血液一般检查课件

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1、EosinophilNeutrophilBandLymphocyteMonocyteBlood routine test (Blood routine test (BRTBRT) )-血液常血液常规检验规检验标标本采集Sample collecting mostly the sample is colleted from vein After sterilize with iodine tincture and alcohol it can also be collected from capillary by pricking the fingerip,heel, great toe or

2、earlobeBut we are always choose vein as the pricking position样样本采集后的处处理 立即加入加有抗凝剂的试管内，并混匀 抗凝剂：EDTA-K2Contents (3 part) RBC (red blood cells)红细 胞 WBCs (white blood cells)白细胞 PLT (platelets)血小板1. The number of red blood cells (RBC) vThe amount of hemoglobin in the blood (Hb)1. Hematocrit （Hct）2. mean

3、corpuscular volume (MCV) 3. Mean corpuscular hemoglobin（MCH）4. Mean corpuscular hemoglobin concentration (MCHC)7.Red blood cell volume distribution width（RDW) RBC related parametersNormal values RBC： Male: 4.0-5.5 1012/LFemale: 3.5-5.0 1012/L Hb： Male: 120-160 g/LFemale: 110-150 g/LRBC and Hb临床意义：增多

4、：a.相对对性增多：如呕吐、烧伤烧伤 、大量 出汗时时致血液浓缩浓缩 。b.绝对绝对 增多：继发继发 性红细红细 胞增多症如 各种心肺疾病所致红细红细 胞代偿偿性或非代偿偿性增加、真性红细红细 胞增多症。减少：a.生理性减少如妊娠、老年等。b.病理性减少见见于各种贫贫血。HCT or PCV（P262)Anticogulated bloodForm two layersDifinition:抗凝全血经经离心沉淀后测测得的红细红细 胞占全血的容积积百分比calculate formula: 血细细胞体积积 / 全血细细胞体积积临临床意义义同RBC和HbMCV (mean corpuscular

5、volume)平均红细红细 胞容积积系指全血中每个红细红细 胞的平均体积积，以飞飞升（fl)为单为单 位（ unit: fl 10-15L) MCV = HCT / RBC 反映平均红细胞的体积MCV,MCH,MCHC（P262） MCH (mean corpuscular hemoglobin) 平均红细红细 胞血红红蛋白量 系指每个红细红细 胞内所含血红红蛋白的平均量，以皮克(pg)为单为单 位。(unit: pg10-12g) MCH = Hb / RBC 反映了每个红细红细 胞内的平均血红红蛋白含量 MCHC (mean corpuscular hemoglobin concentra

6、tion) 平均红细红细 胞血红红蛋白浓浓度MCHC 系指每升血液中平均所含血红红蛋白浓浓度，以g/L表示。 MCHC = Hb / HCT 反映了血液中血红蛋白浓度三个指标标互相联联系 MCV = HCT / RBC MCV = MCH / MCHC MCHC = Hb / HCT MCHC = MCH / MCV MCH = Hb / RBC MCH = MCHC MCV MCV,MCH and MCHC reflect the size and hemoglobin concentration of individual RBC useful in the diagnosis of va

7、rious types of anemia Application: P263,table 4-2-4MCV、MCH、MCHC在贫贫血的形态态学分类类上具重要意 义义the report of BRT for the girl shows RBC: 3.0 1012/L (3.8-5.2 1012/L) Hb：108 g/L (117-157g/L) MCV:70fl (80-100fl) MCHC:290g/L (320-360g/L) MCH:22pg (27-34pg)caseWe can judge The girl got anemia. we can primary diagnos

8、e that maybe she is IDA,or chronic blood loss caused anemia,while the AA, acute loss anemia, hemolytic anemia, megloblastic anemia, and pernicious anemia can be excluded. Combined with her clinical manifestation and other auxiliary examination,we can do the last diagnosis. RDW(RBC volume distributio

9、n width) 红细红细 胞体积积分布宽宽度 反映外周血红细红细 胞体积积异质质性的参数。 是反映红细红细 胞大小不等的客观观指标标volumenumberRDW 其对贫对贫 血的诊诊断有重要意义义。 Application: P263,table 4-2-5 白细细胞计计数The number of white blood cells Normal values：adult 4-10109/L白细胞WBCs白细细胞分类类 The diffrential of WBCs 中性粒细细胞Neutrophil (Ne) 嗜酸性粒细细胞Eosinophil (Eo) 嗜碱性粒细细胞Basophil

10、(Ba) 淋巴细细胞Lymphocyte (Ly) 单单核细细胞Monocyte (Mo)白细细胞分类类两种描述方式: the percentage the absolute countNormal values of each component：Ne 50-70Ly 20-40M 3-8%Eo 0.5-5%Ba 0-1%Neutrophil (Ne) Granule:very tiny, light staining Nuclear:frequently multi-lobed，3-5 lobeswaxberryEosinophilEosinophil (Eo) Granule: larg

11、e, numerous and equal, stained pink or red Nuclear: often has two lobes(telephone receiver) Basophil (Ba) Nuclear: irregular,stain deep blue topurple,often covered by granules Granule:numerous, uneven, can mask the nucleus dirtyLymphocyte (Ly)it is much smaller than others Nuclear: very large for th

12、e size of the cell,almost taken up the whole cell,only left a rim of cytoplasm. Cytoplasm: clear, stains pale blue, often very fewthe color of the cytoplasm is just like the skysMonocyte (Mo)the largest cell among the five types Cytoplasm: abundant and stains pale blue Nuclear: often shaped “ U “ or

13、 kidney bean Neutrophil Eosinaphil Basophil Lymphocyte Monocyte粒细胞非粒细胞临临床意义义五类类白细细胞中任何组组分的变变化均会引起白细细胞总总数的变变化. Ne Eo Ba LyMoNe-升高 生理性: 孕妇，剧烈运动后等 病理性: 大部分的急性疾病急性感染 (尤其是细细菌性)急性溶血 急性失血大部分的白血病The increase/decrease of WBC is mainly caused by Ne!Ne- 下降 某些特殊的感染(病毒，伤伤寒，副伤伤寒) 血液病（AA、IDA、PNH) X 线线、化学因素等 脾功能亢进进

14、 自身免疫性疾病 (SLE)术术 语语 白细细胞减少症: WBC 4.0109/L 中性粒细细胞减少症: Ne 1.5109/L 核左移和核右移（p255)Eo 增高： allergy（变态变态 反应应） (food、medicine、pollen）verminosis（寄生虫病） 下降：无实际临实际临 床应应用价值值。Ba 增高: 某些血液病 (CML :chronic myelocytic leukemia)(Bone marrow fibrosis)allergy 下降：无实际临实际临 床应应用价值值。Ly 主要的免疫细细胞 增高： 感染（主要为为病毒感染后）tumors（肿肿瘤）移植排斥反应应 下降： 免疫功能下降 应应用免疫抑制剂剂后glucocorticoidsMoMo 增高： 亚亚急性心内膜炎M5 下降：无实际临实际临 床应应用价值值。PLT 相关参数 The number of platelets（PLT) 血小板数量normal value: (100-300)109/L Mean platelet volume（MPV)平均血小板体积积 Platelet distribution width（PDW)血小板体积积分布宽宽度摘 要 掌握血常规标 本采用的标本及抗凝剂 掌握RBC、WBC、PLT数量及血红蛋白的正常参