Blood tests are used to detect changes in the number and morphological distribution of blood cells to determine abnormal blood conditions and possible causes.
Red cell-related tests also include hemoglobin (Hb), which is the main oxygen-carrying component of red cells, hematocrit (HCT), and hemoglobin concentration; white blood cells can be further divided into percentages and absolute counts of different subtypes of cells.
Common clinical significance is as follows:
Red blood cell count (RBC)
Normal reference range
- Neonates: (6.0-7.0)×10/L;
- Infants: (5.2 to 7.0) × 10/L;
- Children: (4.2 to 5.2) × 10/L;
- Adult male: (4.0 to 5.5) × 10/L;
- Adult female: (3.5 to 5.0) × 10/L.
Clinical significance
Pathologic changes:
- RBC increase: frequent vomiting, excessive sweating, massive burns, hemoconcentration, chronic pulmonary heart disease, emphysema, plateau disease, tumors, and true erythrocytosis may lead to RBC increase;
- Common causes of decreased RBCs include.
- Decreased RBC production, such as leukemia;
- increased RBC destruction, such as acute hemorrhage, severe tissue injury resulting in blood cell destruction;
- Impaired RBC synthesis, seen in iron deficiency, vitamin B12 deficiency, etc.
Physiological changes:
- After excluding the above causes, increased RBCs also require consideration of.
- Psychological factors (impulsivity, excitement, fear, and cold bath stimulation can all lead to increased adrenaline secretion)
- RBC compensatory hyperplasia (hypoxic stimulation due to low air pressure, e.g. plateau zone; multiple blood donations over time)
- RBC reduction: seen in pregnancy, rapid growth in infants and children aged 6 months to 2 years, relative shortage of hematopoietic material, and decreased hematopoiesis in some older adults.
Hemoglobin (Hb)
Normal reference range
- Males 120 to 160 g/L;
- Female 110 to 150g/L;
- Newborns 170 to 200g/L.
Clinical significance
The values based on (30, 60, 90) g/L are classified as mild, moderate and severe with different severity.
According to the mean corpuscular volume (MCV), the mean corpuscular hemoglobin concentration (MCHC), which is further divided into three categories:
Hematocrit (HCT):
Normal reference range
- Male: 40% to 50%;
- Female: 35% to 45%.
Clinical significance
- Increased: Suggests excessive red blood cells, which are seen in massive burns, continuous vomiting, diarrhea, and dehydration, in addition to pathological erythrocytosis.
- Decreased: seen in patients with anemia, and heavy rehydration, etc.
White blood cell count:
Normal reference range
- Adults: (4.0 to 10.0)×10/L;
- Neonates: (15.0-20.0)×10/L.
Clinical significance (specific significance to be considered in combination with the distribution of leukocyte subtypes):
- Physiological abnormalities: seen after strenuous exercise, feeding, pregnancy, and neonates.
- Pathologic abnormalities: seen in acute septic infection, uremia, leukemia, tissue injury, acute bleeding, etc.; pathologic leukopenia seen in aplastic anemia, certain infectious diseases, cirrhosis, hypersplenism, radiotherapy chemotherapy, etc.
White blood cell sorting count:
Major leukocyte subtypes
- Neutrophils (0.5-0.7)×10/L (50%-70%);
- Eosinophils (0.01-0.05)×10/L (1%-5%);
- basophils (0-0.0l)×10/L (0-1%);
- Lymphocytes (0.20-0.40)×10/L (20%-40%);
- monocytes (0.03-0.08) × 10/L (3%-8%).
Clinical significance
- Neutrophils: the body’s major defense, phagocytic cells that play an important role in infections and other processes.
- Lymphocytes.
- Decreased: Most often seen in the acute phase of infectious disease, radiation sickness, cellular immunodeficiency disease, after long-term application of adrenocorticotropic hormones, or exposure to radiation.
- increased: seen in infectious lymphocytosis, tuberculosis, malaria, chronic lymphocytic leukemia, pertussis, certain viral infections, etc.
- Eosinophilia: generally very low, increased in allergic diseases, skin diseases, parasitic diseases, some blood diseases and tumors such as chronic granulocytic leukemia, nasopharyngeal carcinoma, lung cancer, and cervical cancer.
- Basophils: generally very low, increased in hematologic diseases such as chronic granulocytic leukemia, trauma and poisoning, malignancies, allergic diseases, etc.
- Monocytes: increased in infectious or parasitic diseases, active tuberculosis, monocytic leukemia, malaria, etc.
Platelet count
Normal reference range: (100 to 300) × 10/L
Clinical significance
- Increased platelet count: seen in acute major blood loss and acute infection after hemolysis; true erythrocytosis, primary thrombocytosis, multiple myeloma, chronic granulocytic leukemia, and early stages of certain malignancies.
- Decreased platelet count: seen in.
- impaired bone marrow hematopoiesis, such as aplastic anemia, acute leukemia;
- Excessive platelet destruction, e.g. hypersplenism;
- Excessive platelet depletion, such as diffuse intravascular coagulation
In summary, when a patient gets a routine blood report, if the indicators are not abnormal, it does not mean that the patient does not have a disease, and all other tests need to be combined to judge the patient. When a routine blood report has abnormal indicators, each person’s situation is different, and the report should be interpreted by the doctor to get the most appropriate diagnosis and treatment.