Routine blood tests, the first of the three routine tests, are one of the most common tests used by doctors to diagnose medical conditions. The most commonly used blood tests include hemoglobin measurement, red blood cell count, white blood cell count and white blood cell sorting count.
White blood cell count:
White blood cell count (WBC) normal adults (4.0~10.0)×109/L, newborns (15.0~20.0)×109/L, 6 months-2 years old infants and children (5.0~12.0)×109/L.
1. Leukocytosis.
The first thing that comes to mind with leukocytosis is the presence of infection, but you may not know that chronic leukemia, malignancy, uremia, diabetic ketoacidosis, and acute poisoning from chemical drugs can also cause leukocytosis. Leukocytosis needs to be taken seriously enough because it can be a symptom of chronic leukemia, which, if not treated promptly, can lead to accelerated or acute lesions of slow-growing leukemia.
In addition to these pathological causes, there are also physiological causes such as leukocytosis around the time of menstruation, pregnancy, women during childbirth, strenuous exercise, excitement, and alcohol consumption. Therefore, when you see elevated leukocytes, do not jump to a diagnosis, it may be caused by physiological causes.
2. Leukopenia.
Leukopenia, as a doctor, perhaps the first thing that comes to your mind is still a pathological disease, but you should also be careful not to ignore the physiological and drug causes. Influenza, measles, granulocyte deficiency, remittance and leukemia can all cause leukopenia. Of course, there are also some “false positives” that are easily overlooked.
When a patient is taking sulfonamides, antipyretics, some antibiotics (such as cephalosporins), antithyroid or antitumor drugs, it can cause leukopenia, which can be recovered by discontinuing them. For chemotherapy patients due to the adverse effects of chemotherapy drugs, there will also be a decrease in white blood cells, you can take some white-raising drugs.
3. Leukocyte classification count.
White blood cells are a “large family”, divided into neutrophils, eosinophils, basophils, monocytes and lymphocytes.
The normal value of neutrophils is 50% to 70%, eosinophils 0.5% to 5%, basophils 0 to 1.0%, lymphocytes 20% to 40%, and monocytes 3% to 8%.
(1) Increased.
The most common is neutrophilia, which, along with leukocytes, can be an indicator for determining infection because it is often caused by acute, septic infections. In contrast, normal leukocytes and high neutrophils are not necessarily an infection, as neutrophils fluctuate physiologically.
Of particular concern is the finding that patients with neutrophilia have a higher incidence of coronary heart disease, which is often severe, and a higher mortality rate in patients with cancer. In addition to pathological diseases that increase eosinophilia, there is also an increase when drugs such as midazapril, cefradine, and cefuroxime sodium are applied.
(2) Decrease.
When patients have diseases such as typhoid fever and paratyphoid fever, it may cause a decrease in each cell of the leukocyte classification. And neutropenia is caused when patients take antineoplastic drugs, benzodiazepine sedatives, antiepileptic drugs, etc. And eosinophilic or basophilic granulocytopenia can occur with long-term application of drugs such as adrenocorticotropic hormone or candesartan.
Red blood cell count.
Red blood cells are an important “player” in the blood, with normal values (4.09~5.74)×1012/L for men and (3.68~5.74)×1012/L for women.
1. Erythrocytosis.
In addition to unexplained chronic bone marrow hyperfunction causing true erythropoiesis, erythrocytes can reach up to (7~12)×1012/L. In addition to this there are some physiological causes that can lead to an increase in erythrocytes, such as a faster rate of erythrocyte release from the bone marrow when the body is hypoxic and living on a plateau.
There is also a relative increase in red blood cells, when a large amount of water loss such as vomiting, diarrhea, sweating, shock, etc., the amount of plasma is reduced, blood concentration, then the concentration of each component in the blood increases accordingly. However, it is only a temporary phenomenon, and the red blood cells tend to normalize after the symptoms are relieved. Which can be measured by the red blood cell pressure product to understand the degree of blood concentration, as a clinical basis for the amount of rehydration.
2. Red blood cell reduction.
Different causes of anemia such as aplastic anemia, blood loss anemia, etc. can cause a decrease in red blood cell count.
Hemoglobin.
Hemoglobin (Hb) – the main component that makes up red blood cells, the clinical significance of its increase or decrease is the same as that of red blood cell increase or decrease, and can better reflect the degree of anemia. The normal values are 131~172 g/L for men and 113~151 g/L for women.
1. Increased hemoglobin.
Chronic pulmonary heart disease, true erythrocytosis, plateau disease and other pathological causes can cause hemoglobin increase. In the case of massive water loss and severe burns, blood concentration can also cause increased hemoglobin, but this condition requires special attention and may mask the symptoms of anemia.
There are also conditions that are often easy to overlook, such as when patients are taking drugs such as sodium para-aminosalicylate, primaquine, vitamin K, nitroglycerin, etc., which can also increase Hb, so the effects of taking these drugs should be excluded when diagnosing the disease.
2. Hemoglobin reduction.
(1) The degree of hemoglobin reduction = the degree of red blood cell reduction, mostly seen when bleeding. And because hemoglobin can interact with certain substances to form a variety of hemoglobin derivatives, it can also be used to diagnose certain hematologic diseases.
(2) The degree of hemoglobin reduction > the degree of erythrocyte reduction, which is mostly seen in iron deficiency anemia.
(3) Hemoglobin reduction < erythrocytopenia, most often seen in megaloblastic anemia.
Hemoglobin measurement can also provide a basis for determining the severity of anemia, with >90 g/L being mild, 60-90 g/L moderate, 30-59 g/L severe, and <30 g/L very severe anemia.
Platelet count
Platelets can produce a variety of platelet factors and participate in blood coagulation, normal value (100~300)×109/L for men and (101~320)×109/L for women.
1. Pathological causes.
A variety of conditions can cause thrombocytopenia, such as bone marrow hematopoietic dysfunction, aplastic anemia, etc. will reduce platelet production. Liver cirrhosis, hypersplenism, etc. will cause excessive platelet destruction; splenomegaly, various causes of hemodilution will cause abnormal platelet distribution. In addition to pathological diseases that cause thrombocytopenia, there is also transient thrombocytosis seen in acute hemorrhagic anemia, post-spleen removal, fracture, post-hemorrhage and other traumas.
2. Drug-induced thrombocytopenia.
There are also some drugs caused by poisoning or allergies when taking some drugs can also make platelet reduction. For example, when taking chloramphenicol has a myelosuppressive effect, can cause thrombocytopenia; anti-platelet drugs such as aspirin can also cause thrombocytopenia; there are some anti-tumor drugs, antibiotics, sulfonamides can also cause thrombocytopenia.