2020年12月21日星期一

what does a hemorrhoids look like,Yiwen teaches you to understand the significance of routine blood tests

    Blood test

    White blood cell count (WBC)

    Peripheral blood leukocytes originate from hematopoietic stem cells in the bone marrow. White blood cells include granulocytes, lymphocytes and monocytes. Among them, granulocytes are divided into neutrophils, neutrophils and eosinophils. Cells and basophils. White blood cell count is to measure the total number of various white blood cells in the blood.

    Reference

    Adult: (4~10)×109/L.

    Children: (5~12)×109/L.

    Newborn: (15-20)×109/L.

    Clinical significance

    1. Leukocytosis

    (1) Physiology Mainly seen in premenstrual, pregnancy, childbirth, lactating women, strenuous exercise, excitement, drinking, after meals, etc. Newborns and infants are higher than adults.

    (2) Pathological is mainly seen in various bacterial infections, severe tissue damage or necrosis, leukemia, malignant tumors, uremia, diabetic ketoacidosis, and acute poisoning of chemical drugs such as organophosphorus pesticides and hypnotics. The application of certain white blood cells The chemical drugs will also promote the increase of white blood cells.

    2. Leukopenia

    (1) Diseases are mainly seen in influenza, aplastic anemia, leukemia, etc.

    (2) Medications Use sulfa drugs, antipyretic analgesics, some antibiotics, antithyroid agents, antitumor drugs, etc.

    (3) Special infections such as Gram-negative bacterial infection (typhoid fever, paratyphoid fever), Mycobacterium tuberculosis infection, viral infection (rubella, hepatitis), parasitic infection (malaria), etc.

    (4) The influence of other radiation, chemicals (benzene and its derivatives), etc.

    There are many factors that affect the white blood cell count. If necessary, it should be combined with white blood cell classification and white blood cell morphology and other indicators to make a comprehensive judgment.

    ? White blood cell differential count (DC)

    The white blood cell classification count is to classify the blood after making a smear, and obtain the ratio of various white blood cells. Different factors can cause changes in different types of white blood cells. Therefore, changes in the classification and count of white blood cells can better reflect the physiological or pathological state of the body than the total number of white blood cells.

    Reference

    The absolute value of neutrophils (2.0~7.0)×109/L, the percentage is 50%~70%.

    The absolute value of eosinophils (0.02~0.5)×109/L, the percentage is 0.5%~5%.

    The absolute value of basophils <(0.1) × 109/L, the percentage is 0% to 1%.

    The absolute value of lymphocytes (0.8~4.0)×109/L, the percentage is 20%~40%.

    The absolute value of monocytes (0.12~0.8)×109/L, the percentage is 3%~8%.

    Clinical significance

    【Neutrophils】

    1. Increased neutrophils

    (1) Acute infection or purulent infection, including local infection (abscess, furuncle, tonsillitis, appendicitis, otitis media, etc.); systemic infection (pneumonia, erysipelas, sepsis, scarlet fever, diphtheria, acute rheumatic fever). The percentage of mildly infected white blood cells and neutrophils may increase; moderately infected counts may be> 10.0 × 109/L; severely infected counts may be greater than 20.0 × 109/L, accompanied by obvious leftward shift of nuclei.

    (2) Poisoning: uremia, diabetic ketoacidosis, substituting acidosis, early mercury poisoning, lead poisoning, or hypnotics, organophosphate poisoning.

    (3) Hemorrhage and other diseases. Acute bleeding, acute hemolysis, post-operation, malignant tumor, granulocytic leukemia, severe tissue damage, myocardial infarction and vascular embolism, etc.

    (4) See "Leukocytosis" for physiology.

    2. Neutropenia

    (1) Diseases typhoid fever, paratyphoid fever, malaria, brucellosis, certain viral infections (such as hepatitis B, measles, influenza), blood diseases, anaphylactic shock, aplastic anemia, high-grade cachexia, neutropenia or deficiency Disease, hypersplenism, autoimmune diseases, etc.

    (2) Poisoning damage, heavy metal or organic poisoning, radiation damage, etc.

    (3) Medication Anti-tumor drugs, benzodiazepine sedatives, sulfonylurea insulin secretagogues, antiepileptic drugs, antifungal drugs, antiviral drugs, antipsychotics, some non-steroidal anti-inflammatory drugs, etc.

    【Eosinophils】

    1. Eosinophilia

    (1) Allergic diseases Bronchitis, bronchial asthma, urticaria, drug-induced rash, angioedema, food allergy, tropical eosinophilia, serum sickness, allergic pneumonia, etc.

    (2) Skin diseases and parasitic diseases Psoriasis, eczema, pemphigus, herpetiform dermatitis, fungal skin diseases, paragonimiasis, hookworm disease, cysticercosis, schistosomiasis, filariasis, tapeworm disease, etc.

    (3) Blood diseases, chronic myelogenous leukemia, eosinophilic leukemia, etc.

    2. Eosinophilia

    (1) Disease or trauma: It is found in typhoid fever, paratyphoid fever, after major surgery, severe burns, etc.

    (2) Long-term use of adrenal corticosteroids or corticotropin, etc.

    【Basophils】

    1. Basophilia

    (1) Diseases: Chronic myeloid leukemia, often accompanied by basophilia, up to 10% or more; or lymphonectocytoma, polycythemia, rare eosinophilic leukemia, myelofibrosis or metastatic cancer, etc. .

    (2) Trauma and poisoning After splenectomy; lead poisoning, bismuth poisoning, and injection of vaccines.

    2. Basophilia

    (1) Rapid allergic reactions to diseases such as urticaria, anaphylactic shock, etc.

    (2) Medications are seen in ACTH, excessive use of ACTH and stress response.

    【Lymphocyte】

    1. Lymphocytosis

    (1) Infectious diseases: whooping cough, infectious mononucleosis, infectious lymphocytosis, tuberculosis, chickenpox, measles, rubella, mumps, infectious hepatitis, tuberculosis and other infectious diseases in the recovery period.

    (2) Hematological diseases Acute and chronic lymphocytic leukemia, leukemic lymphosarcoma, etc., can cause an absolute increase in lymphocyte count; aplastic anemia and agranulocytosis can also cause a relative increase in the percentage of lymphocytes. In addition, it can also be seen in the rejection period after kidney transplantation.

    2. Lymphopenia

    Acute phase of infectious diseases, radiation sickness, cellular immunodeficiency disease, long-term use of adrenal cortex hormones or exposure to radiation, etc. In addition, when neutrophils increase due to various reasons, lymphocytes can also be relatively reduced.

    【Monocytes】

    Mononucleosis can be seen in

    (1) Infectious diseases or parasitic diseases such as tuberculosis, typhoid fever, subacute bacterial endocarditis, convalescence of acute infectious diseases, malaria, kala-azar.

    (2) Hematological diseases, monocytic leukemia, and agranulocytosis recovery period.

    (3) Other diseases are subacute bacterial endocarditis.

    ? Red blood cell count (RBC)

    Red blood cells are the most abundant formed component in the blood. As a respiratory carrier, they can carry and release oxygen to various tissues of the body while transporting carbon dioxide, coordinately regulating the maintenance of acid-base balance and immune adhesion. Red blood cell count is one of the main indicators for diagnosing anemia.

    Reference

    Male: (4.0~5.5)×1012/L.

    Female: (3.5~5.0)×1012/L.

    Newborn: (6.0~7.0)×1012/L.

    Clinical significance

    1. Red blood cells

    (1) Relative increase

    Seen in: Severe vomiting, diarrhea, excessive urination, shock, hyperhidrosis, extensive burns, due to a large amount of water loss, reduced plasma volume, blood concentration, the concentration of various components in the blood increases accordingly, which is only a temporary phenomenon .

    (2) Absolute increase

    Seen in: ① Physiological increase, such as hypoxia and high altitude living, fetus, newborn, strenuous exercise or physical labor, accelerated release of red blood cells from bone marrow, etc.; ② Pathological compensation and secondary increase, often secondary to chronic lung Patients with heart disease, emphysema, mountain sickness and tumors (kidney cancer, adrenal tumors); ③Treat red blood cells increase, which is chronic hypermyelofunction of unknown cause, and the red blood cell count can reach (7.0~12.0)×1012/L.

    2. Red blood cell reduction

    (1) Lack of hematopoietic substances is caused by malnutrition or malabsorption, such as chronic gastrointestinal diseases, alcoholism, partial eclipse, etc., causing insufficient iron, folic acid, vitamins and other hematopoietic substances, or insufficient protein, copper, and vitamin C can cause anemia .

    (2) Low bone marrow hematopoietic function Primary aplastic anemia, leukemia, cancer bone metastasis, etc. caused by a variety of physical and chemical factors such as drugs and radiation can inhibit normal hematopoietic function.

    (3) Red blood cells are destroyed or lost too much, such as congenital blood loss or acquired hemolytic anemia, acute and chronic hemorrhagic anemia, bleeding, etc.

    (4) Secondary anemia such as various inflammations, connective tissue diseases, endocrine diseases, etc.

    Hemoglobin (Hb)

    Hemoglobin is often referred to as "hemoglobin". It is the main component of red blood cells and is responsible for the body's function of transporting oxygen to organs and tissues and carbon dioxide. The clinical significance of the increase or decrease is basically the same as that of the increase or decrease of red blood cells, but hemoglobin can better reflect the degree of anemia.

    Reference

    Male: 120~160g/L.

    Female: 110~150g/L.

    Newborn: 180~190g/L.

    Clinical significance

    The decrease in the amount of hemoglobin is an important indicator for the diagnosis of anemia, but the type of anemia cannot be determined, and a comprehensive analysis must be combined with other detection indicators.

    1. Increased hemoglobin

    (1) Diseases: Chronic pulmonary heart disease, cyanotic congenital heart disease, polycythemia vera, altitude sickness, large cell hyperchromic anemia, and certain tumors such as kidney cancer.

    (2) Trauma A lot of water loss, severe burns, etc.

    2. Reduced hemoglobin

    (1) The degree of reduction of hemoglobin is the same as that of red blood cells, which is seen in major bleeding, aplastic anemia, rheumatoid arthritis, and acute and chronic. Bleeding caused by nephritis.

    (2) The degree of hemoglobin reduction in other diseases is more serious than that of red blood cells. It is seen in iron deficiency anemia and is caused by chronic repeated bleeding, such as gastric ulcer disease, gastrointestinal tumors, menorrhagia, hemorrhoid bleeding, etc.; the degree of red blood cell reduction It is more serious than hemoglobin, and is seen in large cell hyperchromic anemia, such as malnutrition anemia lacking vitamin B12, folic acid, and anemia caused by chronic liver disease.

    Platelet count (PLT)

    The main functions of platelets are: ① Nutrition and support for capillaries; ② Through adhesion, aggregation and release reactions, white thrombosis is formed in the wound to stop bleeding; ③ A variety of platelet factors are produced, which participate in blood coagulation and form thrombus to further stop bleeding; ④ The release of platelet contractile protein causes the fibrin network to shrink and promote blood coagulation. Platelets can vary by 6%-10% at different times in a day.

    Reference

    (100~300)×109/L.

    Clinical significance

    1. Thrombocytopenia

    (1) Decreased platelet production, bone marrow hematopoietic dysfunction, aplastic anemia, various acute leukemias, bone marrow metastases, myelofibrosis, multiple myeloma, giant hemangioma, systemic lupus erythematosus, pernicious anemia, megaloblastic anemia.

    (2) Excessive platelet destruction, idiopathic thrombocytopenic purpura, liver cirrhosis, hypersplenism, cardiopulmonary bypass, etc.

    (3) Abnormal platelet distribution, splenomegaly, blood dilution caused by various reasons.

    (4) Other diseases: Diffuse intravascular hemorrhage, paroxysmal nocturnal hemoglobinuria, certain infections (such as typhoid fever, kala-azar, measles, hemorrhagic fever before polyuria, infectious mononucleosis, miliary tuberculosis and sepsis) , Bleeding disorders (such as hemophilia), scurvy, obstructive jaundice, allergic purpura, etc.

    (5) Drug poisoning or allergy. For example, thiamphenicol has myelosuppressive effect and can cause thrombocytopenia; antiplatelet drugs ticlopidine and aspirin can also cause thrombocytopenia; application of certain antitumor drugs, antibiotics, and cytotoxic drugs can cause thrombocytopenia.

    2. Thrombocytosis

    (1) Trauma Acute hemorrhagic anemia, transient thrombocytosis can be seen after spleen removal, fractures, and blood.

    (2) Other diseases are seen in essential thrombocythemia, chronic myelogenous leukemia, polycythemia vera, multiple myeloma, myelodysplasia, leukemia reaction, Hodgkin's disease, early malignant tumor, ulcerative colitis Wait.

    Erythrocyte Sedimentation Rate (ESR)

    Erythrocyte sedimentation rate refers to the sedimentation distance of erythrocytes in a certain condition F and unit hour, referred to as blood. The density of red blood cells is greater than the density of plasma, and under the action of gravity, a natural downward settlement force is produced. Generally speaking, in addition to some physiological factors, where there is infection or necrotic tissue in the body, the erythrocyte sedimentation rate can be accelerated, indicating the existence of disease. The erythrocyte sedimentation rate is a traditional and widely used indicator. Although it lacks specificity for diagnosing diseases, it is easy to operate and has practical value for dynamic observation of the effect of the disease.

    Reference

    Westergren method:

    Male: 0~15mm/h;

    Female: 0-20mm/h.

    Clinical significance

    Increased erythrocyte sedimentation rate

    1. Physiological increase

    Seen in women during menstruation and more than 3 months of pregnancy (within 3 weeks after delivery).

    2. Pathological increase

    (1) Inflammation caused by rheumatic fever, tuberculosis, acute bacterial infection, etc.

    (2) Tissue damage and necrosis such as surgery, trauma, myocardial infarction, etc.

    (3) Malignant tumors with rapidly growing erythrocyte sedimentation rate increase faster, while benign tumors have more normal erythrocyte sedimentation rate.

    (4) Hyperglobulinemia caused by various reasons, such as multiple myeloma, liver cirrhosis, systemic lupus erythematosus, chronic nephritis, anemia, and hypercholesterolemia.

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