血液鉴别试验

定义

The blood differential test measures the percentage of each type of white blood cell (WBC) that you have in your blood. It also reveals if there are any abnormal or immature cells.

选择的名字

Differential; Diff; White blood cell differential count

如何执行测试

A 血液样本 是必要的.

A laboratory specialist takes a drop of blood from your sample and smears it onto a glass slide. The smear is stained with a special dye, which helps tell the difference between various types of white blood cells.

Five types of white blood cells, also called leukocytes, normally appear in the blood:

• 中性粒细胞
• Lymphocytes (B cells and T cells)
• 单核细胞
• 嗜酸性粒细胞
• 嗜碱粒细胞

A special machine counts the number of each type of cell. The test shows if the number of cells are in proper proportion with one another, and if there is more or less of one cell type.

如何准备考试

No special preparation is necessary.

考试的感觉如何

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. 后ward, there may be some throbbing or slight bruising. 这很快就会消失.

为什么要进行测试

This test is done to diagnose an 感染, 贫血, or 白血病. It may also be used to monitor one of these conditions or to see if treatment is working.

正常的结果

The different types of white blood cells are given as a percentage of all white cells:

• 中性粒细胞:40% ~ 60%
• 淋巴细胞:20% - 40%
• 单核细胞:2% ~ 8%
• 嗜酸性粒细胞:1% ~ 4%
• 嗜碱粒细胞:0.5% to 1%
• Band (young neutrophil): 0% to 3%

异常结果意味着什么

有没有感染或 急性 stress increases your number of white blood cells. High white blood cell counts may be due to inflammation, an 免疫反应, or blood diseases such as 白血病. Abnormal or immature white blood cells may indicate 白血病 or bone marrow invasion by cancer or 感染.

It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells.

An increased percentage of neutrophils may be due to:

• 急性感染
• 炎症
• 急性应激
• 惊厥 (seizures or coma in a pregnant woman)
• 痛风 (type of arthritis due to uric acid buildup in the blood)
• Acute or chronic forms of 白血病
• 骨髓增生性疾病
• 类风湿性关节炎
• 风湿热 (disease due to an 感染 with group A streptococcus bacteria)
• 甲状腺炎 (甲状腺疾病)
• 创伤
• 吸烟

A decreased percentage of neutrophils may be due to:

• 再生障碍性贫血
• 化疗
• 流感 (流感)
• 放射治疗 或接触
• 病毒感染
• Widespread severe 细菌感染 (sepsis)

An increased percentage of lymphocytes may be due to:

• 慢性 细菌感染
• 传染性 肝炎 (liver swelling and inflammation from bacteria or viruses)
• 传染性单核细胞增多, or mono (viral 感染 that causes fever, sore throat, and swollen lymph glands)
• 肺结核
• 淋巴细胞性白血病 (一种血癌)
• 多发性骨髓瘤 (一种血癌)
• 病毒感染(如 流行性腮腺炎 or 麻疹)

A decreased percentage of lymphocytes may be due to:

• 化疗
• 艾滋病毒/艾滋病 感染
• 白血病
• 放射治疗 或接触
• 脓毒症 (severe, inflammatory response to bacteria or other germs)
• 使用类固醇

An increased percentage of monocytes may be due to:

• 慢性炎性疾病
• 白血病
• 寄生虫感染
• 肺结核, or TB (细菌感染 that involves the lungs)
• 病毒感染 (for example, infectious 单核细胞增多症, 流行性腮腺炎, or 麻疹)

An increased percentage of eosinophils may be due to:

• 艾迪生疾病 (adrenal glands do not produce enough hormones)
• 过敏反应
• 癌症
• 慢性骨髓性白血病
• 胶原血管病
• Hypereosinophilic综合症
• 寄生虫感染

An increased percentage of basophils may be due to:

• 后 脾切除术
• 过敏反应
• 慢性骨髓性白血病 (一种骨髓癌)
• 胶原血管病
• 骨髓增生性疾病 (group of bone marrow diseases)
• 水痘

A decreased percentage of basophils may be due to:

• 急性感染
• 癌症
• 严重伤害

风险

There is little risk involved with having your blood taken. Veins and arteries vary in size from one person to another, and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight, but may include:

• 大出血
• Fainting or feeling lightheaded
• Multiple punctures to locate veins
• 血肿 (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

参考文献

贝恩BJ. 外周血涂片. 参见:Goldman L, Schafer AI主编. Goldman-Cecil医学. 26日艾德. Philadelphia, PA: Elsevier; 2020:chap 148.

纳斯尔先生，和记黄埔公司. 白细胞的障碍. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24日艾德. Philadelphia, PA: Elsevier; 2022:chap 34.