实验诊断学 血常规检测.pptVIP

医学课件 标本采集~~Sample collecting mostly the sample is colleted from vein It can also be collected from capillary by pricking the fingertip,heel or earlobe 样本采集后的处理 立即加入加有抗凝剂的试管内，并混匀 抗凝剂：EDTA-K2 Contents (3 parts) RBCs (red blood cells)~~红细胞 WBCs (white blood cells)~~白细胞 PLTs (platelets)~~血小板 case the report of BRT for a girl, it shows RBC: 3.0 ×1012/L ↓ Hb：108 g/L ↓ MCV:70fl ↓ MCHC:290g/L ↓ MCH:22pg ↓ We can judge The girl gets anemia. We can primary diagnose that maybe she is IDA,or chronic blood loss. Combined with her clinical manifestation and other examinations,we can get the last diagnosis. RBC and Hb Normal values RBC： Male: 4.0-5.5 ×1012/L Female: 3.5-5.0 ×1012/L Hb： Male: 120-160 g/L Female: 110-150 g/L [临床意义]： MCH (mean corpuscular hemoglobin) 平均红细胞血红蛋白量 系指每个红细胞内所含血红蛋白的平均量，以皮克 (pg)为单位。 (unit: pg＝10-12g) MCH = Hb / RBC（个数） 反映了每个红细胞内的平均血红蛋白含量, 参考范围27-34pg MCHC (mean corpuscular hemoglobin concentration) 平均红细胞血红蛋白浓度 系指每升血液中平均所含血红蛋白浓度，以g/L表示 MCHC = Hb / HCT (MCH/MCV=Hb÷RBC/HCT÷RBC) 反映了血液中血红蛋白浓度 参考范围320-360g/L (32-36%) MCV,MCH and MCHC reflect the size and hemoglobin concentration of individual RBC It is useful in the diagnosis of various types of anemia Application: P263,table 4-2-4 RDW (RBC volume distribution width) 红细胞体积分布宽度反映红细胞体积大小的变异性，变异性大，波峰的基底增宽，反之，基底变窄。 反映红细胞大小不等,体积异质性的参数。 其对贫血的诊断有重要意义 Application: P263,table 4-2-5 白细胞~~WBCs 白细胞计数~~ The number of white blood cells Normal values：adult 4~10×109/L 白细胞分类~~The classification of WBCs 中性粒细胞~~Neutrophil (Ne) 嗜酸性粒细胞~~Eosinophil (Eo) 嗜碱性粒细胞~~Basophil (Ba) 淋巴细胞~~Lymphocyte (Ly) 单核细胞~~Monocyte (Mo) 临床意义 Ne----升高 生理性: 孕妇，剧烈运动后等 病理性: 大部分的急性疾病 急性感染 (尤其是细菌性) 急性溶血 急性失血 急性中毒 大部分的白血病 The increase/decrease of WBC is mainly caused by Ne!! Ne---- 下降 某些特殊的感染(病毒，伤寒，副伤寒) 血液病（AA、IDA、PN