Update: December 2018
Complete blood count is perhaps the most common
examination at the hospital. Whatever pathology the patient has
went to the doctor, the first thing the doctor prescribes is
The results of the general blood test are very informative.
From this study, you can gather information about the state
the patient as a whole, determine whether the body has inflammatory
or tumor process.
After studying a complete blood count, a competent doctor can, if
Do not make a final diagnosis, so at least suspect it.
In order for the study to be informative for a specialist,
he needs to be thoroughly prepared. Alcohol intake or medication
on the eve may distort the results of the analysis, prevent the identification of
causes of disease.
How to prepare for the delivery of material?
- blood must be donated in the morning on an empty stomach. there is
allowed the night before to pass about 10-12 hours after
the last meal;
- dinner before the study should be light, not recommended
eat fatty or spicy dishes, smoked meats, canned foods;
- it is strictly forbidden to drink alcohol the day before
- It is not recommended to smoke, drink tea or
coffee. Patients can only drink non-carbonated water;
- you can not donate blood after medical gymnastics, massage,
acupuncture, sports, physiotherapy, some
examinations (x-ray, ultrasound, MRI, radionuclide techniques);
- before taking the material you should try not to be nervous if
the patient was getting to the hospital for a long time, we must give him time
- If possible, do not take medications the day before and
on the day of the study;
- when medication is vital for the patient
(for example, insulin or antihypertensive drugs), it should
notify the laboratory doctor about this;
- to be tested in dynamics is desirable in the same
How to take blood for general analysis?
For this manipulation, blood is drawn from a finger or
veins. Asepsis rules must be strictly observed in the laboratory.
(cleaning of premises with disinfectants, quartz treatment). Laboratory assistant is required
take blood in sterile gloves, after having processed them 70%
ethyl alcohol. When taking material from a finger, the technician usually
pierces the end phalanx with 4th disposable scarifier
(unnamed) finger. In infants for this purpose use the lobe
ear or big toe.
Blood sampling from a vein (usually the elbow) is performed either
sterile syringe or special vacuum blood collection system
– vacutainer. The vacutainer consists of a needle, a cylinder and special
test tubes that vary in color depending on the desired
studies (for the general analysis of blood use purple
test tube, it contains a special anticoagulant – EDTA).
Vakutayner, compared with a conventional syringe, has large
- First, this method of taking material is safer for
laboratory assistant, as there is no contact with blood.
- Secondly, with a vacuum intake, blood cells are smaller.
damaged and not in contact with air.
Normal blood count
|Indicator||International designation||Norm of indicators|
|Hemoglobin||Hb or HGB||
Men – 132-153 g / l
Women – 119-141 g / l
|Red blood cells||RBC||
Мужчины – 4,1-5,07 *1012/л
Женщины – 3,68-4,59*1012/л
|Hematocrit||HTC or HTC||
Men – 40-48%
Women – 36-42%
|Average red blood cell volume||MCV||76 – 96 femtoliter|
|Average hemoglobin content||MCH||27 to 32 picagrams|
Men – 1.05-10.1 mm / h
Women – 2.12-15.7 mm / h
|White blood cells||WBC||4,05-9,15*109/л|
Hemoglobin является главным дыхательным белком в организме, так
as responsible for the transport of oxygen. It consists of two main
components: non-protein (heme) and protein (globin). Main
part of the heme is iron. When the red blood cell enters the lung,
heme iron combines with oxygen to form oxyhemoglobin.
Then the blood moves to all the cells and tissues of the body.
Oxyhemoglobin gives the cell oxygen, taking carbon dioxide.
The combination of hemoglobin with carbon dioxide is called
However, hemoglobin can connect not only with oxygen and
carbon dioxide. There are special poisons that attach to
respiratory proteins form persistent compounds. Modified
hemoglobin is not able to carry oxygen, which leads to
oxygen starvation of the body. To such compounds
- methemoglobin (nitric oxide, aniline, benzene derivatives);
- carboxyhemoglobin (carbon monoxide);
- sulfmethemoglobin (sulfonic).
Norms of hemoglobin:
|Norm in children||Adults|
Males – 132-153 g / l;
Women – 119-141 g / l.
There are two main types of hemoglobin: Hb A (in adults) and Hb
F (mostly in newborns). They differ in structure
globin and degree of affinity for oxygen. Globin – protein part
hemoglobin, consists of 4 polypeptide chains. Hb A contains 2
alpha and 2 beta chains, Hb F includes 2 alpha and 2
Due to gamma chains, Hb F combines better with oxygen;
compared with Hb A. The blood of an adult contains approximately
1.2% fetal hemoglobin. Increasing it says development
- leukemia (symptoms);
- hypoxia (inflammation of the lungs, anemia);
- lead poisoning;
- hereditary hemoglobinopathies (sickle cell
Change in hemoglobin amount:
|Increased rate (hyperchromemia)||Reduction rate (oligochromemia)|
Red blood cells
Red blood cells – это красные кровяные тельца. They are shaped
biconcave disc that allows them to increase their
surface. The total surface area of all human red cells
составляет около 3000 м2. Normal red blood cell size
– 6.8-7.55 microns.
The main function of red blood cells is the transfer of oxygen due to
hemoglobin contained in them. Reducing the number of red
cell called anemia. However, oxygen deprivation can
develop in a patient not only with a decrease in the number of cells, but also
changing their physical properties.
In addition to the respiratory function, red cells are involved in the regulation
acid-base balance, blood coagulation systems, can
adsorb toxins on its surface. Red blood cell content
in adults and children:
Мужчины – 4,1-5,07 *1012/л;
Женщины – 3,68-4,59*1012/л.
How can red blood cells change?
- in shape (poikilocytosis) – in addition to normal biconcave
disks can also meet target-shaped, spherical cells,
- size (anisocytosis) – reduced (microcytes), increased
- by color (anisochromia) – depending on the content
Types of anemia:
- iron deficiency – due to lack of iron in
организме (см. препараты железа при anemia). Characterized by
reducing the diameter of red blood cells, changing their shape;
- vitamin-B12-deficient – occurs when there is a shortage of vitamin B12
(cyanocobalamin) or B9 (folic acid). Occurs with
atrophic gastritis (when these vitamins are simply not
digested) or when fasting;
- hypo-and aplastic – such anemia develops due to
lesions of red bone marrow stem cells when
red blood cells are simply not formed. There are many reasons for this, for example
tumor process (leukemia), toxic damage;
- hemolytic – appears with increased decay of red
blood cells due to increased spleen function or
An increase in the number of red cells (erythrocytosis) may be
physiological and pathological. Physiological erythrocytosis
occurs during exercise, increased perspiration,
Pathological increase in the number of red blood cells can talk about
blood diseases (Vaca disease, initial stages of myeloid leukemia)
or about hypoxia in the body (mountain sickness, heart defects, smoking,
chronic lung disease).
Human blood consists of a liquid part (plasma) and floating in
her cells (uniform elements). Hematocritное число является
ratio of blood cells to the amount of plasma. Normal values
- Males – 40–48%;
- Women – 36-42%.
|An increase in hematocrit above normal indicates:||Снижение гематокрита бывает with:|
These are immature, young forms of red cells that penetrate
normal in a small amount in the blood. The main difference of reticulocyte
from the erythrocyte is the presence of the nucleus.
Increase their number (reticulocytosis) talks about:
- enhanced hematopoiesis (with blood loss);
- hemolytic anemia;
- lack of oxygen;
- reticular crisis (it happens in the treatment of B12-deficient
Reduction of reticulocytes in the blood occurs when:
- anemia (hypo-and aplastic, B12-deficient);
- radiation sickness;
- therapy with glucocorticosteroids and cytostatics.
This is a relative value that represents the saturation of red.
blood cells hemoglobin. Calculated CPU in relation
hemoglobin concentration to the number of erythrocytes in 1 μl of blood. Fine
color index ranges from 0.85 to 1.05 (normohromia).
- an increase of more than 1.06 (hyperchromia) indicates an increased
hemoglobin content in the cells (vitamin-B12-deficient anemia,
gastric polyposis, liver cirrhosis);
- a decrease below 0.84 (hypochromia) indicates anemia with
pregnancy or lead poisoning.
But today the Mchc indicator is average
hemoglobin in the erythrocyte for the patient and the general practitioner is not
informative, except for the differential diagnosis of rare
types of anemia. The concept of color indicator is abolished. Instead
This use two values:
- MCV is the average erythrocyte volume, normally from 76 to 96 femtoliter.
It is of practical importance, helping to navigate with
red blood cell size. If less than 76 – microcyte, if more
96 – macrocytic. It is useful for diagnosing the type of anemia.
Microcytosis is more often with iron deficiency, macro – with deficiency
- MCH is the average hemoglobin content in the erythrocyte, this is the second
the indicator that replaced the color indicator. Norm from 27 to 32
picagram (if hemoglobin is counted in grams per liter). If less
27 – hypochromia, if more than 32 – hyperchromia.
Platelets не являются клетками в известном смысле этого слова.
These are rather blood plates that do not have a nucleus and organelles, but
have the ability to move. The main function of these cells
is involved in blood coagulation. When integrity is violated
vessel, platelets rush first to the place of damage,
closing it with you. Only after that the system is activated.
Platelet count is called thrombocytopenia, and
their increase – thrombocytosis (see the causes of thrombocytopenia). Why
does platelet count change?
|Reasons for raising||Reasons for the decline|
The degree of reduction of platelet count:
- умеренная – до 100*109/л – возникает при
pregnancy, liver disease, taking certain medications
(diuretic, vikasol, heparin, analgin);
- выраженная – до 30*109/л – встречается у больных с
systemic lupus erythematosus, hemolytic disease of newborns,
DIC, heart failure;
- резко выраженная – менее 29,9*109 /л –
life-threatening condition arising from acute radiation sickness,
Erythrocyte sedimentation rate shows how fast the blood is
it is divided into two layers – upper (plasma) and lower (uniform
elements). This indicator depends on the number of red blood cells
globulins and fibrinogen. That is, the more man has red
cells, the more slowly they settle (see more about the causes
повышения ESR). Increasing the amount of globulins and fibrinogen
on the contrary, it accelerates the erythrocyte sedimentation.
|Повышение ESR||Снижение ESR|
Leukocytes and leukocyte formula
Leukocytes or white blood cells are the main ones.
defenders of the body. They provide the immune system,
forming cellular and humoral immunity.
Leukocyte formula is the percentage
all types of white blood cells. White blood cells are divided into two main
categories: granulocytes and agranulocytes (this separation is due to
the presence of special granules inside the cell). Granulocytes include
neutrophils, basophils and eosinophils. Neutrophils depending on
degrees of maturity are divided into segmented (young) and
stabbed (adults). Agranulocytes include lymphocytes and
Age-related changes in white blood cell count:
|Age||Total white blood cell count||Leukocyte formula|
|Until the first year of life||10,23-12,56*109/л||26-31%||58.5-60.25%||11.7-12.6%||3.5%||0.55%|
|9-12 years old||7,97-8,69*109/л||51.25-52.26%||36.75%||8.88-9.1%||2.0%||0.55%|
|13-18 years old||5,58-8,63*109/л||55.3-68.9%||28.9-35.6% 19.25-37.5||8.1-8.3%||1.5%||0.8-0.57%|
Increase in white blood cell count
|Leukocytes in general||Neutrophils||Lymphocytes||Eosinophils||Basophils|
|Увеличение свыше 10*109/л (лейкоцитоз) наблюдается
chronic myeloid leukemia;
Leukocyte count reduction
|Leukocytes in general||Neutrophils||Lymphocytes||Eosinophils, Basophils|
|Лейкопения (менее 3,98*109/л лейкоцитов):
Degrees of leukocytosis:
- умеренный – от 9,5 до 69,9*109/л;
- выраженный – от 70 до 99,9*109/л;
- резко выраженный – более 100-109/л.
How does a complete blood count change in pregnant women?
- повышается ESR, что не означает наличие воспалительного
process in the body of the future mother. The reason for the increase is
change in the ratio of albumin and globulins in the blood plasma;
- red blood counts decrease (hemoglobin, red blood cells and
hematocrit) – this is due to the redistribution of female blood between
its body and fetus. As a result, anemia and liquefaction
- повышение уровня лейкоцитов – до 11-12*109/л не
is a pathology. Also during pregnancy there is a shift
leukocyte formula to the left that is associated with active