Some patients, unfortunately, do not bother with the question: “How to correctly pass biochemical analysis blood? " before starting the procedure. It happens by different reasons- someone excludes preparation for laboratory testing out of ignorance; some think that such preparation is superfluous. In any case, both those and others need an explanation of the need for special preparation before taking a biochemical blood test.
The need to prepare for the procedure is caused by concern for the patient's health - the slightest inaccuracy, deviation can cause the diagnostician to make mistakes. As a result, there is an incorrect diagnosis, treatment of a nonexistent pathology, or, worse, no treatment of an undetected disease. Lost time can cause long expensive treatment, and sometimes even lead to fatal consequences. Therefore, an urgent advice to all people who are going to take a blood test for biochemistry is not to neglect the rules of preparation for this procedure.
General information about the biochemical blood test
Clinical medical practice shows that many patients do not understand the difference between conventional clinical and biochemical blood tests, and it is very significant. Both types of laboratory testing require blood. The method of sampling will vary depending on the needs and request of the diagnostician.
Attention! It is important what goal the specialist sets for himself: to find out the values of the basic parameters of the test, a capillary material taken from the fingertip is suitable; to find out the values of the extended list of test parameters, venous material taken from the brachial vein is required. In some cases, blood is used, taken by a puncture from a specific part of the body.
The fundamental difference between a clinical blood test and a biochemical one is the object of research - the first one studies uniform composition blood, the second is aimed at studying organic compounds involved in biochemical reactions that occur in human body... Blood cells are erythrocytes, platelets, basophils, eosinophils, lymphocytes. Biochemical compounds are proteins, carbohydrates, enzymes, slags (nitrogenous compounds), pigments, lipids, enzymes and electrolytes. Biochemistry will, for example, consider an erythrocyte as a compound of proteins, fats and carbohydrates and, depending on their amount, the doctor will diagnose the patient.
Procedural features of the biochemical blood test
In this part of the article, we can analyze popular questions related to preparation for biochemical analysis: how to donate blood for analysis so that all the results are clear and not distorted? Why do I need to take a fasting blood test? How many times is blood donated for research during the day? what does the phrase " false positive"? Is it possible to donate blood for biochemistry when the menstrual cycle began, or not?
Typology of laboratory results
From the above, it becomes clear that it is necessary to take a biochemical blood test in such a way as to avoid false results. In laboratory studies, it is customary to characterize the results as:
- negative - such that they refute the preliminary diagnosis of the doctor;
- positive - those that confirm the preliminary diagnosis;
- false negative - such that, despite the presence of pathology, confirmed by other methods clinical research, deny its presence;
- false positive - such that, despite the absence of pathology confirmed by other tests, they show its presence.
False results happen during menstruation, pregnancy, physiological stress, eating disorders and stress.
Important! During the day, blood sampling is carried out no more than two times.
Diet on the eve of the procedure
Before telling what you can eat the day before, let's answer the question: "Is it possible to take a blood test on an empty stomach?" On the eve of blood sampling, you really need to have empty stomach... There are a number of reasons for this: a) lung condition hunger is an excellent background for obtaining an objective research result; b) patients sometimes feel sick during the procedure. When a person has been hungry for more than a day, and tests are taken on a completely empty stomach, the result will be blurred. During fasting, the body begins to enter a state of self-sufficiency, scooping up "untouchable reserves" of glycogen from the liver and other tissues, which, accordingly, distorts the readings for sugar (carbohydrates). Other parameters will also undergo changes - there will be more bilirubin, urea, ALT and AST.
Before the procedure, you should be moderate in the use of the following products:
- fried, smoked, salted, canned;
- sweet (you can drink moderately sweet tea, no more);
- fatty (fatty is not allowed, except for dishes cooked in vegetable oil);
- tea (weak);
- hot spices (it is better not to use it at all);
- salt (10 grams per day).
It is necessary to completely exclude from the diet:
- alcohol;
- coffee;
- Dietary supplements.
Biochemical blood test during menstruation and during pregnancy
Menstruation is a physiological condition in women that can greatly distort the result of biochemical analysis. During menstruation, women experience a lot of blood loss - this affects laboratory parameters... Regular condition when in female body some important substances- hormones, enzymes - seriously altering the results of the examination. It is allowed to do any tests no earlier than 7 days after the onset of menstruation.
The female body during gestation differs significantly from its usual state. Medical science it took decades of observations to develop a clinical picture of biochemical processes in the body of a pregnant woman. Special tables were created, norms were calculated, a special approach was developed - all this made it possible to make a biochemical analysis in pregnant women effective method research.
Important! Any tests are taken two days before the start of menstruation and two days after it ends.
Physical strain and stress
Smooth and calm state of the body - necessary condition to obtain an objective result, the answer to the question: "How to take a blood test correctly?"
Strong physical stress includes many of the body's reserves, which, accordingly, changes the clinical picture. Therefore, patients who come to the clinic are offered to rest for 15-20 minutes before starting the procedure if they are out of breath or tired. For the same reason, it is undesirable to take various stimulants, ranging from Coca-Cola to coffee and cigarettes. You can smoke, but on the eve of the examination it is better not to do this. A sharp mental rise, stress also causes a strong overstrain of the body. In such states of mind, the analysis is contraindicated.
Tips for parents on preparing a child for a blood test
Separately, one should dwell on how to take a biochemical blood test for children. A child who is afraid of the blood sampling procedure is stressed. Mental shock changes the course metabolic processes v child's body- this must be avoided. In the video, a representative of the Union of Pediatricians of Russia gives advice to parents on how to properly prepare a child for laboratory examination.
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General blood analysis is a widely used laboratory test that allows you to establish and suspect a large number of pathologies, as well as control the human condition when chronic pathologies or against the background of ongoing therapy. In a word, a general blood test is both a universal and a nonspecific test at the same time, since its results can be correctly deciphered and interpreted only in connection with a person's clinical symptoms.
Complete blood count - characteristics
A complete blood count is now correctly called clinical blood test... However, doctors, laboratory staff, and patients in everyday life still use the old and familiar term "complete blood count" or, in abbreviated form, KLA. Everyone is accustomed to the old term and understands what it means, therefore, various changes in terminology are simply not perceived by either doctors or patients, and therefore the name general blood test continues to reign in everyday life. In the further text, we will also use an everyday term familiar to everyone, and not a new correct name, so as not to confuse anyone and cause confusion.Currently, a complete blood count is a routine method. laboratory diagnostics the broadest spectrum various pathologies... This analysis is used to confirm a suspected disease, and to identify hidden pathologies that do not manifest symptoms, and for a preventive examination, and to monitor a person's condition during treatment or chronic course incurable disease etc., as it provides a wide range of information about the state of the blood system and the body as a whole. Similar versatility general analysis blood is explained by the fact that in the course of its implementation, various blood parameters are determined, which are influenced by the state of all organs and tissues of the human body. And, consequently, any pathological changes in the body are reflected in varying degrees of severity on the parameters of the blood, because it reaches literally every cell of our body.
But such versatility of the general blood test also has reverse side- it is nonspecific. That is, changes in each parameter of the general blood test may indicate various pathologies on the part of different organs and systems. The doctor cannot unequivocally say from the results of a general blood test what disease a person has, but can only make an assumption consisting of a whole list of various pathologies. And in order to accurately diagnose pathology, you need, firstly, to take into account the person's clinical symptoms, and secondly, to appoint others additional research which are more specific.
Thus, the general clinical analysis blood, on the one hand, gives a large amount of information, but on the other hand - this information requires clarification and can serve as a basis for further targeted examination.
Currently, the general blood test necessarily includes counting the total number of leukocytes, erythrocytes and platelets, determining the level of hemoglobin, erythrocyte sedimentation rate (ESR) and counting the number of different types of leukocytes - neutrophils, eosinophils, basophils, monocytes and lymphocytes (leukocyte formula). These parameters are determined in any laboratory and are mandatory components of a complete blood count.
However, due to the widespread use in last years various automated analyzers, other parameters determined by these devices (for example, hematocrit, average erythrocyte volume, average hemoglobin content in one erythrocyte, average platelet volume, thrombocyte, reticulocyte count, etc.) can be included in the general blood test. All these additional parameters are not necessary for a general blood test, but since they are automatically determined by the analyzer, the laboratory staff include them in the final test result.
In general, the use of analyzers makes it possible to perform a general blood test quickly and process a larger number of samples per unit of time, but this method does not make it possible to deeply assess various pathological changes in the structure of blood cells. In addition, analyzers, just like people, make mistakes, and therefore their result cannot be considered the ultimate truth or more accurate than the result of calculations in manual mode. And the number of indices automatically calculated by analyzers is also not an indicator of their advantage, since they are calculated based on the basic values of the analysis - the number of platelets, erythrocytes, leukocytes, hemoglobin, leukocyte formula, and therefore can also be erroneous.
That is why experienced doctors often ask laboratory staff in difficult cases to conduct a general blood test in a manual mode, since this method is individual and allows one to identify such features and nuances that no apparatus is able to determine, working according to some averaged canons and norms. We can say that a general blood test in manual mode is like individual tailoring, like manual work, but the same analysis on an automatic analyzer is like mass production of clothes according to average patterns or like working on an assembly line. Accordingly, the difference between a manual blood test and an analyzer is the same as between manual individual production and assembly line assembly. For example, when working on the analyzer, you can detect anemia (reduced hemoglobin level), but to determine its cause, additional studies will have to be performed. If the blood test is carried out manually, then the laboratory assistant can determine the cause of anemia in most cases by the size and structure of red blood cells.
Naturally, with sufficient experience of the laboratory assistant, a manual general blood test is more accurate and more complete than that done on the analyzer. But to perform such analyzes, a staff of laboratory assistants and their rather painstaking and long training are needed, but fewer specialists are enough to work on the analyzer, and they will not have to be taught so carefully with the layout of various nuances and "underwater currents". The reasons for the transition to a simpler, but less informative general blood test on the analyzer are diverse, and everyone can isolate them independently. We will not talk about them, since they are not the subject of the article. But in the framework of the description of the differences between the options for manual and automatic execution of a complete blood count, we must mention this.
Any option (manual or on the analyzer) of the general blood test is widely used in medical practice doctors of all specialties. Without it, the usual preventive annual examination and any examination about a person's disease is unthinkable.
Currently, a blood sample from a vein and from a finger can be used for a complete blood count. The results of the study of both venous and capillary (from a finger) blood are equally informative. Therefore, you can choose the method of donating blood (from a vein or from a finger), which is more pleasant to the person himself and is better tolerated. However, if you have to donate blood from a vein for other tests, then it is rational and for a general analysis in one approach to take a venous blood sample.
What does a complete blood count show?
The result of a general blood test shows the functional state of the body and allows you to detect the presence of general pathological processes in it, such as, for example, inflammation, tumors, worms, viral and bacterial infections, heart attacks, intoxication (including poisoning with various substances), hormonal imbalance, anemia, leukemia, stress, allergies, autoimmune diseases and others. Unfortunately, the result of a general blood test can only reveal any of the indicated pathological processes, but it is almost impossible to understand which organ or system is affected. To do this, the doctor must combine the data of the general blood test and the symptoms of the patient, and only then can it be said that there is, for example, inflammation in the intestines or in the liver, etc. And then, based on the identified general pathological process, the doctor will prescribe additional necessary studies and laboratory tests to make a diagnosis. Thus, in summary, we can say that a general blood test shows in what way (inflammation, dystrophy, tumor, etc.) a certain pathology proceeds in a person. Together with the symptoms, according to the data of the general blood test, it is possible to localize the pathology - to understand which organ was affected. But further, for the diagnosis, the doctor prescribes clarifying tests and examinations. Thus, a complete blood count in conjunction with symptoms is an invaluable guideline in the issue diagnostics: "What to look for and where to look?"
In addition, a general blood test allows you to monitor a person's condition during therapy, as well as in acute or incurable chronic diseases, and timely adjust the treatment. For the purpose of assessing general condition body, a general blood test is also required to be taken in preparation for planned and emergency operations, after surgery to track complications, trauma, burns and any other acute conditions.
Also, a general blood test must be taken as part of preventive examinations for a comprehensive assessment of the state of human health.
Indications and contraindications for a general blood test
Indications for the delivery of a general blood test are the following situations and conditions:- Preventive examination (annual, upon admission to work, upon registration in educational establishments, kindergartens, etc.);
- Routine examination before admission to the hospital;
- Suspicion of existing infectious inflammatory diseases(a person may be worried about fever, lethargy, weakness, drowsiness, pain in any part of the body, etc.);
- Suspicion of blood diseases and malignant tumors (a person may be disturbed by pallor, frequent colds, prolonged non-healing of wounds, fragility and hair loss, etc.);
- Monitoring the effectiveness of the therapy for the existing disease;
- Control over the course of the existing disease.
Before a general blood test (preparation)
Taking a general blood test does not require special preparation, so there is no need to follow any special diet. It is enough to eat as usual, refraining from consuming alcoholic beverages during the day. However, since a general blood test must be taken on an empty stomach, you must refrain from any food for 12 hours before taking a blood sample, but you can drink liquid without restriction. In addition, it is advisable to refrain from smoking, high physical activity and strong emotional impressions. If for some reason it is impossible to refuse food within 12 hours, then it is allowed to take a general blood test 4-6 hours after the last meal. Also, if it is not possible to exclude smoking, physical and emotional stress within 12 hours, then you should refrain from them for at least half an hour before taking the test.
Children need to be reassured before passing a general blood test, since prolonged crying can cause an increase in the total number of leukocytes.
It is advisable to stop taking 2-4 days before taking a blood test. drugs, but if this is not possible, then it is imperative to tell the doctor which medications are being taken.
It is also advisable to have a complete blood count before any other medical procedures. In other words, if a person has to go through comprehensive examination, then you first need to pass a general blood test, and only after that go to other diagnostic manipulations.
General blood test
General rules for taking a general blood test
For the production of a general analysis, blood is taken from a finger (capillary) or from a vein (venous) into test tubes. For half an hour before taking the analysis, one should refrain from smoking, physical activity and strong emotional impressions, since these factors can distort the result. It is advisable to go to the clinic half an hour before the test, undress and sit quietly in the corridor, calming down and in a good mood. If a general blood test is given by a child, then you need to calm him down and try not to let him cry, since prolonged crying can also distort the test result. It is advisable for women not to have a complete blood count before and during menstruation, since the result may be inaccurate during these physiological periods.After taking a general blood test, you can go about your usual business, since taking a blood sample does not have a significant effect on your well-being.
Complete blood count from a finger
For the production of a general analysis, blood can be taken from a finger. To do this, the doctor or laboratory assistant wipes the pad of the finger of the non-working hand (left in right-handers and right in left-handers) with cotton wool moistened with an antiseptic (alcohol, Belasept liquid, etc.), and then quickly pierces the skin of the pad with a scarifier or lancet. Next, lightly squeezes the pad of the finger on both sides so that the blood comes out. The first drop of blood is removed with a swab moistened with an antiseptic. Next, the laboratory assistant collects protruding blood with a capillary and transfers it into a test tube. After taking the required amount of blood, cotton wool moistened with an antiseptic is applied to the puncture site, which must be held for several minutes so that the bleeding stops. Blood is usually taken from the ring finger, but if after puncturing the pads it is not possible to squeeze out a drop of blood, then another finger is punctured. In some cases, you have to pierce several fingers to get the right amount of blood. If it is impossible to take blood from a finger, then it is taken from the earlobe or heel using the same technique as from the finger.
Complete blood count from a vein
For the production of a general analysis, blood can be drawn from a vein. Usually, the sampling is carried out from the ulnar vein of the non-working arm (left for right-handers and right for left-handers), but if this is not possible, then blood is taken from the veins for back side hands or feet.To take blood from a vein, a tourniquet is applied to the arm just below the shoulder, asked to squeeze and unclench the fist several times so that the veins clearly appear in the elbow bend area, swell and become visible. After that, the area of the elbow bend is treated with a swab moistened with an antiseptic, and a vein is pierced with a syringe needle. Entering the vein, the nurse pulls the syringe plunger toward herself, drawing blood. When the required amount of blood has been collected, the nurse removes the needle from the vein, pours the blood into a test tube, and puts cotton wool soaked in an antiseptic on the puncture site and asks to bend the arm at the elbow. The hand must be held in this position for several minutes until the bleeding stops.
On an empty stomach or not to take a general blood test?
A complete blood count should only be taken on an empty stomach, as eating food causes an increase in the number of blood leukocytes. This phenomenon is called alimentary (food) leukocytosis, and is considered the norm. That is, if a person takes a general blood test within the next 4 to 6 hours after eating, and receives a large number of leukocytes, then this is the norm, and not a sign of pathology. That is why, in order to obtain reliable and accurate result a complete blood count should always be taken on an empty stomach after a previous 8-14 hour fast. Accordingly, it is understandable why it is recommended to take a general blood test in the morning on an empty stomach - when, after a night's sleep, a sufficient fasting interval will pass.
If for some reason it is impossible to take a general blood test in the morning on an empty stomach, then it is allowed to take the test at any time of the day, but only at least 4 hours after last admission food. Thus, at least 4 hours should pass from the moment a person ate to a general blood test (but it is better if it takes more - 6 - 8 hours).
Indicators of a general blood test
V mandatory the general blood test includes the following indicators:- Total red blood cell count (may be referred to as RBC);
- Total white blood cell count (may be referred to as WBC);
- Total platelet count (may be referred to as PLT);
- Hemoglobin concentration (may be referred to as HGB, Hb);
- Erythrocyte sedimentation rate (ESR) (may be referred to as ESR);
- Hematocrit (may be referred to as HCT);
- The number of different types of leukocytes in percent (leukocyte formula) - neutrophils, basophils, eosinophils, lymphocytes and monocytes. The leukocyte formula also separately indicates the percentage of young and blast forms of leukocytes, plasma cells, atypical mononuclear cells, if any are found in a blood smear.
In addition to the specified mandatory parameters, additional indicators may be included in the general blood test. These indicators are not specifically determined, they are automatically calculated by the hematology analyzer on which the analysis is performed. Depending on the programs included in the analyzer, the following parameters can be additionally included in the general blood test:
- Absolute content(number) of neutrophils (may be referred to as NEUT #, NE #);
- The absolute content (number) of eosinophils (may be denoted as EO #);
- Absolute content (number) of basophils (may be denoted as BA #);
- The absolute content (number) of lymphocytes (may be designated as LYM #, LY #);
- The absolute content (number) of monocytes (can be denoted as MON #, MO #);
- Average erythrocyte volume (MCV);
- Average hemoglobin content in one erythrocyte in picograms (MCH);
- The concentration of hemoglobin in one erythrocyte in percent (MCHC);
- The width of the distribution of erythrocytes by volume (may be referred to as RDW-CV, RDW);
- Average platelet volume (MPV);
- Platelet volume distribution width (may be referred to as PDW);
- The relative content of monocytes, basophils and eosinophils in percent (can be denoted as MXD%, MID%);
- The absolute content (number) of monocytes, basophils and eosinophils (may be designated as MXD #, MID #);
- The relative content of immature granulocytes - neutrophils, basophils and eosinophils in percent (can be denoted as IMM% or young forms);
- The absolute content (number) of immature granulocytes - neutrophils, basophils and eosinophils (can be designated as IMM # or young forms);
- The relative content of all granulocytes - neutrophils, basophils and eosinophils in percent (can be denoted as GR%, GRAN%);
- The absolute content (number) of all granulocytes - neutrophils, basophils and eosinophils (may be designated as GR #, GRAN #);
- The relative content of atypical lymphocytes in percent (may be referred to as ATL%);
- The absolute content (number) of atypical lymphocytes (may be referred to as ATL #).
The above additional parameters are included in the general blood test when they are automatically calculated by the analyzer. But since the analyzers can be different, the list of such additional parameters of the general blood test is also different, and depends on the type of hematological apparatus. In principle, these additional parameters are not too necessary, since, if necessary, the doctor can calculate them on his own based on the main indicators of the general blood test. Therefore, in fact, in practice, doctors pay little attention to all the additional parameters in the general blood test calculated by the analyzer. Accordingly, you should not be upset if there are few or no specified additional parameters in the general blood test, since, in principle, they are not needed.
General blood test rates in adults
You need to know that an adult is considered to be a person who has reached the age of 18. Accordingly, the norms of various indicators of a general blood test for adults apply to people over 18 years of age. Below we will consider what are the normal values of both basic and additional parameters of a complete blood count for adults. At the same time, you need to know that the average normal values are given, and more accurate limits of the norms need to be clarified in each specific laboratory, since they may differ depending on the region, the characteristics of the analyzers and laboratory technicians, the reagents used, etc. So, the total number of red blood cells is calculated in pieces per liter or microliter. Moreover, if the count is per liter, then the number of erythrocytes is indicated as follows: X T / l, de X is the number, and T / l is a tera per liter. The word tera means the number 1012. Thus, if, as a result of the analysis, 3.5 T / l is written, then this means that 3.5 * 1012 erythrocytes are circulating in one liter of blood. If the count is per microliter, then the number of erythrocytes is indicated by X mln / μl, where X is the number, and mln / μl is a million per microliter. Accordingly, if it is indicated that erythrocytes are 3.5 million / μl, then this means that 3.5 million erythrocytes circulate in one microliter. It is characteristic that the number of erythrocytes in T / L and mln / μL coincides, since there is only a mathematical difference between them in the unit of measurement of 106. That is, a tera is more than a million by 106, and a liter is more than a microliter by 106, which means that the concentration of erythrocytes is in T / L and mln / μL is exactly the same, and only the unit of measurement differs.
Fine total number erythrocytes is 3.5 - 4.8 in adult women and 4.0 - 5.2 in adult men.
The total number of platelets in the blood normally in men and women is 180 - 360 G / l. The unit of measurement G / l means 109 pieces per liter. Thus, if, for example, the number of platelets is 200 G / L, this means that 200 * 109 pieces of platelets circulate in a liter of blood.
The total number of leukocytes is normal in men and women 4 - 9 G / l. Also, the number of leukocytes can be counted in thousand / μl (thousands per microliter), and it is exactly the same as in g / l, since both the number of pieces and the volume differ by 106, and the concentration is the same.
According to the leukocyte formula, normal blood levels in adult men and women contain different kinds leukocytes in the following ratios:
- Neutrophils - 47 - 72% (of which 0 - 5% are young, 1 - 5% are stab and 40 - 70% are segmented);
- Eosinophils - 1 - 5%;
- Basophils - 0 - 1%
- Monocytes - 3 - 12%;
- Lymphocytes - 18 - 40%.
The concentration of hemoglobin is normal in adult women 120 - 150 g / l, and in adult men - 130 - 170 g / l. In addition to g / L, hemoglobin concentration can be measured in g / dL and mmol / L. To convert g / l to g / dl, divide the value in g / l by 10 to get the value in g / dl. Accordingly, to convert g / dl to g / l, the hemoglobin concentration value must be multiplied by 10. To convert the value in g / l to mmol / l, the number in g / l must be multiplied by 0.0621. And to convert mmol / l to g / l, you need to multiply the hemoglobin concentration in mmol / l by 16.1.
The normal hematocrit for adult women is 35 - 47, and for men - 39 - 54.
The erythrocyte sedimentation rate (ESR) is normally 5 - 15 mm / hour for women 17-60 years old, and 5-20 mm / hour for women over 60 years old. ESR in men 17 - 60 years old is normally less than 3 - 10 mm / hour, and over 60 years old - less than 3 - 15 mm / hour.
The average erythrocyte volume (MCV) is normally 76-103 fl in men and 80-100 fl for women.
The concentration of hemoglobin in one erythrocyte (MCHC) is normally 32 - 36 g / dl.
The distribution width of erythrocytes by volume (RDW-CV) is normally 11.5 - 14.5%.
The average platelet volume (MPV) in normal adult men and women is 6-13 fl.
Platelet volume distribution width (PDW) is normal in men and women 10 - 20%.
The absolute content (number) of lymphocytes (LYM #, LY #) in adults is normally 1.2 - 3.0 G / L or thousand / μL.
The relative content of monocytes, basophils and eosinophils (MXD%, MID%) is normally 5-10%.
The absolute content (number) of monocytes, basophils and eosinophils (MXD #, MID #) is normally 0.2 - 0.8 G / L or thousand / μL.
The absolute content (number) of monocytes (MON #, MO #) is normally 0.1 - 0.6 G / L or thousand / μL.
The absolute content (number) of neutrophils (NEUT #, NE #) is normally 1.9 - 6.4 G / L or thousand / μL.
The absolute content (number) of eosinophils (EO #) is normally 0.04 - 0.5 G / L or thousand / μL.
The absolute content (number) of basophils (BA #) is normally up to 0.04 G / L or thousand / μL.
The relative content of immature granulocytes - neutrophils, basophils and eosinophils as a percentage (IMM% or young forms) is normally no more than 5%.
The absolute content (number) of immature granulocytes - neutrophils, basophils and eosinophils (IMM # or young forms) is normally no more than 0.5 G / L or thousand / μL.
The relative content of all granulocytes - neutrophils, basophils and eosinophils (GR%, GRAN%) is normally 48 - 78%.
The absolute content (number) of all granulocytes - neutrophils, basophils and eosinophils (GR #, GRAN #) is normally 1.9 - 7.0 G / L or thousand / μL.
The relative content of atypical lymphocytes (ATL%) - normally absent.
The absolute content (number) of atypical lymphocytes (ATL #) is absent in the norm.
Table of norms for a general blood test in adults
Below, for ease of perception, we give the norms of a general blood test for adults in the form of a table.| Index | Norm for men | Norm for women |
| Total red blood cell count | 4.0 - 5.2 T / L or mln / μL | 3.5 - 4.8 T / L or mln / μL |
| The total number of leukocytes | 4.0 - 9.0 G / L or thousand / μL | 4.0 - 9.0 G / L or thousand / μL |
| Neutrophils (neutrophilic granulocytes) in general | 47 – 72 % | 47 – 72 % |
| Young neutrophils | 0 – 5 % | 0 – 5 % |
| Rod neutrophils | 1 – 5 % | 1 – 5 % |
| Segmented neutrophils | 40 – 70 % | 40 – 70 % |
| Eosinophils | 1 – 5 % | 1 – 5 % |
| Basophils | 0 – 1 % | 0 – 1 % |
| Monocytes | 3 – 12 % | 3 – 12 % |
| Lymphocytes | 18 – 40 % | 18 – 40 % |
| Hemoglobin concentration | 130 - 170 g / l | 120 - 150 g / l |
| Total platelet count | 180 - 360 G / L or thousand / μL | 180 - 360 G / L or thousand / μL |
| Hematocrit | 36 – 54 | 35 – 47 |
| Erythrocyte sedimentation rate | 17 - 60 years old - 3 - 10 mm / hour Over 60 years old - 3 - 15 mm / hour | 17 - 60 years old - 5 - 15 mm / hour Over 60 years old - 5 - 20 mm / hour |
| Mean erythrocyte volume (MCV) | 76 - 103 fl | 80 - 100 fl |
| Average hemoglobin content in erythrocyte (MCH) | 26 - 35 pg | 27 - 34 pg |
| The concentration of hemoglobin in one erythrocyte (MCHC) | 32 - 36 g / dl or 320 - 370 g / l | 32 - 36 g / dl or 320 – 370 |
| Red blood cell distribution width by volume (RDW-CV) | 11,5 – 16 % | 11,5 – 16 % |
| Mean platelet volume (MPV) | 6 - 13 fl | 6 - 13 fl |
| Platelet volume distribution width (PDW) | 10 – 20 % | 10 – 20 % |
The table above shows the main indicators of a general blood test with their normal values for men and women.
In the table below, we present the values of the norms of additional indicators, which are the same for men and women.
| Index | Norm |
| Absolute content (number) of lymphocytes (LYM #, LY #) | 1.2 - 3.0 G / L or thousand / μL |
| Relative content of monocytes, basophils and eosinophils (MXD%, MID%) | 5 – 10 % |
| Absolute content (number) of monocytes, basophils and eosinophils (MXD #, MID #) | 0.2 - 0.8 G / L or thousand / μL |
| Absolute content (number) of monocytes (MON #, MO #) | 0.1 - 0.6 G / L or thousand / μL |
| Absolute content (number) of neutrophils (NEUT #, NE #) | 1.9 - 6.4 G / L or thousand / μL |
| Absolute content (number) of eosinophils (EO #) | 0.04 - 0.5 G / L or thousand / μL |
| Absolute content (number) of basophils (BA #) | up to 0.04 G / L or thousand / μL |
| The relative content of immature granulocytes (IMM%) | No more than 5% |
| Absolute content (number) of immature granulocytes (IMM #) | No more than 0.5 G / L or thousand / μL |
| The relative content of all granulocytes (GR%, GRAN%) | 48 – 78 % |
| Absolute content (number) of all granulocytes (GR #, GRAN #) | 1.9 - 7.0 G / L or thousand / μL |
| Relative (ATL%) and absolute (ATL #) content of atypical lymphocytes | Absent |
Complete blood count in children - norms
Below, for ease of perception, we indicate the norms of indicators of a general blood test for children of different ages... It should be remembered that these norms are averaged, they are given only for approximate orientation, and exact values standards need to be clarified in the laboratory, since they depend on the types of equipment used, reagents, etc.| Index | Norm for boys | Norm for girls |
| Total red blood cell count | ||
At least once in a lifetime, every person has been faced with a test. Modern diagnostics it is impossible to imagine these research results without data. A clinical blood test helps to assess the general condition of the body and identify the presence of an inflammatory process, allergies and others pathological conditions... We will learn how to prepare for this test, and whether it is necessary to take it on an empty stomach or not.
What does this analysis show?
A complete blood count is one of the simplest and most significant studies. In the diagnosis of many diseases, he is assigned a leading role. It allows you to diagnose:
- The presence of an inflammatory process (leukocytes and ESR increase).
- Anemia (anemia). The amount of hemoglobin and erythrocytes decreases.
- Suspect an allergy (eosinophils grow).
- Blood clotting problems (decreased platelets)
- Development infectious mononucleosis(monocytes increase and atypical mononuclear cells appear).
- Much more.
Blood test changes rarely indicate specific disease... They simply confirm that not everything is in order in the body, which, in addition to the existing complaints and the results of other studies, allows the patient to diagnose and choose a treatment.
How is the preparation for the analysis going?
In order for the data obtained to be reliable, before passing the analysis, certain requirements must be observed that may affect the result. Blood is taken for analysis in the morning on an empty stomach. This means that the last meal should be the night before, 10 - 12 hours before delivery. In some sources, you can find data that at least 1 - 2 hours should pass before the material is taken. This is incorrect and may distort the results.
Important! V emergency situations this study is done regardless of whether the patient ate or not, but in such cases, the alleged changes in the analysis are so obvious that food intake does not significantly affect them.
What else you need to know about preparing for the study:
- It is undesirable to take alcohol two days before the study.
- For 1 - 2 days, it is worth giving up fried, spicy and spicy foods.
- If possible, in a week you need to stop taking medications or warn a specialist about their use.
- The day before delivery, you need to avoid serious physical and mental stress.
Failure to comply with the rules and requirements for training can cause distortion of results. So, food eaten a few hours before the analysis or alcohol taken the day before can cause an increase in the level of leukocytes in the blood. And taking certain medications altogether changes the clinical picture of the blood, forcing one to think about a non-existent pathology.
Important! All these requirements must be met if it is important for diagnostics to trace minimal changes in blood dynamics. Then, in order to standardize the results, it is necessary that the delivery of all analyzes take place under the same conditions. If this is not important for the doctor and the patient, then you can eat 4 - 5 hours before the study.
How to get tested?
The patient comes to the laboratory in the morning on an empty stomach. Blood sampling is performed with a disposable sterile scarifier, which, after use, is thrown into special place... The opening of the instrument and the puncture of the finger are carried out with the patient. V paid institutions a finger puncture for children and adults can be performed with a special lancet. It is a small needle in a plastic body that quickly pierces the skin. With this procedure pain practically absent.
The puncture site is disinfected antiseptic solution and remove the first drops of blood with cotton wool. Then, using an adapter, the test tube is filled with blood and applied to a glass slide. The test tube is signed, and the puncture site is pressed with cotton wool treated with an antiseptic until the bleeding stops.
Where does blood come from for analysis?
Blood is taken from the ring finger of the left hand, less often from the middle or index finger. This choice is due to the peculiarities anatomical structure... Pinky and thumb are connected by a common shell with a brush, therefore, when infected, microbes will immediately penetrate into the area of the brush. Other fingers have isolated synovium, and with the penetration of infection, it will not give infectious process go directly to the brush. For a puncture, choose the left (or non-working) hand and ring finger that carries the minimum workload.
What will the analysis show?
A standard blood test makes it possible to assess:
- hemoglobin level and red blood cell count;
- the number of leukocytes and their formula (percentage);
- platelet count;
The results of the study are recorded on special form, where the reference values of the norm for each indicator are spelled out in a separate line. A clinical blood test is a simple and reliable method diagnostics of changes in the general condition of the body. In order for the results obtained to correspond to reality and to be able to compare them in dynamics, the patient must comply with the requirements for the preparation of the analysis.
The correctness of the data obtained largely depends on the quality preparation for the general (clinical) blood test, therefore it is very important to know whether a clinical blood test should be taken on an empty stomach or not, and how to prepare for the study in general.
Immediately, we note: in modern medicine There is no unanimous point of view on the question of whether it is worth taking a clinical blood test exclusively on an empty stomach.
There are two opinions: some scientists believe that it is possible and even necessary to eat before the study, while others (most of them) argue that it is categorically impossible to eat before the clinical analysis. We will try to consider both points of view in more detail.
Before deciding whether it is possible to eat before a clinical blood test, it is necessary to clearly understand what the study is and why a blood test is performed at all.
To begin with, general and clinical blood tests are alternative names for the same study.
This study allows you to identify certain pathological processes occurring in the human body, and inflammation on initial stages their development.
This is explained by the fact that of all human organs, biofluid reacts first to inflammation or the development of a disease.
A general blood test is taken in a specially equipped clinical laboratory. In most cases, blood is taken from a finger by puncturing the skin with a medical needle.
Less often, blood for a general analysis is taken from a vein (from a vein, as a rule, a biofluid is taken for a detailed analysis) and decomposed into indicators on special modern analyzers.
General clinical analysis is used in all areas of medicine. It is taken for both diagnostic and prophylactic purposes.
This study is mandatory when patients are admitted to the hospital and when they are discharged from the hospital. Also, a clinical blood test is necessary to monitor the condition of pregnant women.
A general analysis of liquid tissue allows you to obtain information about a wide variety of blood parameters (in total, it is possible to identify from 10 to 50 indicators).
A clinical analysis that provides information on more than 30 parameters is called detailed.
Unlike an ordinary one, a detailed clinical blood test is taken from a vein (an ordinary general one - most often from a finger) and is prepared using more accurate equipment.
So what does the clinical analysis show?
This study provides information on parameters such as:
- iron-containing protein hemoglobin and its level;
- the number of erythrocytes, leukocytes, lymphocytes, platelets and their characteristics;
- hematocrit (the ratio of individual cells to total blood volume);
- erythrocyte sedimentation rate (ESR);
- is there an inflammatory process in the body;
- what is the nature of the disease (bacterial or viral);
- whether the patient has allergic reactions.
So, if the analysis reveals leukocytosis (too many leukocytes) and an overestimated ESR, the patient probably has an inflammatory process in the body, liver and kidney diseases and even cancer are possible.
However, it is impossible to accurately identify the focus of inflammation using clinical analysis alone.
For this, the patient will need to undergo additional examination: it is possible to carry out hardware and other laboratory research.
As such, there are no contraindications to this study, the frequency of its conduct is determined by the attending physician.
Preparing to donate blood
As already noted, the question of whether it is possible to eat before the blood test or the analysis is given exclusively on an empty stomach is debatable.
Most doctors and, accordingly, clinics do not recommend eating before the study.
Take an analysis on an empty stomach, explain medical workers, it is necessary, because many products consumed by a person immediately before the study can significantly affect the results of the analysis, make them unreliable.
So, if the patient before the procedure, at 8 am, drinks sweet tea with a bun or candy, and at 9 am he donates blood, one can not hope for the correctness of the data obtained - blood sugar will definitely be higher than it actually is.
If the patient eats a chop or a chicken leg before the examination, the results of the analysis will show that the blood is much thicker than normal.
In this case, the patient who did not bother to come for an analysis on an empty stomach will either begin to be treated for diseases that do not exist in him, or will be asked to come to the study again and retake blood.
Obviously, both options are unacceptable.
But in medicine, there is another point of view. Some doctors say that it is okay to eat before the procedure, especially if the patient is used to having breakfast regularly, and the hunger state is unnatural and uncomfortable for him.
Such patients do not have to come to the laboratory on an empty stomach: they can eat their usual breakfast. However, in this case, you should not eat sweets, fatty and fried foods or meat.
It is also not necessary to eat before taking blood dairy products and any unhealthy food (fast food, canned food, sugary carbonated drinks). By the way, it is better to give up the listed types of food a day before the study.
For those who cannot do without breakfast, especially pregnant women and young children, before taking blood, you can eat porridge, a cereal bar with weak and unsweetened tea, stewed or boiled vegetables, soups not in meat broth.
Thus, ideally, it is worth coming to the test on an empty stomach, and immediately after the end of the study, you can refresh yourself with a pre-prepared brake (you can take a sandwich, fruit or yogurt with you to the clinic) or go to the buffet.
That is, the interval between donating blood and eating at 10 hours is still better to hold.
Given that most laboratories start working at 8 am, you should simply try to arrive early so as not to be at the back of the line.
Additional nuances of preparation
What else do you need to know when going to a clinical laboratory to donate blood? It is not recommended to drink alcohol and smoke before the procedure (preferably one day before the collection).
In addition, it is advisable to protect yourself from strong emotional upheavals and physical exertion, since all these conditions can significantly affect the qualitative composition of the blood.
If less than a week before the date of the laboratory examination, the patient has suffered serious illness, then it is better to postpone the donation of blood and allow the body to fully recover.
If the patient needs regular intake of certain pharmaceuticals, and the patient took the medicine before the study, then he must inform the doctor about it.
The results of clinical analysis are prepared, as a rule, a day or two in state polyclinics and just a few hours in private laboratories.
Deciphering the results should be dealt with by the patient's attending physician, even if there is a column with norm indicators in the laboratory forms.
After that, having analyzed the received data, the specialist makes a decision on further actions.
If there is enough information, then the doctor prescribes necessary treatment if not, additional examination.
After all, if it is possible to identify, for example, an inflammatory process through a blood test, then a specific focus of inflammation is rather problematic.
Also, the attending physician may prescribe a repeated clinical analysis if, in his opinion, the results of the first study are severely distorted.
For most studies, blood is taken strictly on an empty stomach, that is, when at least 8 hours pass between the last meal and blood sampling (preferably at least 12 hours). Juice, tea, coffee must also be excluded.
You can drink water.
Exclude from the diet 1-2 days before the examination fatty foods, alcohol. For an hour before taking blood, you must refrain from smoking.
Before donating blood, physical activity must be excluded.
Blood should not be donated immediately after ray methods examination (X-ray, ultrasound examination), massage, reflexology or physiotherapy procedures.
Since different laboratories can use different research methods and units of measurement of indicators, then for correct assessment and comparing the results of your laboratory tests, it is recommended to carry them out in the same laboratory.
Before surrender general blood test, the last meal should be no earlier than 3 hours before blood sampling.
For determining cholesterol, lipoproteins blood is taken after 12-14 hours of fasting. To determine the level uric acid you must follow a diet: refuse to eat foods rich in purines - liver, kidneys, limit meat, fish, coffee, tea in the diet ..
Donating blood for hormonal research carried out on an empty stomach (preferably in the morning; in the absence of such an opportunity - 4-5 hours after the last meal in the daytime and evening hours).
When examining the level prostate-specific antigen (abbreviated PSA or PSA) abstinence must be strictly observed the day before and on the day of the study. Blood should not be donated for several days after TRUS or palpation prostate(prostate).
On the results of hormonal studies in women reproductive age influence physiological factors associated with stage menstrual cycle, therefore, when preparing for a test for sex hormones, you should indicate the phase of the cycle.
Hormones reproductive system
leased by days of the cycle:
LH, FSH - 3-5 days;
Estradiol - 5-7 or 21-23 days of the cycle;
progesterone 21-23 days of the cycle.
prolactin,
DHA sulfate, testosterone - 7-9 days.
Blood for insulin and C-peptide is given strictly on an empty stomach in the morning.
Hormones thyroid gland, insulin, C-peptide surrender regardless of the day of the cycle.
General clinical analysis of urine.
For general analysis, use only the first morning urine sample. The first few milliliters of urine is drained to remove the desquamated cells from the urethra. The toilet of the external genital organs is pre-performed. Urine for examination must be delivered within 2 hours of collection.
Collection of daily urine.
Collect urine within 24 hours with the usual drinking regimen (about 1.5 liters per day). In the morning at 6-8 o'clock, you need to urinate (pour this portion of urine), and then, during the day, collect all the urine in a clean dark glass vessel with a lid, the capacity of which is at least 2 liters. The last portion is taken exactly at the same time when the collection was started the day before (the start and end times of the collection are noted). Store the container of urine in a cool place. At the end of the collection of urine, its volume is measured, the urine is shaken and 50-100 ml is poured into a container in which it will be delivered to the laboratory.
It is necessary to indicate the entire volume of daily urine!
Collection of urine for research according to the Nechiporenko method.
Immediately after sleep (on an empty stomach), the middle portion of the morning urine is collected. Collecting urine is carried out according to the "three-glass" test: the patient begins to urinate in the first glass, continues - in the second, finishes - in the third. The second portion should be predominant in volume, which should be collected in a clean, dry, colorless dish with a wide neck. The collected medium portion of urine (20-25 ml) is delivered to the laboratory
Collection of urine for research according to Zimnitsky.
The patient remains on the usual diet, but takes into account the amount of fluid drunk per day. After emptying Bladder at 6 o'clock in the morning, every 3 hours during the day, urine is collected in separate containers, which are indicated by the collection time or portion number, a total of 8 portions. 1 portion - from 6-00 to 9-00, 2 portion - from 9-00 to 12-00, 3 portion - from 12-00 to 15-00, 4 portion - from 15-00 to 18-00, 5 portion - from 18-00 to 21-00, 6 portion - from 21-00 to 24-00, 7 portion - from 24-00 to 3-00, 8 portion - from 3-00 to 6-00. All collected urine in 8 special containers is delivered to the laboratory.
Collection of urine for microbiological examination (urine culture)
The urine is collected in a sterile container. The collection of morning urine is carried out after a thorough toilet of the external genitalia. THE FIRST 15 ml OF URINE ARE NOT USED FOR ANALYSIS. FOLLOWING 3-10ml. ASSEMBLED IN A STERILE CONTAINER WITH A LID. It is necessary to deliver the container to the laboratory by 8 o'clock.
Biochemical express analysis of feces for dysbiosis.
It is necessary to take 2-4 g (volume of 1-2 teaspoons) of feces into a special container, which must be delivered to the laboratory on the same day. It is necessary to indicate the type of stool (diarrhea, constipation, unremarkable, stool with laxatives).
Research on enterobiasis (to identify teniids and pinworms).
For this study the biomaterial is taken from the perianal folds (around the anus) by the patient himself. The procedure is carried out in the morning immediately after getting out of bed BEFORE HYGIENIC PROCEDURES, URINARY AND DEFECTION. With a cotton swab in a circular motion, material is taken from the perianal folds (where the above helminths lay their eggs). After the stick is placed in a special container (unused end cotton swab must be deleted). Thus, the material is ready for delivery to the laboratory.
Study of a smear from the throat with the determination of sensitivity to antibiotics, diphtheria, mycobacterium tuberculosis, hemolytic streptococcus.
Before the examination, you can not brush your teeth, rinse your mouth with water, drink, eat.
- services orthopedic dentistry and dental implantation;
- professional cleaning and
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