Erythrocyte parameters of blood, ESR - Causes, symptoms and treatment. MF.

Hemoglobin( Hb, hemoglobin)

The respiratory pigment of blood, which participates in the transport of oxygen and carbon dioxide, which also performs buffer functions( maintenance of pH).Contained in erythrocytes( red blood cells of blood).It consists of a protein part - globin - and iron-containing porphyrin part - heme. It is a protein with a quaternary structure formed by 4 subunits. The iron in the heme is in a divalent form.

Physiological forms of hemoglobin:

1) oxyhemoglobin( HbO2) - the hemoglobin compound with oxygen is formed mainly in the arterial blood and gives it a scarlet color( oxygen binds to the iron atom through a coordination link);2) reduced hemoglobin or deoxyhemoglobin( HbH) - hemoglobin, which gave oxygen to tissues;3) carboxyhemoglobin( HbCO2) - a hemoglobin compound with carbon dioxide;is formed, mainly, in the venous blood, which as a result acquires a dark-cherry color.

Pathological forms of hemoglobin:

1) carbhemoglobin( HbCO) - is formed by carbon monoxide poisoning( CO), while hemoglobin loses the ability to attach oxygen;

2) methemoglobin - is formed by the action of nitrites, nitrates and some drugs( the transition of ferrous iron to trivalent leads to the formation of methemoglobin - HbMet.)

The hemoglobin content in the blood is slightly higher in men than in women. The children of the first year of life have a physiological decreasehemoglobin concentration. The decrease in hemoglobin in the blood( anemia) may be due to increased losses of hemoglobin in various types of bleeding or increased disruption( hemolysis) erythrosisThe cause of anemia may be a lack of iron, necessary for the synthesis of hemoglobin, or vitamins involved in the formation of erythrocytes( mainly B12, folic acid), as well as a violation of the formation of blood cells in specific hematological diseases. Anemia can occur again in a variety of chronic non-hematological diseases

Units of measure: g / dL
Alternative units of measure: g / l.
Conversion factor: g / L x 0.1 == & gt;g / dL.
Reference values:

Increased hemoglobin level:

1. diseases, accompanied by an increase in the number of red blood cells( primary and secondary erythrocytosis);
2. blood thickening;
3. congenital heart disease;
4. pulmonary heart failure;
5. physiological reasons( for residents of high mountains, pilots after high-altitude flights, climbers, after increased physical exertion).

Lowering of the hemoglobin level:

anemia of different etiology( the main symptom).

Hematocrit( Ht, hematocrit)

The hematocrit is the proportion( %) of the total volume of blood that the erythrocytes make up. The hematocrit reflects the ratio of erythrocytes and blood plasma, and not the total number of erythrocytes. For example, in patients with shock due to blood clotting, the hematocrit may be normal or even high, although, due to blood loss, the total number of red blood cells can be significantly reduced. Therefore, hematocrit can not be used to assess the degree of anemia shortly after loss of blood or blood transfusion. Hematocrit may decrease slightly when taking blood in the lying position. False elevated results can be observed with prolonged compression of the vein by a tourniquet upon the collection of blood. A false decrease in hematocrit can be observed due to blood dilution( taking blood from the same limb immediately after intravenous injections).

Units of measure: %.
Reference values:

Increased hematocrit:

1. with erythremia;
2. symptomatic erythrocytosis( congenital heart defects, respiratory failure, hemoglobinopathies, kidney neoplasms accompanied by enhanced erythropoietin formation, polycystic kidney disease);
3. hemoconcentration in case of burn disease, peritonitis, dehydration of the body( with severe diarrhea, indomitable vomiting, excessive sweating, diabetes).

Hematocrit lowering:

1. anemia;
2. hyperhydration;
3. second half of pregnancy.

Erythrocytes( red blood cells, red blood cells, RBC)

Erythrocytes are blood elements that contain hemoglobin, transporting oxygen and carbon dioxide. Mature red blood cells do not contain a nucleus, they are disk-shaped. The average life span of erythrocytes is 120 days. In newborns, the size of red blood cells is somewhat larger than that of adults. An increase in the number of red blood cells is called erythrocytosis ( polyglobulia).

Reduction of the number of red blood cells( and hemoglobin) - by anemia . Physiological erythrocytosis is noted in newborns in the first days of life, under stress, increased physical exertion, increased sweating, and starvation. The number of red blood cells can physiologically decrease after eating, between 17.00 and 7.00 hours, as well as when taking blood in the lying position. After a prolonged compression of the bundle, it is possible to obtain false overestimated results. In addition to determining the number of erythrocytes, a number of morphological characteristics of red blood cells are used in diagnosis, which are assessed using an automatic analyzer( see Erythrocyte Indexes MCV, MCH, MCHC) or visually in a blood smear under a microscope when calculating the leukoformula. Normally, the erythrocyte diameter is 7.2 - 7.5 microns. Erythrocytes with a diameter of 6.7 μm or less are called microcytics, more than 7.7 μm are macro-cells, and more than 9.5 μm in diameter are called megalocytes.

Macrocyte - a condition where 50% or more of the total number of erythrocytes are macro-cells. It is noted with B12 and folic deficiency anemia, liver disease.

Age, sex	Red blood cell count, million / μL
& lt;2 weeks	3.9 - 5.9
2 - 4.3 weeks	3.3 - 5.3
4.3 weeks - 4 months	3.5 - 5.1
4 - 6 months	3.9 - 5.5
6 - 9 months	4.0 - 5.3
9 - 12 months	4.1 - 5.3
1 - 3 years	3.8 - 4.8
3 - 6 years	3.7 - 4.9
6 - 9 years	3.8 - 4.9
9 -12 years	3.9 - 5.1
12 - 15 years	Women	3.8 - 5.0
Men	4.1 - 5.2
15 - 18 years	Women	3.9 - 5.1
Male	4.2 - 5.6
18 - 45 years	Female	3.8 - 5.1
Male	4.3 - 5.7
45 - 65 Years	Female	3.8 - 5.3
Male	4.2 - 5.6
& gt; & gt;65 years	Women	3,8 - 5,2
Men	3,8 - 5,8

Increase in the level of erythrocytes( erythrocytosis):

1. erythremia, or Vaqueza disease is one of the variants of chronic leukemia( primary erythrocytosis);
2. secondary erythrocytosis: a) absolute - with hypoxic conditions( chronic lung diseases, congenital heart defects, erythropoiesis stimulation( hypernephroma, Izenko-Cushing's disease, cerebellar hemangioblastoma), when erythropoiesis stimulates and the number of erythrocytes increases, b) relative - with blood thickening(excessive sweating, vomiting, diarrhea, burns, swelling and ascites), when the volume of plasma decreases while maintaining the number of red blood cells.

Reduction in the level of erythrocytes( erythrocytopenia):

1. deficient anemia of different etiology - as a result of deficiency of iron, protein, vitamins, aplastic processes;
2. hemolysis;
3. leukemia, myeloma;
4. metastasis of malignant tumors.

Red blood cell indices

Erythrocyte indices are calculated values ​​that allow quantitative characterization of important indicators of erythrocyte status. MCV is the mean volume of the erythrocyte( mean cell volume).This is a more accurate parameter than a visual assessment of the size of red blood cells. However, it is not reliable for a large number of erythrocytes with a modified form. Based on the MCV value, microcancer anemia( iron deficiency, thalassemia), normocytic and macrocytic anaemias are distinguished. Microcytosis is characteristic for iron deficiency anemia, macrocytosis - for B12- and folic acid-deficient. Aplastic anemia is normal or macrocytic.

Reference values:

Increased SIT:

1. megaloblastic anemia( vitamin B12 and folic deficiency);
2. liver disease;
3. false increase( multiple myeloma, hyperleukocytosis).

Reduction of MCH: Iron deficiency anemia

MCHC( mean cell hemoglobin concentration) - mean hemoglobin concentration in erythrocyte

Calculated by dividing blood hemoglobin concentration( in g / 100 ml) by hematocrit and multiplying by 100. The indicator reflects the saturation of the erythrocyte with hemoglobin;characterizes the ratio of the amount of hemoglobin to the cell volume. Thus, it does not depend on the volume of the cell, in contrast to the MCH.

Units of measure: g / dl. Alternative units of measure: g / l. Conversion factor: g / L x 0.1 == & gt;g / dL.

Reference values:

Increased ICSU: Spherocytosis is congenital and other spherocytic anemia.

Lowering of ICSU:

1. iron deficiency anemia;thalassemia;
2. some hemoglobinopathies.

ESR

Units of measure: mm / h.

Reference values ​​

Age, floor	ESR, mm / h
10 years	0 - 10
10 - 50 years old	Male	0 - 15
Female	0 - 20
& gt;50 years old	Male	0 - 20
Female	0 - 30

Increase( acceleration of ESR):

physiological:

1. advanced age;
2. in women during pregnancy, menstruation, in the postpartum period.

pathological:

1. inflammatory processes;
2. intoxication;
3. acute and chronic infections( pneumonia, osteomyelitis, tuberculosis, syphilis);
4. autoimmune diseases( collagenoses);
5. myocardial infarction;
6. trauma, fractures of bones;
7. condition after shock, surgical interventions;
8. anemia, condition after hemorrhage;
9. kidney disease( chronic nephritis, nephrotic syndrome);
10. malignant tumors;
11. paraproteinemia( myeloma, Waldenstrom's macroglobulinemia);
12. hyperfibrinogenemia;
13. taking medications( estrogens, glucocorticoids).

Decrease( deceleration of ESR):

1. starvation, decreased muscle mass;
2. reception of corticosteroids;
3. pregnancy( especially 1 and 2 semester);
4. is a vegetarian diet;
5. hyperhydration;
6. myodystrophy.