general examination of blood

RBC neutrophil hematocyte eosinophil 45% WBC basophilblood monocyte platelet lymphocyte Fg plasma water 55% serum solid element

1.blood cell counterythrocyte countmethod reference interval clinical significanceleukocyte countplatelet countreticulocyte count

1)

(1)()

0.38ml 20ul

Neubauer

3mm WBC WBC

WBC WBC

1mm WBC/L=N/41010620

(2)automated hematology analyzer,AHAprincipal of coulter hematology ststemhistogram

erythrocyte histrogam

normalcyte

microcyte macrocyte

36 360 fl

leukocyte histogram

L M N 35 90 160 450 fl

platelet histogram

2 20 fl

3.5~51012/L 4~5.51012/L2)

1anemia

2

granulocyte poolMitotic poolMaturation poolStorage poolMargin poolCirculating pool

10 Bone marrow 10h 1~2)

4~10109/L

2.determining the concentration of hemoglobinHemoglobin Structuremethodhemiglobincyanide (HiCN)method

THE NORMAL HUMAN HEMOGLOBENS

HemoglobinGlobin ChainsMajor SourceEmbryoNeonateAdult%%%Gower12/2Yolk sac5000Gower22/2Yolk sac2500Portland2/2Yolk sac2500Hb F2/G2aLiver,spleen07512/A2Hba2/2Bone marrow02597HbA22/2Bone marrow013

120160g /L110150g/L170200g/L7094.2122.2g/L86.5111.8g/L

layer after blood centrifuged 3. hematocrit(packed cell volume) definition Relative volume of blood occupied by erythrocytes. An average figure for humans is 45 per cent, i.e. A packed red cell volume of 45ml in 100ml of blood.

0.470.04 0.420.05 3HematocritCentrifugingHematocrit is % of total volume made of cellsAHAHCT=RBCMCV

4.erythrocyte indicesMean corpuscular volume MCV=Hct1031012/RBC fL 80~90fLmean corpuscular hemoglobin MCH=Hb1012/RBCPg 27~32Pgmena corpuscular hemoglobin concentration MCHC=Hb/Hct 320~360

MCV(fl) MCH(pg) MCHC (%) >100 >31 32-36

82-95 27-31 32-36

5.red blood cell volume distribution width, RDWCV 11.6%14.6%

1) 1983BessmanMCVRDW 2)iron deficiency anemia, IDA RDW95% 3) RDW-RDW

6.Erythrocyte sedimentation rate(ESR310min40minThe ESR measures the distance a red blood cell falls in a vertical tube over a given period of time.

1)2) () 18~50010mm/h020mm/h >65510mm/h

3HIVESRSLEESRNHLHLM

7. reticulocyte(Ret ribomucleic acidRNAbrilliant cresyl blue79mICSH4:0.20.3IV0.70.8III

1) 2) -YRNAflow cytometryFCM 3)

0.005~0.015 (24~84)109/L

RetRctRct%mean reticulocyte volume, MCVrreticulocyte hemoglobin distribution width , HDWrreticulocyte hemoglobin content , CHrmean reticulocyte hemoglobin concentration , MCHCrLFRMFRHFRreticulocyte maturity index RMIRMI=MFR+HFR/LFR100

1 122 Ret3 clinical significance of reticulocyte count

8blood film examinationmaking and staining blood film:

obseve erythrocyte form and distributionobserve leukocyte formobserve platelet formobserve parasite

observe erythrocytecoloursizeshapeabnormal structure normal erythrocytered cell observed under electric microscope

(rouleaux formation)

observe leukocytedifferential leukocyte count abnormal white cell

(5%)10%25%1)shift to the left()

2)shift to the right53%

(1)(neutrophilia)70%7l09/L

(1020) l09/L(2030) l09/L

()1236h ,10l09/L12d112h(1020) l09/L

(acute myelogenous leukemiaAML)(acute lymphocytic leukemiaALL)(1050) l09/L100l09/L10%(100600) l09/L 50l09/L

2neutropenia l09/Lgranulocytopenia0.5l09/L(agranulocytosis)

12(aleukemic leukemia)34systemic lupus erythematosusSLE5

4

/

1DhlePelgerHuetChediakHigashiMayHegglinAlder-Reilly

21abnormal lymphocyte23ALLCLL

3(plasma cellflame cell

Dacie and Lewis PRACRICAL HAEMATOLOGY TENTH EDITIONClinical Laboratory MedicineKenneth D. McClatchey

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