血液一般检查讲稿双语

First section: Blood routine test (BRT)

Has Someone here ever heard of BRT before? Yes! Very good many students have heard before. (NO? maybe you are all very healthy ).when you go to hospital, doctors always apply for a BRT as a reference to your disease. They can know about the red blood cells ,white blood cells and platelets et,al.

So BRT is the most common examination in clinical laboratory. Today we will learn the blood routine test (the abbreviation is BRT) or complete blood count (CBC). 1．Sample collecting

first, we will learn about the collection of BRT sample. The blood can be collected from finger or vein. But we are always collecting blood from vein, Because the result come from a vein sample is more accurate and stable than from finger.

But if it is very difficult to find a good vein to collect, for example ,when we meet with a baby. After we collected the sample, the blood must be anticoagulated with EDTA-K 2. Because we will count cells in it. We will learn in the later. Here please remember the anticoagulant----EDTA-K2. OK, lets take a look of the main contents of BRT. It conclude three parts, they are RBC,WBC,PLT.

Now we will learn one by one. 2. RBC related parameters

At first, will learn about the red blood cells. There are seven parameters related to it. They are：

1） The number of red blood cells (RBC) 2） The amount of hemoglobin in the blood (Hb) 3） Hematocrit （Hct）

4） mean corpuscular volume (MCV) 5） Mean corpuscular hemoglobin（MCH）

6） Mean corpuscular hemoglobin concentration (MCHC) 7） Red blood cell volume distribution width（RDW)

1） RBC and Hb

Now ,lets learn about RBC and hemoglobin. we put the two indexes together ,because they

have the same clinical signifcance.

（1）The normal values

The normal values of RBC is to male :the normal number of RBC is 4.0-5.5,to Female: is 3.5-5.0 million millions per liter . so it is different between male and female.

Familiar to RBC, the normal value of hemoglobin is different between male and female too. All the values above are required to remember.

The numbers of RBC or the concentrations of Hb is increased, it can be caused by relative factors or absolutely factors.

For example , when we sicking \\ burning or sweating too much ,much waters in our body will be lost, the plasma is concentrated, so the RBC numbers is relatively increasing.

Some diseases, such as heart disease , lung disease, can also cause the number of RBC increasing. We all know that the main function of RBC is carry oxygen, when people got heart disease, for example, heart failure, the body will be lack of oxygen, so it will produce more RBC as compensation.

（2）Clinical significance

If the numbers of RBC or the concentrations of Hb is decreased, we call this anemia. Certainly it include physologic anemia and pathologic anemia.

When people is pregnant or getting old , the physologic factors will cause the number of RBC decreased, this called physologic anemia. It neednt to cure.

If the iron in the body is deficiency , the bone marrow cant produce enough RBC or the RBC which produced are abnormal. These all can be cause anemia. Anemia is very common in clinic. Please turn to page 268 , lets look at the table 4-2-2-the classification of anemia.

2）HCT or PCV（P280)

Ok, this is all of the numbers of RBC and hemoglobin.

Now , we will learn another index of RBC－－ Hematocrit or packed cell volum (PCV). HCT is the ratio that the volumes of blood cells (mainly RBC) in the whole blood. So the calculate formula is V cell / V whole blood.

Because the cells in the blood mainly is RBC, which is the reason why the blood is red, so the clinical significance of HCT is accord with the change of RBC. When the RBC or Hb increasing, HCT will increase too. And when the RBC or Hb decreasing ,HCT will decrease too.

3）MCV,MCH,MCHC（P280）

Now, lets learn three related indexes of RBC, they are MCV, MCH and MCHC.

The MCV is the abbreviation of mean volume of each RBC, so from the definition, we can see that it represent the average size of RBC.

Patients with IDA (iron deficient anemia) , their RBC are smaller than normal people, the MCV is decreased. So we can judge the RBC size from this index.

MCH is the abbreviation of mean hemoglobin of each RBC, it represent the average hemoglobin of RBC. We also cite IDA as example, we all know, it is necessary that the iron in our body must be adequate in the course of hemoglobin producing, when the iron is deficiency, the hemoglobin in the RBC will be reduced, certainly the MCH is decreased.

The MCHC is the mean corpuscular hemoglobin concentration,

These three indexes can be calculated with the number of RBC, HCT and hemoglobin. When two indexes among them is known, the left index can be calculated too.

MCV,MCH and MCHC reflect the size and hemoglobin concentration of individual cells. It is useful in the diagnosis of various types of anemia. P281,table 4-2-5

4）RDW

Ok, please come back to the slide.

Lets learn the last index about RBC---RDW.

At first lets see the definition: the RDW is the abbreviation of the RBC volume distribution width.

It is a measure of the variation of RBC volume.

In normal people, the RBC volume is homogeneous，is about 7um, but in certain anemia, some RBC become larger, some RBC become smaller, So the size of RBC become variety, the RDW will be increased.

Application: P281,table 4-2-6 3.WBC related parameters

Now lets learn about WBC, first lets see the parameters related to WBC They are the number of white blood cells and the component of WBC,

WBC are divided into five types: neutrophil, lymphocyte, monocyte, eosinophil and basophil. Each type cells can be described in two forms: the percentage and the absolute count. Mostly we

use the percentage to describe the component of WBCS.

1）The function of WBC

－Fight infection －Make antibodies

2）Divided into Five types according to its shape Types of WBCs normally present in blood:

- neutrophils (infection-fighters), 2 types:

? polys or segs = segmented neutrophils (mature) ? bands or stabs = banded neutrophils (young)

- lymphocytes (immunity) - monocytes (phagocytosis) - eosinophils (allergy, parasites) - basophils (hypersensitivity)

In neutropenia, most WBCs are lymphocytes. An early indication of recovery is the presence

of monocytes,

Non-malignant blasts are sometimes seen during neutrophil recovery following chemotherapy, especially in conjunction with GCSF/GMCSF therapy, as a result of an over stimulated bone marrow releasing immature cells into the peripheral circulation. Neutrophil (Ne)

make up 55-70% of total WBC count very tiny light staining granules the nucleus is frequently multi-lobed

can phagocytizing foreign cells, toxins, and viruses Eosinophil (EO)

make up 0.5-5% of total WBC count large granules stained pink (or red) the nucleus often has two lobes the granules contain enzymes

attacks parasites and any antigen complexes are also responsible for allergic response

Basophil (Ba)

less than 1% of total WBC count

granules are large, stain deep blue to purple granules often numerous ,can mask the nucleus granules contain histamines mediate hypersensitivity reactions lymphocyte (Ly)

make up 20-40% of totle WBC count

it is an agranular cell with very clear cytoplasm the cytoplasm stains pale blue

nucleus is very large for the size of the cell , stains dark purple Lymphocyte is much smaller than the three granulocytes play an important role in our immune response produce antibodies and provide secondary immunity

The lymphocyte is an agranular cell with very clear cytoplasm which stains pale blue. Its nucleus is very large for the size of the cell and stains dark purple. (Notice that the nucleus almost fills the cell leaving a very thin rim of cytoplasm.) This cell is much smaller than the three granulocytes (which are all about the same size). These cells play an important role in our immune response. The T-lymphocytes act against virus infected cells and tumor cells. The B-lymphocytes produce antibodies. Monocyte (Mo)

it is agranular, make up 4-10% of totle WBC count It is the largest cell among the five types the cytoplasm is abundant and stains pale blue

nucleus often shaped U or kidney bean , stains dark purple develop into large macrophages phagocytize pathogens during infection

This cell is the largest of the leukocytes and is agranular. The nucleus is most often \kidney bean shaped; the cytoplasm is abundant and light blue. These cells leave the blood stream (diapedesis) to become macrophages. As a monocyte or macrophage, these cells are phagocytic

本文来源：https://www.bwwdw.com/article/fptv.html