General blood test, ESR - Causes, symptoms and treatment. MF.
The general blood test is prescribed for almost all diseases, during pregnancy and in prophylactic purposes for the detection of diseases. A general blood test is taken from the finger.
The general blood test of includes the determination of hemoglobin concentration, the number of red blood cells, leukocytes and platelets, hematocrit and erythrocyte indexes( MCV, MCH, MCHC).
Indications for general blood analysis and ESR
A general blood test together with the leukocyte formula is widely used as one of the most important examination methods for most diseases. Changes occurring in the peripheral blood are non-specific, but at the same time reflect changes occurring in the whole body.
The study of the leukocyte formula is of great importance in the diagnosis of hematological, infectious, inflammatory diseases, as well as assessing the severity of the condition and the effectiveness of the therapy. At the same time, changes in the leukocyte formula are not specific - they may have a similar nature in different diseases or, on the contrary, there may be unlike changes in the same pathology in different patients. The leukocyte formula has age characteristics, therefore its shifts should be estimated from the position of the age norm( this is especially important in the examination of children).
Erythrocyte sedimentation rate( ESR):
Inflammatory diseases.
Infections.
Tumors.
Screening study for preventive examinations.
Measurement of ESR should be considered as a screening test, which has no specificity for any particular disease. ESR is usually used in a complex of general blood analysis.
Preparing for a general blood test and ESR
A general blood test is performed on an empty stomach. There should be at least 8 hours between the last meal and blood donation for a general analysis. It is advisable to exclude fatty, fried and alcohol from the diet 1-2 days before the examination. An hour before taking blood, you must refrain from smoking.
It is necessary to exclude the factors influencing the results of research: physical stress( running, climbing the ladder), emotional arousal. Before the procedure, you need to rest for 10-15 minutes, calm down.
Always inform your doctor about taking medication.
Blood should not be taken after radiography, rectal examination, or physiotherapy.
Different test methods and units can be used in different laboratories. To evaluate the results was correct, we recommend that you take the tests in the same laboratory at the same time. Comparison of such results will be more comparable.
Decoding of the general blood test
Modern hematological analyzers allow obtaining accurate and highly informative characteristics of blood cells.
Any changes in the general blood test and abnormalities are treated as pathological and require careful examination of the patient .Changes in the hemogram with many diseases can have a nonspecific character. In this case, they are used for dynamic observation of the patient and in terms of estimating the prognosis.
In diseases of the hematopoietic system, the study of the general blood test acquires the paramount diagnostic value. It defines a further strategy for examining the patient with the subsequent choice of the treatment regimen and is necessary for monitoring the therapy.
In hematological analyzers of various manufacturers, normal blood counts can vary significantly depending on the norms used in a particular country. Below are the normal values of peripheral blood in adults according to the order of the Ministry of Health of the Russian Federation.
Blood Count Standards
| Blood index | Normal values |
| Hemoglobin, g / l Male Female | 130.0-160.0 120.0-140.0 |
| Red blood cells( RBC), * 1012 / L Male Female | 4,0-5.0 3.9-4.7 |
| Hematocrit,% Male Female | 40-48 36-42 |
| Mean hemoglobin in erythrocyte( MCH), pg | 27.0-31.0 |
| Average volumeerythrocyte( MCV), fl, μm | 80.0-100.0 |
| Average concentration of hemoglobin in erythrocyte( MCHC), g / dl | 30,0-38,0 |
| RBC width, RDW-CV,% | 11,5-14,5 |
| Reticulocytes, ‰( or%) | 2,0-12,0( 0,2-1,2) |
| Leukocytes, * 109 / l | 4,0-9,0 |
| Neutrophils, Segmented | 1.0-6.0( 0.04-0.30) 47.0-72.0( 2.0-5.5) |
| Eosinophils | 0,5-5.0( 0.02-0.3) |
| Basophils | 0-1.0( 0-0.065) |
| Lymphocytes | 19.0-37.0( 1.2-3.0) |
| Monocytes | 3, 0-11.0( 0.09-0.6) |
| Platelets, * 109 / L | 180.0-320.0 |
| Average platelet count( MPV), fl | 7.4-10.4 |
| The width of the distributionplatelets by volume,( PDW),% | 10-20 |
| Thrombocrete( PCT),% | 0,15-0,40 |
| ESR, mm / h | 2, 0-20,0 |
Red blood cell parameters Red blood cell parameters
- Red blood cells
- Erythrocytosis
- Hemoglobin
- Hematocrit
- Average red blood cell volume
- Average hemoglobin content in red blood cell
- Average hemoglobin concentration in erythrocyte
- Rice red cell anemiawidth)
- Morphology of red blood cells
- Reticulocytes
- Erythrocyte sedimentation rate( ESR level)
Platelet blood parameters
- Platelets( PLT-platelet)
- Thrombocytosis
- Thrombocytopenia
- mean platelet volume( MPV - mean platelet volume)
- platelet distribution width by volume( PDW - platelet distribution width)
- Thrombocrit( PCT - platelet crit)
Leukocyte blood parameters
- number of leukocytes
- Neutrophils
- Eosinophils
- Basophils
- Monocytes
- Lymphocytes
- Plasma cells
- Atypical mononuclear cells
The leukocyte formula is the percentage of different types of leukocytes( neutrophils, lymphocytes, eosinophils, monocytes, basophils).The leukocyte formula includes the determination( in%) of neutrophils, lymphocytes, eosinophils, basophils, monocytes.
Erythrocyte sedimentation rate( ESR)
Erythrocyte sedimentation rate( ESR) is a nonspecific indicator of inflammation.
ESR is a measure of the rate of blood separation in a tube with anticoagulant added on 2 layers: the upper( transparent plasma) and the lower( settled red blood cells).The rate of erythrocyte sedimentation is estimated from the height of the plasma layer formed( in mm) in 1 hour. The specific mass of erythrocytes is higher than the specific mass of the plasma, therefore in a test tube in the presence of anticoagulant( sodium citrate) under the influence of gravity, the erythrocytes settle to the bottom.
The process of sedimentation( sedimentation) of erythrocytes can be divided into 3 phases, which occur at different rates. First, the red blood cells slowly settle in separate cells. Then they form aggregates - "coins", and subsidence occurs more quickly. In the third phase, a great many aggregates of erythrocytes are formed, their subsidence first slows down, and then gradually ceases.
The index of ESR varies depending on a variety of physiological and pathological factors. The values of ESR in women are slightly higher than in men. Changes in the protein composition of the blood during pregnancy lead to an increase in ESR during this period.
Reduction of red blood cells( anemia) in the blood leads to an acceleration of ESR and, on the contrary, an increase in the red blood cell content slows down the rate of sedimentation. During the day, fluctuations in the values are possible, the maximum level is noted in the daytime. The main factor that influences the formation of "coins" in the case of erythrocyte sedimentation is the protein composition of the blood plasma. Acute-phase proteins, adsorbed on the surface of erythrocytes, reduce their charge and repulsion from each other, promote the formation of "coins" and the accelerated sedimentation of erythrocytes.
Increase in acute phase proteins, for example, C-reactive protein, haptoglobin, alpha-1-antitrypsin, in acute inflammation leads to an increase in ESR.In acute inflammatory and infectious processes, the change in erythrocyte sedimentation rate is observed 24 hours after the temperature rises and the number of leukocytes increases. In chronic inflammation, the increase in ESR is due to an increase in the concentration of fibrinogen and immunoglobulins.
The Westergren method differs from the widely used method for the determination of ESR in the Panchenkov with the characteristics of the tubes used and the scale of results calibrated according to the method of Westergren. The results obtained by these two methods coincide in the range of normal values, both methods have the same reference values. The Westergren method is more sensitive to an increase in ESR, and the results in the zone of increased values obtained by the Westergren method are higher than the results obtained by the Panchenkov method.
Determination of ESR in dynamics, in combination with other tests, is used in the control of the effectiveness of treatment of inflammatory and infectious diseases.