体检血常规各项指标

体检血常规各项指标 10*12/L 血常规化验单 新生儿 [英文缩写]blood routine; 血RT。白细胞计数及分类[英文缩写]CD 6.0-7.0 代号 项目 参考范围 10*12/L 结HGB 血红蛋白 成年 男性 果 120-160g/L WBC 白细胞 成人 女性 4.0-10.0 110-150g/L 10*9/L 新生儿170-200g/L 6个月-2岁婴儿 HCT或 红细胞比积 或 红男性 11-12 10*9/L PCV 0.42- 0.49 细胞压积 新生儿 L/L或42%-49% 15-20 10*9/L 女性 RBC 红细胞 成年 男性 0.37-0.43L/L 4.0-5.5 或37%-43% 10*12/L PLT 100-300 10*9/L 血小板 女性 MPV 7-11fl 平均血小板体积 3.5-5.0 PCT 0.11-0.28% 血小板压积 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet MCV 82-95 fl EO# 0.05-0.3 10*9/L 平均红细胞体积 嗜酸性粒细胞 MCH 27-31pg BASO# 0-0.1 10*9/L 平均血红蛋白量 嗜碱性粒细胞 MCHC 320-360g/L RDW_SD 37-51% 平均血红蛋白浓度 红细胞分布宽度 SD NEUT% RDW_CV 11.5-14.5% 中性细胞比率 杆状核 0.01-0.05 红细胞分布宽度CV (1%-5%) PDW 15%-17% 血小板分布宽度 分叶核 0.50-0.70 P-LCR 13-43% 大型血小板比率 (50%-70%) ESR 血沉 男性0-10 mm/L LYMPH% (20%-40%) 淋巴细胞比率 女性O-15 mm/L MONO% 单核细胞比率 (3%-8%) 1(血细胞计数仪 项目:WBC，GR#，GR%，LY#EO% (0.5%-5%) 嗜酸性粒细胞比率 和MON#，LY%和MON%，HGB，MCHC，PLT，HCT及推BASO% (0%-1%) 嗜碱性粒细胞比率 算项目RBC，MCV，MCH，PCT，MPV，RCDW，LCDW。 NEUT# 2(三分群血常规，就是说五种白细胞被分成了大中小三中性细胞数 杆状核0.04-0.5 10*9/L 群: LY% 淋巴群 分叶核2-7 10*9/L MO% 中间群 GR% 粒细胞群(中性粒细胞、 LYMPH# 0.8-4.0 10*9/L 淋巴细胞数 嗜酸性粒细胞和嗜碱性MONO# 0.12-0.8 10*9/L 单核细胞数 粒细胞) for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 3(中文名称、英文缩写 参数、红细胞各项指数、白细胞分类结果等许多参数，甚至 (仪器不同，某些缩写也不同，仅供参考) 还有三个细胞分布直方图。所以血常规的概念可以扩大为含中间细胞绝对值MO,，MONO#，W—MCC 有多项红细胞参数，血小板计数和白细胞分类等多达十余项粒细胞绝对值GR,，GRAN#，W—LCC 指标的一组实验内容，较为常见的是含有16,18项参数的血淋巴细胞绝对值LY,，LYM,，W--SCC, 常规化验结果。血常规具体各项目的名称、参考值、临床意淋巴细胞百分比LY,，LYM,，W--SCR, 义参考书中各项目的详细介绍。 中间细胞百分比MO,，MONO,，W--MCR, 粒细胞百分比GR,，GRAN,，W--LCR,. ,(问:什么是血象? 血液化验问答总汇 答:这是一个习惯的称呼，某些临床医生和病人习惯将血常 规检查称为“血象”，在某些书中甚至专业书中也有类似的写,(问:血常规检查包括哪些内容? 法。如医生说:“先去查个血象”，实际上这时候要病人做个 血常规检查，这个血象检查指包括红细胞计数，白细胞计数，答:血常规检查是医院中最常见的一项化验，用于对病人身 血红蛋白(就是人们所说的血色素)和白细胞分类等一些最体状况的一般了解和对疾病的初步判断和对治疗疗效的观 常见的检验项目。 察。血常规一般应包括红细胞计数、白细胞计数、血红蛋白 测定和白细胞分类计数。但由于现代实验室中做血常规检查 ,(问:为什么要常做血常规检验? 常使用多参数血细胞计数，一次测定可以得到多达十几项参 数，所测定的项目除上述四个参数外还包括血小板和血小板 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 答:在医院看病时，医生往往要求病人首先做个血常规检查。何看懂? 血常规检验虽不是什么特异性的实验，但由于血液不断的在 全身循环，流经身体的各个重要器官，渗透到各组织中，参答:现在在一般大中型医院做血常规检验，多采用自动血细与人体的新陈代谢，调节和维护人体各处机能活动和内外环胞分析仪测定。患者拿到的是列有十几项参数的化验结果。境的平衡，人体各部位稍有异常改变，都会由血液携带其各因为医院采用的仪器不同，打印结果的编排顺序也不一样。种信息传达出来，故检查血液中各种细胞成分的量和质的变表1、2、3列出自动血细胞计数仪测定血细胞各项参数的中化即可协助判断肌体各种组织器官的病变情况。血常规中的文名称、英文缩写(仪器不同，某些缩写也不同，仅供参考)、许多项具体指标都是一些常用的敏感指标，对机体内许多病参考值、测定单位。 理改变都有敏感反映，其中又以白细胞、红细胞、血红蛋白 和血小板最为具有诊断参考价值，所以，许多病人在病因不表1 多参数血常规项目、缩写、参考值和单位简表 明时都要做血常规检查。另外，一些已经明确诊断或治疗过中文名称 英文缩写 参考值范围 单位 程中的患者也需要经常做血常规检查，这时观察治疗效果、 用药或停药、继续治疗或停止治疗、疾病复发或痊愈的常用红细胞计数 RBC 男4.0~5.5 女3.5~5.0 新生儿6.0~7.0 指标。需要特别提到的是，在化疗、放疗及血液病等特殊病10*12/L或106/μl 人中，血常规检查是个非常重要的和经常需要检测的观察指血红蛋白(血色素) HGB或Hb 男:120~170 女:110~160 新标。 生儿:170~200 g/L 平均红细胞体积 MCV 80~98 fl ,(问:仪器化验和打印的血常规检验内容又多又复杂，如平均细胞血红蛋白 MCH 27~31 pg for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 平均细胞血红蛋白浓度 MCHC 320~360 g/L 标本编号 NO.0113 红细胞压积 HCT 男:40~50 女:37~48 % 白细胞 WBC 7.7x10*9/L 红细胞分布宽度 RDW 11~15 % 淋巴细胞百分比 LY% 23.3% 白细胞计数 WBC 4.0~10.0 10*9/L或103/ml 中间细胞百分比 MO% 8.3% 中性粒细胞 NEU;NE;GR; 50~70 % 粒细胞百分比 GR% 68.4% 杆状核粒细胞 1~4 % 淋巴细胞绝对值 LY 1.8x10*9/L 嗜酸粒细胞 EOS 2~6 % 中间细胞绝对值 MO 0.6x10*9/L 嗜碱粒细胞 BAS 0~1 % 粒细胞绝对值 GR 5.3x10*9/L 红细胞 RBC 3.06L×10*12/L 淋巴细胞 LYM;LY 20-40 % 血红蛋白 Hgb 92g/L 单核细胞 MON;MO 3-8 % 血小板计数 PLT 100-300 10*9/L或103/ml 红细胞压积 HCT 27.2L% 平均血小扳体积 MPV 6.0-11.5 fl 平均红细胞体积 MCV 89fl 血小板体积分布宽度 PDW <20% % 平均红细血红蛋白量 MCH 30.1pg 平均红细胞血红蛋白浓度 MCHC 338g/L 血小板压积 PCT 0.115-0.285 % 红细胞体积分布宽度 RDW 13.5%CV 表2 多参数血液细胞分析[血常规)化验单打印样式 血小板 PLT 174x10*3/mL (日本光电MEK6108K型) 血小板压积 PCT 0.11% 日期和时间 17/AUG/98 16:12 平均血小板体积 MPV 6.8fl for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 血小板体积分布宽度 PDW 18.9% 红细胞体积分布宽度 RDW-CV 0.121 血小板分布宽度 PDW 12.2fl 表3 多参数血液细胞分析(血常规)化验单打印样式 平均血小板体积 MPV 11.4fl (日本东亚 SYSMEX F-820型) 编号和日期 NO.10 25/8/98 ,(问:红细胞的生理功能是什么，红细胞测定有何意义? 时间 10:00 白细胞 WBC 7.0x10*9/L 答:红细胞是人体中最多的一类细胞，它的主要生理功能是红细胞 RBC 4.48x10*12/L 通过细胞内所含有的血红蛋白进行氧与二氧化碳的交换。红血红蛋白 HGB 133g/L 细胞的寿命约为120天，每天有许多细胞因衰老而死亡，另红细胞压积 HCT 0.397 有许多新生的红细胞取代衰老的，使红细胞数量保持着动态平均红细胞体积 MCV 88.6fl 平衡，以保持身体新陈代谢的正常需要。机体发生出血、血平均红细胞血红蛋白量 MCH 29.7pg 液生成障碍、红细胞破坏严重或红细胞异常增生等问题时红平均红细胞血红蛋白浓度 MCHC 335g/L 细胞数量都可发生变化。此时需做红细胞计数以得到红细胞血小板 PLT 103x10*9/L 的确切数量。 小细胞(淋巴细胞为主)百分比 W-SCR 0.285 红细胞英文缩写为RBC。正常人红细胞因性别和年龄差大细胞(粒细胞为主)百分比 W-LCR 0.715 异有所不同: 小细胞(淋巴细胞为主)绝对值 W-SCC 2.0x10*9/L 大细胞(粒细胞为主)绝对值 W-LCC 5.0x10*9/L 男 性:(4.0,5.5)x10*12/L for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 女 性:(3.5,5.0)x10*12/L 瘤、骨髓纤维化等;各种慢性疾病导致肌体长期消耗，如恶 新生儿:(6.0,7.0)x10*12/L 性肿瘤、尿毒症、肝病、风湿病、内分泌疾病等;造血物质 缺乏或利用障碍引起的疾病，如缺铁性贫血、铁粒幼细胞性 (1)红细胞相对增多 血浆容量减少而使红细胞数量相对贫血、叶酸或维生素B12缺乏导致的巨幼细胞性贫血。 增多，超过参考值上限或红细胞与血红蛋白比例失常。常见 于以下情况:严重呕吐和腹泻、大量出汗、大面积烧伤所致 (4)红细胞破坏过多导致红细胞数量的减少，多见于溶血的脱水、尿崩症、晚期消化道肿瘤、糖尿病酸中毒等均因血性贫血、地中海性贫血、异常血红蛋白病、阵发性睡眠性血浆中水分丢失过多而使红细胞呈现相对增加。 红蛋白尿症、免疫性溶血性贫血、机械性溶血性贫血等。 (2)红细胞绝对增加 此为多种因素引起红细胞数量的增 (5)各种急性慢性失血，如外伤大出血、手术大出血、产加。如居住在高原地区;新生儿生理性红细胞数量相对增加;后大出血、急性消化道出血、溃疡所致的慢性失血、其他慢严重的慢性心肺疾病，如阻塞性肺气肿、肺原性心脏病、先性失血等因素可导致红细胞数量减少。 天性心脏病等可使红细胞数量呈病理性增加;血液系统疾病 之一的真性红细胞增多症也属红细胞数量病理性绝对增加。 ,(问:血红蛋白是用于人是否贫血的主要指标吗? 红细胞数量减少可以分为红细胞生成减少、红细胞破坏 过多和大量失血三种主要原因。 答:血红蛋白是人体血液中红细胞内的主要成分，它的主要 生理功能是作为呼吸系统的载体，它具有易与氧和二氧化碳 (3)红细胞生成减少，如再生障碍性贫血、白血病、骨髓结合的特性，可将人体吸入的氧气从肺部输送到全身各组织，for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 再将组织中的二氧化碳运送到肺后呼出体外。血液的颜色是克?”;“我有几克血?”这样的问题。其实这里面所涉及的只是红色的，这也与血红蛋白有关。 一个常用的测定项目:血红蛋白。血色素即是血红蛋白，是 血红蛋白确是用于评价是否贫血的一个重要和常用指非的称呼，或者叫“俗称”，英文缩写可写为HGB或Hb。标，但不是唯一指标。医生常说的贫血和不贫血也多以血红血红蛋白可以用“克”这一单位来计量，是表示单位体积血蛋白测定值为主要依据。这里需要解释的是，血红蛋白和红液中携带的血红蛋白量。惯用测量单位是每百毫升(分升)血液细胞计数具有基本相同临床应用价值，血红蛋白与红细胞还中含有多少克血红蛋白，而现在多统一采用国际单位制，以有特定的比例关系，如每升血液中有1.00×10*12个红细胞，每升(一千毫升)血液中有血红蛋白多少克为准。例如以前人们相当于每升血液中血红蛋白浓度为30克(30g,L)。可以通过说“我的血色素是15克(15g/dl)”，而现在应该说“我的血红这个比例关系分析血红蛋白浓度和红细胞数量是否平行。如蛋白是150克(150g/L)”。血红蛋白参考值因性别和年龄不同有较大的差异则说明红细胞的体积大小和形态有所改变，或而略有差异，国内较为公认的参考值如下: 红细胞内含的血红蛋白的量有所改变，此时应该注意MCV、 MCH、MCHC等几个红细胞参数，他们也是分析判断贫血的 男 性:120,160g/L，最高不应超过175g/L。 几个重要指标。 女 性:110,150g/L，最高不应超过165g/L。 ,200g/L。 新生儿:170 ,(问:“你有几克血”是怎么回事儿，血红蛋白的参考值是 多少? 儿童的血红蛋白量随着年龄的增加逐渐降低而接近于成 年人，居住在高原地区的人血红蛋白比居住在平原地区的人答:临床工作中经常听到有病人说“医生，我的血色素有几偏高，这是一种生理性的增高。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 血红蛋白与红细胞的使用价值近似，血红蛋白的升高和 降低可参考红细胞升高与降低的临床意义。 ,(问:表示贫血的红细胞参数有哪几项? 如何用它们判断 贫血类型? ,(问:什么是血色素，观察人的皮肤和眼皮能判断贫血吗? 答:医生用于判断贫血的主要指标是血红蛋白浓度，除了血 红蛋白外还可参考红细胞数量，如二者比例失调，还应进一答:血色素是习惯称呼，现在统称为血红蛋白。 ,(问:什么是血色素，观察人的皮肤和眼皮能判断贫血吗? 步参考平均红细胞体积(MCV);平均红细胞血红蛋白量 (MCH)，平均红细胞血红蛋白浓度(MCHC)，红细胞体积分布 宽度(RDW)。 答:血色素是习惯称呼，现在统称为血红蛋白，是评价病人 传统上贫血可分为大细胞性贫血、正细胞性贫血、单纯是否贫血的一个重要指标。各种原因造成的血液丢失和减少， 细胞性贫血和小细胞低色素性贫血。它们的分类方法是按照使得血红蛋白低于参考值时即为贫血。长期贫血的病人除了 有具体的临床表现外，还可能在外表上有不同的表现。如皮MCV、MCH、MCHC的不同而设定的，详见表4。 肤颜色和巩膜(俗称白眼球)与血色素高低有一定关系，一些有 表4 贫血的MCV、MCH、MCHC分类法 经验的医生和人士可以通过仔细观察人的巩膜，眼皮、面颊、 贫血类型 MCH(pg) MCV(fl) MCHC(g/L) 指端、嘴唇等部位初步判断是否贫血及贫血的程度，如发现 上述部位呈现苍白色，没有健康的血色或粉红色，即疑及贫(参考值) 27,31 80,98 320,360 血问题，但最终的和准确的血红蛋白结果还必须由实验室测 定后得到。 大细胞性贫血 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet >正常32,50 >正常，100,160 正常，320,360 血。 正细胞性贫血 正常，27,31 正常，80,98 正常，320,360 ,,(问:RDW是什么参数，它与贫血的分类有何关系? 单纯细胞性贫血 <正常，21,24 <正常，70,80 正常，320,答:RDW是一个新的红细胞参数，它的全称是红细胞体积分360 布宽度，它的所表达的内容是红细胞体积大小的均匀程度，小细胞低色素性贫血 如果红细胞体积大小均匀一致，则该参数较低，在参考值范 <正常，12,29 <正常，50,80 <正常，240,围以内。如红细胞体积大小不一致，差异较大，则该参数高300 于参考值。参考值为:11%,14.5%。RDW作为一种新的红 细胞测量参数。它只能出现在用自动化细胞计数仪测定的结 大细胞性贫血，常见于因叶酸及维生素B12缺乏导致的果中。它同样可以作为贫血分类的指标之一，一般可以通过巨幼细胞性贫血、妊娠期或婴儿期巨幼细胞性贫血、恶性贫RDW和MCV这两个参数进行贫血的形态学分类。具体贫血血等。 分类指标和常见疾病如下: 正常细胞性贫血，常见于慢性再生障碍性贫血、急性失 (1)MCV降低，RDW正常小细胞均一性贫血。常见于慢血性贫血、溶血性贫血等。 性疾病、轻型地中海贫血、儿童。 小细胞低色素性贫血，常见于缺铁性贫血和海洋性贫血。 (2)MCV降低，RDW升高小细胞非均一性贫血。常见于 单纯细胞性贫血，常见于慢性感染、炎症、肝病、尿毒缺铁性贫血、β-型地中海贫血、血红蛋白H病、血红蛋白S症、恶性肿瘤、风湿性疾病、其它慢性消耗性疾病引起的贫病。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet (3)MCV正常，RDW正常正常细胞均一性贫血。正常人试管的底端，红细胞之间互相接触密切，尽可能排除所有血属于此种情况。其他异常表现可有慢性疾病、慢性肝病、脾浆，此时血浆会全部被挤出到血细胞的上面，这时红细胞所切除术后、急性出血、慢性淋巴细胞白血病、慢性粒细胞白占全血的百分比就是我们所要得到的红细胞压积，即压实的血病、化疗后等情况。 红细胞所占的体积数(或百分比)，也叫红细胞比积或红细胞比 (4)MCV正常，RDW升高正常细胞非均一性贫血。如早容。测定红细胞压积还可用毛细管法和血细胞计数仪法测定。期或混合性营养缺乏、血红蛋白异常的贫血症、骨髓纤维化、红细胞压积通常缩写为HCT或Ht，测定单位现在多用每升血骨髓发育不良、铁粒幼细胞性贫血等。 液中红细胞占有多少升来表达(L/L)。 (5)MCV升高，RDW正常大细胞均一性贫血。如再生障参考值: 碍性贫血、白血病前期、冷凝集素升高等。 男:0.40,0.50L/L(40%,50%) (6)MCV升高，RDW升高大细胞非均一性贫血。加叶酸 女:0.37,0.45L/L(37%,45%) 或维生素B12缺乏导致的巨幼细胞性贫血、部分镰刀状细胞 红细胞压积的测定有助于了解红细胞的增多与减少，当性贫血。 各种原因所致的红细胞绝对值增高时，红细胞压积也会有相 应的增加。血液浓缩时红细胞压积可达50%以上，临床上常,,(问:什么是红细胞压积，测定红细胞压积有何意义? 用于了解脱水病人的血液浓缩程度，作为计算补液量的参考。 红细胞压积降低于各种贫血有关，因红细胞体积大小的不同，答:血液经抗凝处理后，通过离心可以把血液分为两大部分，红细胞压积的改变并不与红细胞数量平行，需同时测定红细血浆和血细胞。如果将血液放在一个特殊的试管中(温氏管)胞数量和血红蛋白浓度，并用于计算红细胞各项平均值才有按规定的时间和速度进行离心，最终使得红细胞完全压实在参考价值。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 成两大部分，沉淀在下面的是凝固在一起的红细胞、白细胞,,(问:血液是由那些部分组成的? 和血小板三种有形成分;浮在上面的清晰透明的淡黄色液体 是血清，血清中不含有血细胞和纤维蛋白原成分。 答:血液是人体的重要组成部分，它维持着人体各部分的生 理功能，是维持生命的基本成分之一，没有了血液，人的生,,(问:血液是如何循环的，人有多少血液? 命将不会存在。血液是如此的重要，那么血液的组成是怎样 的呢? 答:血液是一种黏稠的红色液体，它流经人体的各个部分， 简单地说，血液主要由血浆和血细胞(就是人们所说的血从心脏出发，经过动脉到小血管到毛细血管，再到静脉，回球)两大部分组成，将血液用抗凝剂抗凝处理后，放在离心机到心脏，经过心脏将血液送入肺内，静脉血在肺脏的肺泡中内离心或静置一段时间后就可发现血浆和血细胞明显分为两进行气体交换后，血液重新带足氧气变为鲜红的动脉血，再部分，血细胞因为分量较重被沉淀在底部，悬浮在红色血细回流到心脏中，进行下一轮的循环。 胞上面的黄色透明液体就是血浆。 一个成人大约有相当于体重的8%的血液在全身各个部 血细胞部分是由有固定形态的红细胞、白细胞和血小板位循环，也就是说如果体重为60公斤的人约有4.8公斤的血三部分组成的。 液。血液的比重约为1.060，因此4.8公斤重的血液约有4.5 血浆中含有91%,92%的水分，其他的主要成分是血浆升。 蛋白、激素、营养物质、代谢产物、酶类、电解质、微量元 素和血液气体等。 ,,(问:化验中要求的全血、血浆和血清有何区别? 如果血液不经过抗凝处理，让其自然凝固，血液也会分 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 答:血液经抗凝处理后的全部血液为全血;离心除去血细胞,,(问:血液应该是鲜红的，为什么有时抽出的血是暗红后所得到的淡黄色液体为血浆。 的或黑红色的呢? 如血液不经抗凝处理，让他自行凝固，则在抽血后的一答:前面说过血液有动脉血和静脉血之分。人体动脉多处于段时间内，血液会自动在一系列凝血因子的作用下发生凝集，身体的较深部位，因此不易看到，动脉中流动的血液因含有血液首先凝固成一个整体，再经过一段时间或用离心机离心，较多的氧份而呈鲜红色，因此在动脉末梢部位如耳垂或指尖血液中凝固的部分会与一些清澈淡黄色的液体分离开，这些部取血或皮肤外伤后流出的血常显红色或鲜红色，此外略有液体称为血清。血清与血浆从表面上看似乎没有什么不同，贫血的患者血液也多显鲜红色。静脉一般分布在身体的表浅但其内在的主要区别是血清中不含纤维蛋白原，是未经抗凝部位，如在肘部、手背、大腿和脚面极易看到，并且呈青紫处理过的血液凝固后得到的。 色，静脉中流淌的血液为静脉血，静脉血因含有较多的二氧 抽血做化验中常遇到某些化验要求用血清测定、用全血化碳和其他代谢产物而显得颜色暗淡。做血液化验时多从肘测定、用血浆测定，即是指血液标本的三种主要处理方式和部静脉抽血，因此你看到的抽出的血液常为暗红色或黑红色，要求。 此时也可表明你的血液中含红细胞和血 血清多用于血液生化、免疫等方面的测定;血浆多用于红蛋白较多。此外当血液浓缩时或患有肺心病的病人静脉血凝血等方面的测定;全血则多用在血细胞、血常规、血沉等可呈黑紫色。 方面的测定。 在指尖等末梢部位取血时也有可能见到血液的颜色较 血液的抗凝处理需要抗凝剂，选用什么抗凝剂应根据具深，类似于静脉血，这是因为它们多来源于末梢静脉一端，体的实验要求进行选择。 或血红蛋白浓度较高，或血液浓缩等因素造成。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet ,,(问:抽静脉血化验之前有哪些准备? 抽血后医生或护士会将血液分配在不同的试管内以适应 不同的实验要求。 答:提到化验，病人就会联想到抽血和疼痛，心情就会有不 同程度的紧张，小孩还可能会大哭大闹。抽血固然会疼，但,,(问:采末梢血有何要求和准备? 程度很轻。紧张甚至恐惧主要是心理作用。为保证化验结果 的稳定和准确，病人应给予积极的配合，保持放松状态。 答:末梢血主要有耳垂取血和指尖取血两个部位，婴儿可在 抽血检查一般采静脉血，静脉血化验除特殊要求的项目脚后跟取血。耳垂取血痛感较轻，但取血量较少，特别是耳以外，一般要求在上午抽血，抽血前尽量减少运动量，不要垂较小的人比较难于取血。指尖取血痛感较明显，但采血量吃食物，保持空腹，可以喝少量的水，除某些必须按时服用较多，特别是对于血常规化验，可得到较为稳定的测定结果。 的药物以外，尽量将其他药物移到抽血之后再服用，以免对 采血前应将皮肤清洗干净。在冬季寒冷的室外进到室内某些实验结果有所干扰。如是住院病人，应在比较平稳的状后不要立即取血，应使身体暖和以后，特别是应使采血的耳态下，由医生或护士为您抽血。抽血前应尽量清洁抽血部位垂和手暖和起来。在采指血前不要用热水烫手，保持手指干的皮肤。抽血量的多少是根据化验内容的不同及项目的多少燥，如指尖有伤口、甲沟炎、红肿或皮肤病应避开使用此手来决定的，抽血量一般在2,20毫升，最多不会超过50毫升。指。指尖采血一般用无名指，因无名指刺破后不会影响手的经常听患者说“抽了这么多的血需要多少营养才能补回来日常生活功能，当然也可用中指或食指，无特殊区别。采耳呢?”其实这完全没有必要担心和紧张，因为这只占人体全部垂血时应将耳垂上的耳环等挂饰物取下，采血后不要立即挂血量的0.5‰,3‰，不需要任何补充和特殊营养，人体完全上。 可自动进行调整和适应。 采血后应用消毒棉块或其他消毒止血物品压紧针刺破for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 处，不要触及脏物，不要立即浸水洗手。 答:空腹抽血已成为许多项化验检查基本要求，主要有以下,,(问:末梢血可用于哪些化验? 原因: (1)许多抽血化验项目的正常参考值均来源于正常人群空 腹抽血的结果，经统计分析后得到的。 答:末梢血因其取血方便，多用于一些简单易行，用血量少， (2)进食后可血液中许多化学成分可发生改变，因而不能测定快速的化验检查。较为常用的项目有血常规化验、血型、 微量法或称快速血糖(使用血糖试纸条法)、微量法血沉(潘氏得到准确的化验值，如进食含脂肪高的食物后可使甘油三酯法血沉)、微量红细胞压积测定等。 明显升高数倍;食用高糖食物两小时内可使血糖迅速生高。 在头天晚间进食后到第二天清晨，空腹时间达十小时以上， 由于现代化测定技术的飞速发展，一些原来需用静脉血 体内各种物质已达到相对稳定和平衡，食物性因素对血液成或用血量较大的项目也有了快速的微量法;这些项目也可使 分基本没有影响，此时抽血可得到相对稳定准确的结果。 用末梢血，如与肝功能有关的谷丙转氨酶、胆红素、谷草转 氨酶、乙肝表面抗原(澳抗)等测定;与肾功能有关的肌酐、尿 (3)人体生物周期的变化，某些项目指标因采血时间不同，素氮和尿酸;与血脂有关的胆固醇和甘油三酯测定;某些酶变化较大，如皮质醇分泌高峰在早晨，下午至晚间则逐渐下 降，因此在同一时间测定的结果具有可比性。 类如激酸激酶、乳酸脱氢酶、胰淀粉酶、微量元素的测定等。 (4)人在早间运动较少，而进食、劳动、运动、工作等诸许多新的可用微量末梢血进行快速检测的项目还在不断建立 中。 多因素的影响，可使一些化验指标波动，有碍检测结果的准 确性，也不利于与以前所做结果的比较。 ,,(问:许多实验为何要求空腹抽血? for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet ,,(问:耳垂血、指血、静脉血、动脉血各有何用? 小儿贫血概论 答:人体血液是通过心脏和动脉、静脉以及遍布全身的毛细 血管进行循环的。人们在医院中进行抽血化验主要有两种方 [定义] 式，即静脉血和末梢血。 贫血(Anemia)是小儿时期常见的一种症状或综合征， 静脉血一般采用肘静脉(俗称:胳膊血)，用注射器穿刺抽 是指末梢血液中单位容积内红细胞数，血红蛋白量以及红细血，抽血量根据化验项目不同及项目多少不同，抽血几毫升 胞压积低于正常，或其中一项明显低于正常。由于地理环境至几十毫升不等，一般常用于血糖、血脂、肝肾功能、免疫 因素的影响，此三项正常值国内外均有差异。因为红细胞数、球蛋白、甲状腺功能等生物化学及免疫学实验和绝大多数特 血红蛋白量二者与红细胞压积不一定平行，故临床多以红细殊实验。 胞数和血红蛋白量作为衡量有无贫血的标准。须指出的是， 耳垂血和指血统称为末梢血，常自耳垂部或指尖取血， 由于红细胞数和血红蛋白量与血容量有关。例如在血容量减采血量较少，多在0(1毫升左右，常用于血常规检查、血型、 少时(脱水)，虽然单位容积内红细胞数和血红蛋白量是正常，快速血糖等简单快速的实验，但现在有许多医疗单位血常规 但可能已有贫血。此时单凭红细胞数和血红蛋白量就不能反检验也用静脉血来做，可获得更准确稳定的结果。 映贫血的真实情况。 动脉血因携带氧气，为人体新陈代谢提供能量，通常用 [分度] 于做血液气体分析。 临床上根据血红蛋白量和红细胞数降低程度的不同而将 贫血分为以下几度:血红蛋白在9-12克,分升为轻度，6-9 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 克,分升为中度，3-6克,分升为重度，3克,分升以下为极80-94立方微米)，红细胞平均血红蛋白量(MCH，正常值27-32重度。 红细胞数在300万-400万,立方毫米(以下单位同)微微克)和红细胞平均血红蛋白浓度(MCHC，正常值32-38为轻度，200万-300万为中度，100万-200万为重度，100万克,分升红细胞)的测定结果而将贫血分为四类:1)大细胞以下为极重度。 性贫血 MCV>94立方微米，MCH为>32微微克，MCHC 必须指出的是，血红蛋白量的减低与红细胞数的减低程正常。属于此类贫血者有营养性巨幼红细胞性贫血。2)正细度在不同种类的贫血可不平行，例如在大细胞性贫血时，红胞性贫血 MCV、MCH和MCHC均正常。此类贫血见于再细胞数的减低较血红蛋白量的减低为显著，在小细胞低色素生障碍性贫血、急性失血后贫血。3)单纯小细胞性贫血 性贫血时，血红蛋白量的减低则较红细胞数的减低为显著。 MCV为<80立方微米，MCH小于正常，MCHC正常。慢性 此外，在诊断贫血时必须参照不同年龄小儿血红蛋白量感染、慢性肾脏疾病所致的贫血属于此类。4)小细胞低色素 -20微微克，和红细胞数的正常值作比较，才能较准确地判断贫血的程度，性贫血 MCV<80立方微米，MCH为12例如新生儿初生时，其血红蛋白量如为12克,，这与初生时MCHC<30克,分升。此类贫血见于缺铁性贫血、地中海贫血血红蛋白的正常值比较，则表明患中度贫血。 等。 [分类] 二、病因分类法 这种分类法是根据疾病发生的原因进行分类，故对诊断由于贫血的病因和发病原理多种多样，因此，迄今尚无 一个既能阐明病因与发病原理，又能指导临床的统一分类法。和治疗都有一定的指导意义。造成贫血的原因是由于红细胞目前一般采用形态分类和病因分类。 的生成与破坏二者不平衡所致，据此将贫血分为失血性，溶 一、形态分类 血性和造血不良三类: 这种分类的基础是根据红细胞平均容积(MCV，正常值 1)失血性 急性失血(如创伤大出血，出血性疾病等)for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 和慢性失血(如溃疡病、钩虫病、肠息肉等)。 作用。因此，可互相补充。 2)溶血性 [临床] 红细胞内的异常(内因性)包括(1)红细胞膜缺陷 如遗传贫血的临床表现与其病因，程度轻重、发生急慢和年龄性球形细胞增多症、遗传性椭圆形细胞增多症。(2)红细胞酶等因素有关。一般而论，急性的贫血如急性失血或溶血，虽缺陷 如6-磷酸葡萄糖脱氢酶缺陷症、丙酮酸激酶缺陷症等。贫血程度较轻，亦可引起严重症状甚至休克。而慢性贫血，(3)血红蛋白合成与结构异常 如地中海贫血、异常血红蛋白早期由于机体各器官的代偿功能较好，可无症状或症状较轻，病等。 当代偿不全时才逐渐出现症状。小儿对慢性贫血的耐受性一 红细胞外异常(外因性)包括 (1)免疫因素 存在有破坏般较成人为大。个别慢性贫血患儿(如重型β,地中海贫血)，红细胞的抗体，如新生儿溶血症、自身免疫性溶血性贫血、在重度贫血时仍可走路上楼。由于红细胞主要功能是携带氧药物所致免疫性溶血性贫血等。 (2)感染因素 因细菌的溶血气输送全身，贫血时，血液含氧量减少而呈低血氧症，这就素或疟原虫等对红细胞的破坏。(3)化学物理因素 如苯、铅、引起组织与器官功能减退而产生各系统症状。主要临床表现砷、蛇毒、烧伤等可直接破坏红细胞。(4)其他 如脾功能亢进。 可分为三方面; 3)造血不良 一、 一般表现 皮肤、粘膜苍白为突出表现。由于红细胞数及血红蛋白如缺乏造血物质(缺铁性贫血，营养性巨幼红细胞性贫 血);骨髓抑制 (先天性再生低下性贫血、再生障碍性贫血、含量减低，使皮肤(面，耳轮、手掌等)、粘膜(睑结膜、口感染、恶性肿瘤，血液病等)。 腔粘膜)及甲床呈苍白色。重度贫血时皮肤往往呈蜡黄色， 以上两种分类法各有其优缺点，目前国内外多采用病因每易误诊为合并轻度黄疸，相反，伴有黄疸，青紫或其他皮分类法。由于形态分类可用于推断病因，对病因诊断起辅助肤色素改变时可掩盖贫血的表现。此外，病程较长的还常有for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 易疲倦，毛发干枯，营养低下，体格发育迟缓等症状。 3)神经系统 二、 造血器官反应 常表现精神不振、注意力不集中，性情易激动等，脑组 婴儿期由于造血器官的功能尚未稳定，当造血需要增加织严重缺氧可出现昏厥。年长儿可有头痛、昏眩、眼前有黑时，往往骨髓外造血器官和组织呈增生性反应，回复到胎儿点或耳鸣等。 时期的造血状态，出现肝脾和淋巴结不同程度增大(再生障 [治疗] 碍性贫血骨髓外造血一般不增强)，末梢血液中可出现有核红一、去除病因 细胞、幼稚粒细胞。 这是治疗贫血的关键，但尚有某些贫血趵病因尚未充分 三、各系统症状 明了，对此，应积极加以研究，明确其病因，并予以去除。 1)循环和呼吸系统 二、一般疗法 这两个系统的症状是互相联系的，贫血时，由于组织缺适当护理，预防感染，注意饮食疗法，饮食的质和量应氧，可出现一系列代偿功能改变，如通过心率加快和呼吸加取决于小儿的年龄和病情。 速来达到增加运输氧气的能力(活动后更明显)。体格检查可三、药物疗法 发现心率加快，脉搏加强，动脉压增高，有时可见毛细血管治疗贫血的药物主要有:铁剂、维生素Bl、和叶酸。铁搏动。到重度贫血代偿功能失调时，出现心脏扩大，心前区剂仅适用于治疗缺铁性贫血，维生素Bl和叶酸适用于营养性收缩期杂音，甚至发生充血性心力衰竭。 巨幼红细胞性贫血。此外， 氯化钴、睾丸酮、中药首乌、阿 2)消化系统 胶、当归、鸡血藤、熟地黄等均有刺激骨髓造红细胞的作用。 胃肠蠕动及消化酶的分泌功能均受到影响，出现食欲减肾上腺皮质激素可用于治疗自身免疫性溶血性贫血和先天性退、恶心、腹胀或便秘等。偶有舌炎，舌乳头萎缩等。 再生低下性贫血。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 四、输血疗法 临床诊断的前提和必要条件。 重度贫血或因贫血而引起心功能不全，输血是抢救措施。多参数血细胞计数仪的使用为临床提供了大量普通手段长期慢性贫血者，若代偿功能良好，可不必输血，必需输血难以测量的参数，使血细胞形态学观察不再局限于显微镜下时宜注意输血量和速度。输血量一般10ml,kg,次。输血速少数细胞的微观结构，对血细胞的体积分布情况，离散程度，度不宜过快，以免引起心力衰竭和肺水肿。对于贫血合并肺特别是异常体积血细胞的数量、分布区域有了更进一步的了炎的患儿，每次输血量和速度更应减少和减慢。 解，使形态学和病因之间的联系更加紧密，更能反映病因学。 五、并发症处理 利用血细胞计数仪对血细胞进行分析，其优越性不光表现在 婴幼儿贫血易合并急、慢性感染，营养不良，消化紊乱血液病的筛查与早期诊断上，对疾病治疗过程中的动态观察等，对此，除应积极处理外，还需要考虑某些特点，如贫血也是其它检查所不能及。现就常见的血细胞参数变化及血细患儿在消化紊乱时，对于体液失调的调节能力较无贫血的患胞直方图等问题作初步探讨。 儿差，在处理时宜结合具体情况，仔细分析观察，并及时给一、血细胞计数仪的优点 以对症和针对病因的治疗。 最新出现的血细胞计数仪采用了电子、光学、化学等技 术，可以更全面、更准确、更快速对单个或多个样本血液中 血细胞计数仪及其临床应用 的白细胞、红细胞及血小板等进行分析，精确度高，成本低 廉，在第一时间为临床医生提供了准确、丰富的实验检查资作者:杨慧 文章来源:好医生 料。数据储存方便、利于提取和分析，已成为临床医学实践 中最为重要的诊断方法之一。 利用血细胞计数仪进行血常规检查是目前临床应用最为 比起传统的手工方法，血细胞计数仪具有明显的优广泛的检查项目，正确合理地使用和解释检验项目及结果是 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 势，但如果操作不当，结果的可信度也会大打折扣。 有不同，本文以KX-21型血细胞计数仪为例，分别就白细胞、 红细胞和血小板直方图的临床应用进行讨论。 二、如何保证血细胞计数仪结果的可信度, 保证标本的生理状态 采集标本应严格按照标准的操作 下面让我们先看看的组成吧 ，避免溶血、污染等现象的发生，防止“垃圾进垃圾出”。 (一) KX-21型血细胞计数仪报告组成 分析中做到准确、精确 使用血细胞计数仪进行分析是1. 普通血常规结果 要做到操作熟练，参数设置恰当，保证监测信息的准确可靠。 包括白细胞总数(WBC)、红细胞总数(RBC)，血红蛋 合理评价检测结果 由于血细胞计数仪获得的数据是立白浓度(HGB)，红细胞比积(HCT)、平均红细胞体积(MCV)，体的，多方面的，因此有必要全面、详细地分析和评价试验平均红细胞血红蛋白含量(MCH)，平均红细胞血红蛋白浓度的结果，切不可武断行事，同时应该结合病人的临床症状给(MCHC)以及血小板计数(PLT)等。这些指标的正常参考出正确的诊断结论。 值见表1。 三、血细胞直方图的临床应用 表1 血常规正常参考值 直方图是血细胞计数仪用电阻抗原理对血细胞进行检 测，以细胞体积为横坐标，细胞的相对数量为纵坐标，表示 某一种细胞数量分布情况，可反映细胞体积大小异质性的直 观的表达方式，主要由白细胞直方图、红细胞直方图和血小 板直方图共同组成。不同型号的血细胞计数仪的分析结果稍 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 2. 正常白细胞直方图特征 白细胞分类及正常参考值见表2，主要有6个部分，分别图1 正常白细胞直方图 如图1所示。其中:(1) (2) 表示滴入溶血剂后的小白细胞个3. 正常红细胞直方图特征 数比率和个数，相当于淋巴细胞;(3) (4) 表示滴入溶血剂后红细胞分类及正常参考值见表3，图2是正常红细胞直方的中细胞个数比率和个数，相当于单核细胞，嗜酸性粒细胞，图的分布特征，(7)表示RDW-SD，即红细胞分布宽度—SD，嗜碱性粒细胞。(5) (6) 表示滴入溶血剂后的大白细胞个数比它是将直方图顶点的高度定位100%，自下而上高度为20%时率和个数，相当于嗜中性粒细胞。 红细胞分布宽度，是反映红细胞体积异质性改变的参数，能 表2 白细胞正常参考值 客观地反映红细胞大小不等的程度。主要用途是?缺铁性贫 血的诊断和疗效观察;?缺铁性贫血和地中海贫血的鉴别诊 断;?有助于贫血的病因学分类。 表3 红细胞正常参考值 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 测血小板造血功能等有意义。 图2 正常红细胞直方图 4.正常血小板直方图特征 血小板分类及正常参考值见表4，图3是正常血小板直方 图3 正常血小板直方图 图的分布特征。(8)PDW:血小板分布宽度，将直方图顶点 下面让我们着重看看这些直方图的临床意义 的高度定位100%，自下而上高度为20%时血小板分布宽度， (二)白细胞直方图的评价 对检测血小板凝集，与红细胞的重叠等有意义。(9)MPV: 1.白细胞系统的指标(表5) 平均血小板容积，低鉴别线和高鉴别线之间的血小板平均容 积，被认为可以提供血小板早血功能，体内血小板动态等有 表5 白细胞系统的指标 用信息。(10)P-LCR:大血小板比率，12fl与高鉴别线之间 的血小板比率，对检测血小板凝集，与红细胞的重叠以及监 细胞总数 WBC for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 中性粒细胞百分率 GRAN%,绝对值GRAN 淋巴细胞百分率 LYM%,绝对值LYM 中值细胞百分率 MID%,绝对值MID 嗜酸性粒细胞百分率 EO%,绝对值EO 嗜碱性粒细胞百分率 BASO%,绝对值BASO 单核细胞百分率 MONO%,绝对值MONO 变异淋巴细胞百分率 ALYM% 2.白细胞直方图 图4 嗜中性粒细胞增多 (1)嗜中性粒细胞增高，核左移 如图4所示，中性粒细胞比例增高或淋巴细胞比例减低 时，白细胞直方图表现为粒细胞峰明显变大,淋巴细胞峰明显 变小。严重细菌感染时，如果中性粒细胞发生中毒性改变， 粒细胞峰可向左移动或向右延伸。 图5 单核细胞增多 (2)单核细胞比例增高(图5) 白细胞直方图表现为在单for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 核细胞区出现一个明显的峰,其大小与单核细胞比例增高的程(3)淋巴细胞减少(图6) 度有关，常显示“R3”报警提示。值得注意的是，仪器显示(4)酸性粒细胞比例增高(图7) 白细胞直方图上也在单的“MO”或“MID”增高仅表示可能是单核细胞增高，也可个核细胞区出现一个明显的峰,其大小也与嗜酸性粒细胞增高能是嗜酸性粒细胞或幼稚细胞等，因此，必须涂片染色后经的程度有关,注意事项与单核细胞比例增高相同。 显微镜确认。 红细胞溶解不全，白细胞凝集等的直方图特征分别见图8 和9。值得注意的是，异常的直方图仅提示检查者粗略判断各 类白细胞细胞比例变化或有无明显异常细胞出现，提示在显 微镜复检时应注意这些变化的真正病理意义，或在正常人体 检中筛选是否需要进一步血涂片检查，仅根据白细胞直方图 的变化来进行临床诊断的说法是不正确的。 图6 淋巴细胞减少 图8 红细胞溶解不全 图7 嗜酸性粒细胞增多 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 图9 白细胞凝集 升高，而轻型地中海贫血时，RDW正常。 (三)红细胞直方图的评价 (3)对贫血进行分类(Bessmanff分类法):将MCV与 1. 红细胞系统的指标 RDW结合对贫血分类更完善。 主要包括:红细胞计数(RBC)，血红蛋白浓度(HGB)，关于传统的RBC参数与RDW变化与贫血的关系总结如红细胞比积(HCT)，平均红细胞体积(MCV)，平均红细胞表6，7，8。 血红蛋白含量(MCH)，平均红细胞的血红蛋白浓度(MCHC)，表6 各种贫血MCV、MCH、MCBC的变化 红细胞分布宽度(RDW)，红细胞直方图(RBCHISTOGRAM) 等。其中，MCV，MCH，MCHC三项又被称为红细胞指数， 是判断贫血的经典参数，但临床实践发现，MCHC的异常往 往是由测量误差所致，而并非真实的疾病状态，给临床判断 带来不便。但有两种情况例外，一个是严重缺铁性贫血MCHC 表现为减少，另一个是遗传性球性红细胞增多症时MCHC增表7个中贫血RDW的变化 高，这两种情况MCHC具有重要的实验室检查价值。 RDW是由红细胞体积的变异系数表示，比红细胞大小不 均的观察更为客观准确，其增大的临床意义有: (1)用于IDA诊断与疗效观察，IDA时，增高，当MCV 正常时，RDW增大为早期缺铁的指征，补铁后，RDW正常。 (2)用于小细胞低色素性贫血的鉴别诊断，IDA时RDW表8基于MCV和RDW的贫血分类法 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 用红细胞体积的异质性可以一目了然的观察到根据MCV和 RDW为基础的贫血分类，观察贫血治疗后的反映以及各群红RDW正RDW正RDW正RDW增 REW增高 RDW增高 细胞的MCV。如红细胞大小发生变化或异质性改变，均可见常 常 常 高 红细胞直方图左移或右移，或出现双峰。 早期或混合营叶酸 (1)小细胞贫血时，RDW正常，红细胞主群左移，分儿童 缺铁 成人 再障 养缺乏 /B 12 布在0-100fl，峰顶在75fl处。主要是“小细胞低色素”RDW Hbs(2/3) 慢性疾慢性疾贫血性血红蛋轻度增高，红细胞主群左移，分布在50,100fl，峰顶在65fl肝病 病 病 白病 或地贫 处，主要见于“小细胞低色素和不均一性。RDW明显增高， 直方图表现为有两个细胞峰，小细胞峰左移，峰顶在50fl处，无贫血 无贫血 大细胞峰封顶在90fl处，“小细胞低色素和不均一性”。 骨纤 的血红 杂合子HbH病 肝病 (2)大细胞性贫血(图10，11)时，主要有以下几种情蛋白或免疫性溶血 地贫 况:? RDW正常，红细胞主群右移，分布在75,130fl，峰酶一场 顶在100fl处，即“大细胞性”。?RDW轻度增高，红细胞主 冷凝集素病 群明显右移，分布在75,150fl，峰顶在105fl处，RDW轻度 CLL MDS 增高，“大细胞、均一性”。?RDW明显增高，红细胞峰明显 新生儿 右移，有两个细胞峰，峰顶在100fl处为主，“大细胞、不均2. 红细胞直方图 一性”。 正常红细胞分布在50,200fl范围内，呈左偏态分布，利 (3)正常细胞性贫血:? RDW正常，红细胞主群分布 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 在55,110fl，峰顶在88fl处，“正常分布”。?RDW轻度增 高，红细胞主群分布在40,120fl，峰顶在80fl处，“不均一 性”。?RDW明显增高，红细胞分布在40,150fl，峰顶在90fl 处，怀疑异常分布，“不均一性”。各种常见贫血RBC直方图 图11红细胞大小不等 见图12，13。 缺铁早期，血细蛋白(Hemoglobin， Hb)，MCV尚属正 常的情况下HDW可增高。故RDW在缺铁贫的早期诊断上有 意义，经铁剂治疗恢复期的红细胞直方图，由于造血原料得 补充，造血系统增生，网织红细胞增高，此时红细胞直方圈 出现大小不同的细胞群体，RBC直方图呈现取峰，基线增宽， 图12 各种常见贫血的RBC直方图 标志着治疗有效，一段时期还会增高，且MCV、MCH、MCHC 值均恢复正常。巨幼细胞性贫血图峰右移，峰值低，基底部 增宽，说明体积大的细胞分布多，示为大细胞性贫血(图14)。 图10 大细胞性贫血 图13 缺铁性贫血与轻型低贫的RBC比较 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet )。 近横坐标(图15 (1) 大血小板(图16):峰右移，35fl处接近横坐标， MPV明显增高。 A治疗前 B治疗后7天 (2) 血小板凝集(图17):分布峰左侧起点高，离横坐 标0.6cm，右侧在20fl处，离横坐标0.4cm.与正常差别明显。 血片上可见5,15个凝集成堆的血小板。 (3) 此外还有例如小红细胞干扰，小血小板等均可导 致血小板直方图异常。 C治疗后17天 D治疗后20天 血小板为多功能的细胞(在生理止血及某些病理过程起 着重要的作用。血小板是巨核细胞浆分出的片断， 易于粘附、 聚集和破坏，干扰因素多，必须对图形、数据进行谨慎分析， 并且寻找出结论的实验室和临床证据。除了以上分析的干扰 E治疗后26天，F治疗后223天 外，还应结合显微镜下分析结果。 图14 某贫血患者治疗前后红细胞直方图的变化情况 (四)血小板直方图的评价 仪器在2,30fl范围内分析血小板，直方图上正常血小板 图15 正常血小板直方图 集中在2,15fl，呈左偏态分布，在25,30fl处，曲线逐渐接 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 缺乏叶酸及 维生素B12 RDW升高 图16 巨大血小板 获得性溶血 性贫血 白细胞计数与分类计数的临床意义 图17 血小板聚集 白细胞是周围血的有核细胞,其数量显著少于红细胞,占课后总结: 0.1%~0.2%。根据其形态特征可以分为粒细胞、淋巴细胞和单RDW在直方图上的应用 核细胞，其中粒细胞还可以分为中性粒细胞、嗜酸性粒细胞 和嗜碱性粒细胞。白细胞的检查对临床诊断有重要的意义。 再生障碍性 通常白细胞计数波动在30%以下，在临床诊断上无意 贫血 义，只有通过定时和反复观察才有意义。 正常RDW 白细胞总数受多种因素的影响: 细胞增殖缺 陷 1、年龄:成人的白细胞总数为(4~10)×109，新生 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 儿为(15~20)×109，6月~2岁为(11~20)×109， 3、中性粒细胞增多常见于: 2、日间变化;午后高于清晨:一日之内最高和最低可 a. 急性感染:白细胞增高的程度与感染灶的范围感染相差一倍。 的严重性及机体的反应性有关。 3、安静松弛时稍低，活动和进餐后稍高， b. 急性中毒:如急性化学药物中毒，白细胞升高，可 4、运动、疼痛、和情绪的影响。 达20×109/L以上，以中性分叶核为主。 5、妊娠和分娩常常升高，尤其是最后一个月。 c. 急性大出血:白细胞升高程度与机体的应激状态， 出血造成的一过性缺氧有关。 如果检查出有以下改变的就有明显的病理意义。 d. 严重组织损伤:较大手术后12-36小时，白细胞常1、核左移: 在10×109/L以上。 周围血中杆状核细胞增多，甚至出现晚幼粒、中幼粒等 e. 白血病或恶性肿瘤:如急慢性粒细胞性白血病和其细胞。常见于急性化脓性感染、白血病、急性中毒、急性溶他肿瘤等。 血。 4、中性粒细胞减少常见于: 2、核右移: a. 某些感染:如某些革兰氏阴性菌的感染，如伤寒副 正常人周围血中的中性粒细胞核以2-3分叶为主，若5伤寒;病毒感染和原虫感染(如疟原虫感染)。 分叶核以上超过3%时叫核右移。常伴白细胞总数减少，为造 b. 某些血液病:如再生障碍性贫血。 血功能衰退的表现。主要见于营养性巨幼细胞性贫血和其他 c.慢性理化损伤:长期化疗和放疗的病人，骨髓造血功恶性贫血。 能会明显受到抑制而导致白细胞减少。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet d.自身免疫性疾病:如系统性红斑狼疮等，由于自身免 b、减少: 如长期使用肾上腺皮质激素，某些传染病疫性抗核抗体导致白细胞减少。 早期。 e.脾功能亢进。 8、嗜碱性粒细胞记数的临床意义: 5、 淋巴细胞增多 a. 嗜碱性粒细胞增多:如慢性粒细胞白血病(嗜酸性 a. 某些病毒感染:如风疹病毒、流行性腮腺炎病毒等 粒细胞也可增多)，嗜碱粒细胞白血病(少见)，某些转移癌 b. 某些慢性感染:如结核的恢复期。 及骨髓纤维化。 c. 淋巴细胞白血病、淋巴瘤细胞白血病。 b. 嗜碱性粒细胞减少的意义不大。 6.淋巴细胞减少: 白细胞计数与分类计数的临床意义 如接触放射线或应用肾上腺皮质激素治疗会导致淋巴细 胞减少。 1.中性粒细胞增多、减少的临床意义 7、嗜酸性粒细胞计数的临床意义 由于中性粒细胞在白细胞中所占百分率最高(50%~70%)， 因此它的数值增减是影响白细胞总数的关键。 生理变化，劳动、寒冷、精神刺激等使嗜酸性粒细胞降 (1)中性粒细胞增多 低，白天低，夜晚高，上午波动较大，下午比较恒定。 ?生理性增多 其病理变化为: 见于胎儿、新生儿，妊娠5个月以上白细胞增多可达15× a、增多:如过敏性疾病、寄生虫病、某些传染病、皮 109/L，分娩时疼痛和产伤可使其进一步增高，如无合并10肤病、某些恶性肿瘤、某些血液病; for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 症于产后2周左右恢复正常;剧烈运动、严寒、暴热等刺激也大量血细胞破坏内脏(如肝、脾)破裂或宫外孕破裂所致大可见白细胞增多。 出血，此时白细胞可迅速增高，达20×109/L，且可出现于血 以上一过性白细胞增多在去除影响因素后不久则可恢复红蛋白降低之前。 正常，系边缘池内的白细胞过多地进入循环池所致，而持续急性中毒 见于急性化学药物中毒如安眠药、有机磷等中时间较长的白细胞增多则与贮备池加快释放等有关。 毒;代谢性中毒如糖尿病酮症酸中毒、尿毒症等也常见白细 ?病理性增多 胞(中性粒细胞)增多。 A.反应性增多 以上反应性白细胞增多常与边缘池内细胞过多释放入血 最常见于急性化脓菌感染，如金黄色葡萄球菌、肺炎链且机体动用贮备池、成熟池乃至分裂池内的白细胞有关。 球菌等。其白细胞总数的增高视感染范围、严重程度及机体B.肿瘤性或持续性白细胞增多 反应性如何而有所不同.轻度感染时白细胞总数可正常，分类常见于急、慢性粒细胞性白血病，急性者白细胞一般时可见中性粒细胞百分率增高;中度感染时白细胞多>l0×109<100×109/L，分类时以原、幼粒细胞为主，而慢性型者白细个/L并可伴轻度核象左移;重度感染时白细胞明显增高胞常>100×109/L，分类时以中幼、晚幼以下各阶段粒细胞为常>20×109个/L并出现明显的核象左移。感染过于严重如感主，并伴有较多的嗜酸、嗜碱粒细胞，此时须与中性粒细胞染中毒性休克或机体反应性较差时白细胞可不增高反而减低型类白血病反应相鉴别。 但伴有严重的核象左移。 (2)中性粒细胞减少 严重的组织损伤如严重的烧伤、机械性损伤、较大手术?某些感染 见于某些革兰氏阴性杆菌(如伤寒、副伤寒沙后、心肌梗塞等均可见白细胞增高，并可借此来区别心梗与门氏菌)感染及病毒感染时如无并发症均可见白细胞减少。 心绞痛。 ?某些血液病 如再生障碍性贫血及非白血性白血病，此for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 时白细胞可< 1×109/L，分类时呈淋巴细胞相对增多，非白血可见血中嗜酸粒细胞轻或中度增多。 性白血病只有经骨髓检查才能确诊。 D.某些传染病 一般急性传染病血中嗜酸粒细胞均减少 ?慢性理化损伤度 长期接触电离幅射(如X射线等，或唯猩红热时嗜酸粒细胞增多，可能系乙型溶血性链球菌能产应用、接触某些化学药物、有毒物质(如氯霉素及含有机磷的生活化补体的酶继而引起嗜酸粒细胞增多。 农药等)。 ?肿瘤性或持续性增多 ?自身免疫性疾病 如系统性红斑狼疮等因自身免疫性A.某些恶性肿瘤 尤其是淋巴系统的恶性疾患如何杰金抗核抗体导致白细胞减低。 病及某些上皮系肿瘤，肺癌时也可见嗜酸粒细胞增多。 ?脾功能亢进 肿大的脾脏中单核-巨噬细胞系统吞噬破B.某些血液病 慢性粒细胞性白血病，嗜酸粒细胞坏过多的白细胞及分泌过多的脾素灭活了促进粒细胞生成的可>10%，并可见其幼稚型;罕见的嗜酸粒细胞性白血病，其白某些因素。 血病性嗜酸粒细胞可达90%，出现较多的幼稚型，并可见形 态学改变。 2.嗜酸粒细胞增多、减少的临床意义 (2)嗜酸粒细胞减少 (1)嗜酸粒细胞增多见于 由于嗜酸粒细胞在白细胞中所占百分率较低故其减少多 ?反应性增多 无临床意义。在长期应用肾上腺皮质激素时由于它抑制组胺 A.过敏性疾患 如支气管哮喘、血管神经性水肿、风疹、合成可间接导致嗜酸粒细胞减少。 食物过敏、血清病等均可见血中嗜酸粒细胞增多，可>10%。 3.嗜碱粒细胞增多、减少的临床意义 B.寄生虫病 特别是肠道寄生虫如钩虫、蛔虫感染等。 C.某些皮肤病 湿疹、天疱疮、银屑病、剥脱性皮炎等(1)嗜碱粒细胞增多见于 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet ?慢性粒细胞性白血病时常伴嗜碱粒细胞增多，可达 B.绝对性增多 某些病毒或细菌所致的传染病如风10%或更多。 疹、流行性腮腺炎、传染性单核细胞增多症、传染性淋巴细 ?罕见的嗜碱性粒细胞性白血病 嗜碱粒细胞异常增胞增多症、百日咳等常见淋巴细胞增多;某些慢性感染如结多，可达20%以上，多为幼稚型。 核病恢复期亦可见淋巴细胞增多;急、慢性淋巴细胞性白血 ?骨髓纤维化和某些转移癌时也可见嗜碱粒细胞增多。 病时前者以原幼淋巴细胞为主，后者则以白血病性成熟淋巴 (2)嗜碱粒细胞减少 细胞为主，并均可导致白细胞总数增高.白血病性淋巴肉瘤时 由于嗜碱粒细胞所占百分率甚低故其减少多无临床意义.多以原、幼淋巴细胞为主。 于速发型过敏性反应如寻麻疹、过敏性休克、促肾上腺皮质 (2)淋巴细胞减少 主要见于长期接触放射线和应用激素和糖皮质激素应用过量以及应激反应等可见嗜碱粒细胞肾上腺皮质激素之后，在急性化脓性感染时由于中性粒细胞减少。 明显增高导致淋巴细胞相对减少。 4.淋巴细胞增多、减少的临床意义 5.单核细胞增多、减少的临床意义 (1)淋巴细胞增多 (1)单核细胞增多 ?生理性增多 出生后一周的婴儿淋巴细胞可达 ?生理性增多 出生后二周的婴儿血中单核细胞增50%以上，可持续到6~ 7岁，其后逐漱接近成人的数值。 多可达15%，儿童亦可较成入稍高。 ?病理性增多 ?病理性增多。 A.相对增多 再生障碍性贫血、粒细胞缺乏症等因中 A.某些感染 如亚急性感染性心内膜炎、疟疾、黑热性粒细胞明显减少以致淋巴细胞百分率相对增高。 病、急性感染的恢复期均可见单核细胞增多.活动性结核如严for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 重的浸润性肺结核、粟粒性结核等单核细咆百分率可明显增高，可达30%以上而使白细胞总数可达20×109 /L B.某些血液病 粒细胞缺乏症的恢复期可见一过性单核细胞增多;恶性组织细胞病、恶性淋巴瘤及骨髓增生异常综合征(MDS)等单核细胞也可增多;急性单核细胞性白血病时白细胞总数增高且出现大量原始、幼稚单核细胞，成熟单核细胞亦可增多。 (2)单核细胞减少的意义不大。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet