blood cell analyzer

With the development of basic medicine, the application of high technology. Especially with the introduction of computer technology, the measurement level of the blood cell analyzer is continuously increasing, and the measurement parameters are continuously increasing. Not only has the medical test level been improved, but also more useful experimental indicators have been provided for the clinic, which has important clinical significance. The significance of PLT, MPV and PDW in the diagnosis of hemorrhagic diseases. 1MPV increased, see non-immune platelet destruction, recovery period of myelosuppression, up to 8 days after cardiopulmonary bypass, sepsis, giant platelet syndrome, CML, etc. 2MPV decreased, see aplastic anemia, spleen, renal failure and chemotherapy. When 3PLT is extremely low, if the MPV rises, the bleeding tendency is not serious, and if the MPV drops, it is obviously prone to bleeding. Basic Information Specialist classification: growth and development examination classification: blood examination Applicable gender: whether men and women apply fasting: fasting Tips: Try to reduce the amount of exercise before blood draw, do not eat food, keep fasting, you can drink a small amount of water, in addition to some drugs that must be taken on time, try to take other drugs to the blood and then take it, so as not to some experiments The result is interference. Normal value The normal reference range of each parameter is as follows: F-800, cytometer as an example: White blood cell count (WBC): (4.0 to 10) × 109 / L. Red blood cell count (RBC): Male: (4.0 ~ 5.5) × 1012 / L. Female: (3.5 ~ 5.0) × 1012 / L. Hemoglobin (Hb) Male: 120 ~ 160g / L. Female: 110 ~ 150g / L. Hematocrit (HCT) Male: 0.4 to 0.5. Female: 0.37~0.48. Average red blood cell volume (MCV): 80 to 94 fl. Average red blood cell hemoglobin content (MCH): 26 to 32 pg. Average red blood cell hemoglobin concentration (MCHC): 320 to 360 g/L. Platelet count value (PLT): (100 to 360) × 109 / L. Percentage of lymphocytes (W-SCR): 0.2 to 0.4. Absolute value of lymphocytes (W-SCC): (1.5 to 3.0) × 109 / L. Percentage of neutral cells (W-LCR): 0.5 to 0.75. Neutrophil absolute value (W-LCC): (3.0 to 5.8) × 109 / L. Red blood cell distribution width variation (RDW-CV): 0.11 to 0.16. Average platelet volume (MPV): 6.5 to 11.5 fl. Platelet distribution width (PDW): 10 to 15 fl. Clinical significance The meaning of some of the parameters is described as follows: (1) The significance of combining Hb with MCV, MCHC, and RDW in the diagnosis of various anemias. (2) The significance of PLT, MPV and PDW in the diagnosis of hemorrhagic diseases. 1MPV increased, see non-immune platelet destruction, recovery period of myelosuppression, up to 8 days after cardiopulmonary bypass, sepsis, giant platelet syndrome, CML, etc. 2MPV decreased, see aplastic anemia, spleen, renal failure and chemotherapy. When 3PLT is extremely low, if the MPV rises, the bleeding tendency is not serious, and if the MPV drops, it is obviously prone to bleeding. Low results may be diseases: acute blood loss caused by high blood loss may be disease: recurrent aphthous ulcer, pediatric giant platelet syndrome, electric burns precautions (1) Most blood cell analyzers used in clinical practice can use either venous blood anticoagulation or peripheral blood (manual dilution). The venous blood anticoagulant is best ED-TA-2K, followed by EDTA- 2Na, but can not use heparin. (2) Impedance blood cell analyzer is susceptible to dust interference in the air. If the specimen is diluted and placed in the chamber, the 30 min PLT will increase significantly, while the MPV will decrease (the dust particle volume is 5-8 fl, which is smaller than the platelet). Therefore, the environment should be kept clean throughout the sampling test, and each sample cup must be dust-proof. (3) If the sample is left for a long time after dilution, it will affect the result of cell counting. The blood should be diluted according to the conventional method and then placed in a room with a dust cover. After 30 minutes, the RBC reading will decrease by about 5%. After 2 hours, the RBC can decrease by about 12%, which is caused by the high dilution of autolysis. Therefore, it is generally required that the specimen must be tested within 1 h after dilution. (4) The type and quality of the reagent also have an effect on the test results. 1 Different kinds of cytometers have strict requirements on the pH, ionic strength, osmotic pressure and conductivity of the diluent. If the pH is too high or too low, the stability of the cell will decrease, the autolysis will increase, and the cell counting result will be deviated. . Too high or too low conductivity also directly changes the basic current of the instrument, thus affecting the cellular pulse signal, causing deviations in cell counting and classification. Increased osmotic pressure will cause MCV, HCT decline and MCHC to rise; osmotic pressure drop will increase MCV, HCT, MPV, PDW and MCHC. 2 Different kinds of hemolytic agents have different ability to destroy red blood cells, and there are also differences in Hb conversion speed and stability. If the reagents of various types of cytometers are mixed with each other, the accuracy and precision of the analysis results will be affected. Therefore, the choice of reagents for the blood analyzer should be directly matched with the instrument or prepared in strict accordance with the formula provided by the instrument manufacturer. Inspection process Multi-angle laser polarized light scattering detection method: The instrument using this technique uses the sheath flow to dilute the blood of the specimen. After dilution, the internal structure of the white blood cell is similar to the natural state, and only the basophilic cells have a slight change in the cell structure due to its hygroscopic property. Hemoglobin in red blood cells is separated from cells under the action of high osmotic pressure. The water in the sheath flow enters the red blood cells, so that the cell membrane structure is still intact. It has the same refractive index as the sheath flow and does not affect the detection of white blood cells. The instrument simultaneously detects the scattered light generated by the cells passing through the laser beam from four angles. The 0° front angle scattered light is used to measure the volume of the cells. The 10° narrow-angle scattered light is used to determine the cell structure, and the 90° vertical scattered light pair The internal granules and cytoplasm of the cells were measured, and 90° depolarized light scattering separated eosinophils from neutrophils and other cells. ABBOTT's CD-3000, CD-3500 blood cell analyzer uses this technology. Using the above method to perform a five-group instrument, the final results are presented on a high-resolution white blood cell distribution map. Using computer image technology, various color pixels represent a certain concentration of cells, so that subpopulations and abnormalities are easily recognized, and isolated leukocyte subpopulations can be observed from different orientations in three dimensions. By rotating the three-dimensional axis by some kind of operation, the cell distribution in different orientations can be displayed. Not suitable for the crowd 1. Patients who have taken contraceptives, thyroid hormones, steroid hormones, etc., may affect the results of the examination and prohibit patients who have recently taken the drug history. 2, special diseases: patients with hematopoietic function to reduce disease, such as leukemia, various anemia, myelodysplastic syndrome, etc., unless the examination is essential, try to draw less blood. Adverse reactions and risks 1, subcutaneous hemorrhage: due to pressing time less than 5 minutes or blood draw technology is not enough, etc. can cause subcutaneous bleeding. 2, discomfort: the puncture site may appear pain, swelling, tenderness, subcutaneous ecchymosis visible to the naked eye. 3, dizzy or fainting: in the blood draw, due to emotional overstress, fear, reflex caused by vagus nerve excitement, blood pressure decreased, etc. caused by insufficient blood supply to the brain caused by fainting or dizziness. 4. Risk of infection: If you use an unclean needle, you may be at risk of infection.