Leukocytic formula

Leukocytic formula - the percentage of various forms of white blood count in stained smear. It is subject to significant individual fluctuations (tables. 1). For a correct understanding of what is happening in the blood shifts necessary to take into account not only the interest (relative), but the absolute value (the contents of each type of cells in 1 mm3 blood). To do this, the percentage of cells multiplied by the total number of blood leukocytes without two zeros. For example: the number of cells in 1 mm3 blood - 6500, monocytes - 7%. The absolute number of monocytes in 1 mm3 blood - 7X65=455. The contents of one type of cells (see) can vary independently. So, when oppression bone marrow absolute neutrophil count decreases, and lymphocytes may remain unchanged, but their percentage is growing. It will be a relative limfotsitoz. For example: when typhoid fever , the number of leukocytes may be reduced to 3000 1 mm3and lymphocytes to be 50%. Meanwhile, the absolute number of lymphocytes here 50X30=1500, i.e. absolute limfozitoza not. Changes in leukocyte formula may depend on the redistribution of cells in the bloodstream or from changes in the activity of the blood-forming organs. With the accelerated regeneration of cells, mainly of neutrophils in the blood increases the number of band cells are young, immature forms - metamyelocyte, plasmic order has been revealed. This change of leukocyte formula (characteristic, particularly, for inflammatory processes) is called the shift of neutrophils to the left (increasing the number on the left side recording). Changes in leukocyte formula cannot be considered in isolation from the overall clinical picture. So, for example, for infections caused coccal flora typical of neutrophilic leucocytosis with a shift to the left and eosinopenia, for Tivo-partypany diseases, viral, influenza, brucellosis characteristic picture of bone marrow suppression with neutropenia and relative limfotsitoz. However, the increase in the number of neutrophils in viral influenza can testify not only about recovery, but also about the complication of the disease bacterial infection. When leukocyte count formula should pay attention to pathological changes in white blood cells: the emergence of a major ("toxic") graininess in neutrophils, indicating a severe intoxication of the patient, degenerative changes - vacuolization cytoplasm and nuclei, pignose (wrinkling) cores, etc. In the same smear account and changes of erythrocytes (see).
the range of normal fluctuations of various forms of leukocytes in blood

Leukocytic formula percentage in the blood of certain types of white blood cells. Leukocyte are based on counting painted in dry the dark smear of blood on the possibility of a greater number of leukocytes, but not less than 200. It allows to estimate the functional state of different blood-forming tissues that supply blood certain types of leukocytes. Leukocytic formula is subject to considerable fluctuations in healthy people. Practically use most L. f. blood of the person proposed by the shilling (V. Schilling) (table. 1).
For the correct understanding of the real proportion of some forms of leukocytes is necessary to know the total number of 1 mm3 blood and percentages of the number of leukocytes translate in absolute numbers. The number of cells of a particular species may be changed independently of each other, therefore it is necessary to distinguish their relative and absolute increase and decrease. For example, if the leukemia increases both relative and absolute number of lymphocytes; the relative quantity of neutrophils is low, and their absolute number may increase.
There are also two types of shift: regenerative and degenerative. The first is the numerical increase young and together with them, stab with a corresponding reduction segmented. Shift this points to the "rejuvenation" of the white blood cells as a result of increased activity of bone marrow and increased loss of neutrophils. Shift degenerative is to increase only one form - stab. The total number of leukocytes is not enlarged and normal or even reduced. Shift this points to the oppression of the bone marrow.
For visual display of absolute amounts and ratios of individual forms of cells in 1 mm3 blood proposed graphic image leukocyte formula of the so-called leukocyte profile (Fig. 1). The norm for an adult adopted the following figures: neutrophils 3000-5500, lymphocytes 1200-2000, monocytes 200-600, eosinophils 100-250, basophils 0-80, and the total number of leukocytes 4000-8000. Combining in each column the points set in the field, the corresponding absolute quantity of a particular type of white blood cells, obtained a polygonal line, which is a leukocyte profile.

Fig. 1. Leukocyte profile: 1 - normal, 2 - a long malaria, characterized by a profile with truncated top of neutrophils; In - basophils; e - eosinophils; N - neutrophils; L - lymphocytes; M - monocytes. Boxes marked limit of normal for the absolute quantities of this type of cells.

OK all points are within the rectangle. Vihodnie any point of the section beyond the boundaries of normal indicates an increase or decrease in the absolute number of this type of cells. Normal leukocyte profile adult - pointed, with the highest point in the column of neutrophils and steep descent to the column lymphocytes. On leukocyte profile you can set the true functional hyperplasia of those or other departments of the hematopoietic system.
For a more complete characteristics of the age composition of neutrophils Sheremetev Palace Moszkowski offers to Express their average age composition of the fraction in which the numerator is the percentage of plasmic order has been revealed (M), metamyelocytes (Yu) and band (P), and the denominator is the total percentage of all neutrophils (N):
[M + YU + P] /H
OK this nuclear index equal to 0.05. With the increasing cumulative percentage of young neutrophils (M, s, P), for example to 40 nuclear index can walk to 0.5. Cm. also Leukocytes.