocytes are able to leave the blood into the tissues, then into the lymph and with its current return back to the blood. To decipher a general blood test, you need to have an idea of the following:
Of course, with complete cessation of hematopoiesis First, the level of granulocytes in the blood drops, which becomes noticeable precisely by the quantity neutrophils, because the eosinophils and basophils in the blood and normally very little. A little later the level begins to decrease red blood cells(live up to 4 months) and lymphocytes(up to 6 months). For this reason, bone marrow damage is detected by severe infectious complications, which are very difficult to treat. Since the development of neutrophils is disrupted earlier than other cells ( neutropenia- less than 1.5 × 10 9 /l), then in blood tests it is most often detected relative lymphocytosis(more than 37%), and not absolute lymphocytosis (more than 3.0 × 10 9 / l). Causes increased level of lymphocytes ( lymphocytosis) - more than 3.0 × 10 9 /l:
Causes decreased level of lymphocytes ( lymphocytopenia) - less than 1.2 × 10 9 / l (according to less stringent standards 1.0 × 10 9 / l):
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