七年实验诊断第二讲白细胞参数检查.ppt

* * * * * * * * * * * * * * * * BASOPENIA NO CLINICAL SIGNIFICANCE LYMPHOCYTES Appearance Round nucleus about 90% of cell Agranular 8-10 mm Normal range 0.20～0.40 * LYMPHOCYTE FUNCTION B lymphocytes become plasma cells produce antibodies B cells formed in bone marrow and travel to lymph nodes, lymph nodules and spleen T cells migrate from bone marrow and mature in thymus Have many immune function NK cells Cellular mediated cytotoxicity * LYMPHOCYTOSIS Count varies with age Viral infection Other infections Syphilis（梅毒）, toxoplasmosis(弓形虫), mycoplasma（支原体） Drug sensitivity Lymphoid malignance Miscellaneous Autoimmune, hyperthyroidism, Addison’s, graft rejection * LYMPHOPENIA Decreased production Inherited immuno-deficient. AIDS Increased destruction Steroids/ Cushing’s Radiation, chemo ALG/ATG MONOCYTES Appearance Large nucleus Horseshoe or kidneybean shape About 50% of the cell 14-20 mm Normal range 0.03~0.08 * MONOCYTOSIS Infections TB, SBE, syphilis, Malaria Kala-azar Hematological disease Acute myeloid leukemia—M4 or M5, MM, Lymphoma, MDS Collagen Vascular Disease Gastrointestinal disorders Ulcerative colitis * MONOCYTOPENIA NO CLINICAL SIGNIFICANCE * MORPHOLOGICAL CHANGE IN PERIPHERAL BLOOD LEUKOCYTE 外周血白细胞形态变化 * THE CHANGE OF NUCLEAR PICTURE OF NEUTROPHIL GRANULOCYTE中性粒细胞的核象变化 1. NUCLEUS SHIFTING TO THE LEFT （核左移） Definition Increased number (＞0.05 ) of the band neutrophils or presence of immature neutrophils in blood. Significance 1.Acute blood loss 2.Acute poison 3.Acute hemolysis 4.Leukemia and leukemoid reaction * THE SEVERITY OF SHIFT TO LEFT Slight shifting to the left: Stab cells 5%, no immature-myelocyte; common infection, hemorrhage, hemolytic diseases. Middle shifting to the left: Stab cells 10%, a few immature-myelocyte; severe infection, acute hemolytic, poisoning. Severe shifting to the left: Stab cells 25%, more immature-myelocyte; myelocytic leukemia. * THE CHANGE OF NUCLEAR PICTURE OF NEUTROPHIL GRANULOC