Leukocyte, white blood cell (WBC) is colorless, spherical and nucleatedblood corpuscle。The total number of normal adults is (4.0~10.0) x 10nine/50. It can change within a certain range due to different times of the day and the functional state of the body.
Leukocytes generally have active mobility, and they can migrate from intravascular to extravascular, or from extravascular tissue to intravascular.Therefore, white blood cells exist inbloodIt is also widely found in blood vesselslymph glandOutside the organization.
Leukocyte (WBC) is a kind of colorless, spherical and nucleated blood cell.The total number of white blood cells in normal adults is (4.0~10.0) x 10nine/50. It can change within a certain range due to different time of day and different functional states of the body.Leukocytes are not a uniform group of cells. According to their morphology, function and origin, they can be divided into three categories: granulocytes, monocytes and lymphocytes. Among them, granulocytes can be divided into neutrophils, eosinophils and basophils according to the different staining properties of particles in the cytoplasm[1]。
Leukocytes are the "guardians" of the human body in the fight against disease.When bacteria invade human body, white blood cells can pass through through deformationCapillary wallAnd concentrate on the invasion site of bacteria to surround and engulf them.If the number of white blood cells in the body is higher than the normal value, it is likely that the body has inflammation.
Physiological characteristics
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Most white blood cells only stay in the blood for a while and then enter the tissue to play a role.Therefore, all white blood cells can stretch out pseudopodia for deformation movement. With this movement, white blood cells can be squeezed out from the gap of capillary endothelial cells and enter the tissues around the blood vessels. This process is called diapedesis.The exuded white blood cells can also travel in the tissue by means of deformation movement, and have the characteristic of moving towards certain chemicals, which is called chemotaxis.Chemicals that can attract white blood cells for directional movement are calledChemotactic factor。Some white blood cells also have the function of phagocytosis, which can swallow and kill or degrade pathogens and tissue fragments.Some leukocytes can also secrete interleukin, interferontumor necrosis factorEtccell factor, participate in the regulation of inflammation and immune response.[1]
physiological function
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The main function of white blood cells is defense.Different kinds of white blood cells participate in the body's defense response in different ways.
Neutrophils
The average time that neutrophils stay in the blood vessels is only 6-8 hours. They quickly pass through the blood vessel wall and enter the tissues to play their roles, and they will not return to the blood after entering the tissues.About half of the neutrophils in the blood vessels circulate with the blood flow. Usually, white blood cell counts only reflect the situation of these neutrophils;The other half is attached to the wall of small blood vessels.At the same time, about 2.5 x 10 are still stored in the bone marrowtwelveMature neutrophils can be mobilized into the circulating blood stream when the body needs them.[1]
Neutrophils in bloodSpecific immunityIt plays a very important role in the body's resistance to microbial pathogens, especially inpyogenic bacterium The first line of invasion has strong phagocytic activity, which can phagocytose bacteria, aging red blood cells, antigen antibody complexes and necrotic cells.Neutrophils contain a large number of lysosomal enzymes, so they can completely decompose bacteria and tissue fragments swallowed into cells.When neutrophils engulf dozens of bacteria, they disintegrate themselves, and various lysosomal enzymes released can dissolve surrounding tissues and form pus.
Basophil
BasophilThere are large particles with deep alkaline staining in the cytoplasm ofEosinophilsChemokine A and anaphylactic slow reaction substancesbiological activitySubstance.Heparin has anticoagulant effect, which is beneficial to keep blood vessels unobstructedPhagocyteIt can successfully reach the antigen invasion site to play a role.In addition, heparin can also be used as the auxiliary group of lipase to enhance the role of lipase and accelerate the decomposition of fat intofree fatty acidsProcess.[1]
Histamine and anaphylactic slow reaction substances released by basophils participate in allergic reactions caused by certain foreign bodies (such as pollen).Meanwhile, eosinophil chemokine A released at the same time can attract eosinophils to gather locally to limit the role of basophils in allergic reactions.[1]
Eosinophils
The number of eosinophils in the blood has obvious diurnal periodic fluctuations. The number of cells decreases in the morning and increases at midnight.This number of cellsPeriodic changeYes andadrenal cortexreleaseGlucocorticoidThe diurnal fluctuation of quantity is closely related.When the concentration of glucocorticoid in blood increased, the number of eosinophils decreased;When the concentration of glucocorticoid decreased, the number of cells increased.Eosinophils have weak phagocytic function, but it is generally believed that they do not play a major role in the defense against bacterial infection.The main functions of eosinophils in vivo are: ① to restrict basophils andmast cellsstayImmediate anaphylaxisRole in; ②Participate in the immune response to worms.In the case of parasitic infection and allergic reaction, eosinophils are often increased.[1]
monocyte
When monocytes enter the blood stream from bone marrow, they are still immature cells. After staying in the blood for 2-3 days, they migrate to the surrounding tissues. The cell volume continues to increase, with a diameter of 60-80 μ m. The number of lysosomal particles and mitochondria in the cells also increases, becoming mature macrophages.Compared with other blood cells, monocytes contain more non-specific lipases, which can digest certain bacteria (such asMycobacterium tuberculosis）And has stronger phagocytosis ability, which can swallow more and larger bacteria and particles.Activated monocyte macrophages can generate and release various cytotoxic factors, such as interferon, tumor necrosis factor and interleukin, and participate in the regulation of other cell growth.Monocyte macrophages also play a key role in the induction and regulation of specific immune responses.[1]
lymphocyte
Lymphocytes are a large class of immune cells, which mainly participate in the specific immune response of the body.According to the different processes and functions of cell growth and development, lymphocytes are divided into T cells and B cells.In terms of function, T cells are mainly related to cellular immunity, while B cells are mainly related to humoral immunity.[1]
In addition, there is a kind of lymphocytes in the bloodcell surfaceThe mark shows that they are neither B cells nor T cells. Therefore, they are called null cells, accounting for aboutMesolymphocyte5% - 10% of the total.The naked cells of concern are killer cells (killer cells. K cells) andNatural killer cells(natural killer cell, NK cell), the killing effect of K cell is antigen dependent, but its antigen is non-specific.The killing effect of NK cells does not depend on the existence of antigens and antibodies. It plays an important role in killing tumor cells.Interferon can activate NK cells, while interleukin-2 can stimulate the proliferation of NK cells, thus enhancing the killing effect of NK cells.[1]
Classification
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There are five kinds of white blood cells in the blood, which are:lymphocyte, basophils, neutrophils, eosinophils and monocytes.
Leukocytes are colorless and nucleated blood cells, which are generally spherical in the blood. According to the morphological differences, they can be divided into two categories: granular and non granular.
Granular leukocyte
Granular leukocytes (granulocytes) contain special staining particles. Three types of granular leukocytes can be distinguished by staining with Reich dye, namelyNeutrophils、EosinophilsandBasophil。
Neutrophils have the ability of deformation movement and phagocytosis, and they are the most important defense system against invasive bacteria, especially acute suppurative bacteria.When the number of neutrophils is significantly reduced, the chance of infection in the body is significantly increased.Eosinophils have large eosinophilic granules containingPeroxidaseandacid phosphatase。Eosinophils haveChemotaxisIt can engulf antigen antibody complex, reduce its damage to the body, and resist the effect of histamine and other inflammatory factors.There are basophilic granules in basophils, which contain histamineheparinAnd5-hydroxytryptamineAnd other bioactive substancesantigen- The antibody is released during reaction.
A few white blood cells can occasionally be seen in normal human feces, soFecal examinationThe number of white blood cells in the intestine can be used as a basis for inflammation.
Monocytes are the largest blood cells in the blood.Think it ismacrophageIts predecessor has obvious deformation movement, which can engulf and remove injured and aging cells and their debris.Monocytes also participate inimmune reaction, will carryAntigenic determinantIt is transferred to lymphocytes to induce specific immune response of lymphocytes.Monocytes are also the main cell defense system against intracellular pathogenic bacteria and parasites, and also have the ability to identify and kill tumor cells.Lymphocytes are cells with specific immune function.T lymphocytes are mainly involved incellular immunityB lymphocytes participate in the reactionhumoral immunityReaction.
The number of adult white blood cells is (5-9) × 10 ^ 9/L. Neutrophils account for 0.50-0.70, eosinophils for 0.005-0.05, basophils for 0.005-0.01, monocytes for 0.03-0.08, and lymphocytes for 0.20-0.40.The number of white blood cells in children's blood is higher than that in adults.Different physiological conditions (such as pregnancy) can cause changes in the number of white blood cells.When there is inflammation, the number of white blood cells in the blood increases significantly.Different types of leukocytes have different defensive and protective effects.
Morphological characteristics of five leukocytes in peripheral blood by rayleigh staining
The clinical significance of the changes in the number of white blood cells
White blood cells are a popular topic, because laboratory tests are often carried out in hospitals, and the most common isBlood routine examinationThe most common use of blood routine examination isWhite blood cell countAnd classification.Therefore, it is necessary to have a preliminary understanding of it and reserve relevant basic knowledge.
White blood cell count refers to counting the number of white blood cells contained in unit volume of blood.
principle
Use white blood cell counting diluent (mostly dilute acetic acid solution) to dilute the blood to a certain multiple and destroy red blood cells, drop it into the cell counting plate, count the number of white blood cells in a certain range under the microscope, and calculate the total number of various white blood cells per liter of blood by conversion.
Normal value
1. Unit: 10 ^ 9/L
2. Normal value range: (unit: 10 ^ 9/L)
(1) Adult: (4.0-10.0) × 10 ^ 9/L
⑵ Newborns: (15-20) × 10 ^ 9/L
⑶ (11-12) × 10 ^ 9/L from 6 months to 2 years old
⑷ 8 × 10 ^ 9/L for 4 to 14 years old
(5) Children (5.0-12.0) × 10 ^ 9/L
rise
The increase of white blood cell count is not completely the manifestation of the disease, so there are physiological and pathological increases.Physiological increase can be seen in strenuous exercise, physical labor, extreme heat and cold, full meal or bath, emotional tension, hunger, hypoglycemia, women's menstruation and ovulation, late pregnancy, childbirth, etc.Its mechanism may be that when stimulated by various physiological factorscatecholamineIncreased secretion, leading to peripheral leukocytes entering the circulation.The leukocytosis in these cases is temporary, and it will recover quickly after removing the influencing factors.The most common reason for pathological increase is infection, especially bacterial infection, and the degree of infection is often in direct proportion to the increase in the number of white blood cells. However, the reaction ability of the elderly is reduced, and the increase may not be obvious when infection occurs.Another reason for the significant increase in the white blood cell count that needs special vigilance is the disease of the hematopoietic system. At this time, the white blood cells may increase several times or tens of times more than that of the normal people. Further blood smear, bone marrow puncture, molecular biology and other tests are needed to make a clear diagnosis.In addition, the white blood cell count will also increase when glucocorticoid is applied.[2]
reduce
Virus infection is a common cause of decreased white blood cell count, such asInfluenza、Viral hepatitis, chicken pox, rubella, etc;Long term exposure to radiation, poisoning caused by various physical and chemical factors, tumor chemotherapy and radiotherapyHypersplenismAutoimmune diseases, some blood diseases such as aplastic anemia, bone marrow fibrosis and the use of certain drugs will lead to a decrease in white blood cell count[2]。
Whether the white blood cell count increases or decreases, it is necessary to further determine which type of white blood cell is abnormal, and it cannot be concluded simply based on the total number of white blood cells.
Hypochondria
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definition
Leukopenia(1eukopenia) is a common blood disease, which means that the absolute count of adult peripheral white blood cells is continuously lower than 4 × 10nine/L (children ≥ 10 years old but below 4.5 × 10nine/L or<10 years old, less than 5 × 10nine/L)。When the absolute count of adult peripheral blood granulocytes is lower than 2 × 10nine/50. Children ≥ 10 years old and below 1.8 × 10nine/L or<10 years old less than 1.5 x 10nine/L is calledGranulopenia(neutropenia)；Less than 0.5 × 10nine/L is called a-granulocytosis.
This kind of disease can be divided into congenital disease and acquired disease, and acquired disease is the most common.The main causes of the disease are: ① neutrophil production defect.More than 10 neutrophils are generated in the bone marrow of normal adults every day.Cytotoxic drugs, chemical poisons, ionizing radiation and other chemical or physical factors are the most common causes of neutropenia, which can directly damage bone marrow stem cells, progenitor cells or bone marrow hematopoietic microenvironment, causingPancytopenia。In addition, the impactHematopoietic stem cellsDiseases and various causescell differentiationMaturity barriers can also causeNeutropenia。②Neutrophils are destroyed or consumed excessively.Autoimmune disease, infection or septicemia can cause excessive consumption of granulocytes, resulting in granulocytopenia. ③The distribution of neutrophils was abnormal.A large number of granulocytes were transferred to the marginal pool, resulting in a relative reduction of granulocytes in the circulating pool, which could not be detected during counting;Or granulocytes remain in other parts of the circulating pool, and granulocytes in the circulating blood flow decrease, resulting in pseudogranulocytopenia[3]。
Diagnostic points
Most leukopenia patients have a slow onset, which may include dizziness, fatigue, limb weaknessAnorexia, low fever, insomnia and other non-specific symptoms.A few patients had no obvious symptoms and were only found during blood examination.Some patients may repeatedly develop El cavity ulcer, pulmonary infection or urinaryGenital tract infection。
Granulocytopenia is mostly caused by patients' allergic reaction to drugs or chemicals, or cytotoxic drug treatment, or high-dose radiotherapy.The onset of the disease is often sudden, and the patient will soon have high fever, chills, headache, body and joint pain and other symptoms after the onset of fatigue, dizziness, sore throat and other prodromal symptoms.The patients suffered from severe infection, and the lungs, urogenital tract, oropharynx and skin were the most likely sites for infection.Sometimes necrotic ulcers may appear in the oral cavity, nasal cavity, skin and other mucous membranes.Due to the lack of granulocytes, the infection is easy to spread, the focus should not be limited to a rapidly deteriorating state, and the mortality rate is extremely high[3]。
Leukopenia and agranulocytosis can be diagnosed by blood routine examination.patientLeukopeniaNeutrophils decreased and lymphocyte percentage increased.However, bone marrow smear has different bone marrow images due to different causes of granulocytopenia.In order to eliminate the error in the inspection method, repeat the inspection if necessary.
In clinical practice, the causes of leukopenia and neutropenia should be carefully identified.Patients with infection history, drug, poison or radiation exposure history, or radiotherapy and chemotherapy should consider the diagnosis of related diseases.Note that for patients with high fever, it is necessary to distinguish the causal relationship between infection and agranulocytosis.Those who have a history of rheumatoid arthritis and other connective tissue diseases and have anti leukocyte autoantibodies may be the clinical manifestations of autoimmune diseases in the blood system.If accompanied by red blood cells andThrombocytopeniaVarious pancytopenia diseases, such as megaloblastic anemiaAplastic anemiaandMyelodysplastic syndromeEtc.At the same time, pay attention to the differentiation between this kind of disease and leukemia[3]。
Supplementary Examination
1. Blood routinePeripheral red blood cells、hemoglobinAnd platelets are mostly normal.Absolute white blood cell count is lower than 4X 10nine/50. Absolute count below 0.5 X 10 in agranulocytosisnineChildren, lymphocytes are relatively increased.The nucleus of granulocyte moves to the left or there are too many nuclear lobulations, and toxic particles, vacuoles and other degeneration can be seen in the cytoplasm.When the condition improves, lymphocytes and monocytes first rise, then granulocytes gradually rise until they return to normal[3]。
2. Myelogram varies due to different causes.In the early stage, there may be no obvious change, or there may be a "maturation obstacle" with many young granulocytes and fewer mature granulocytes.In case of granulocyte deficiency, neutrophils in bone marrow are significantly reduced or even disappeared, and granulocytes in various stages gradually appear in the recovery phase[3]。
3. Bone marrow biopsyBone marrow biopsyyesMyelofibrosisThe diagnosis of bone marrow metastatic carcinoma and lymphoma is of great value.Bone marrow examination can help differentiate from myelodysplastic syndrome[3]。
4. Other tests include in vitro bone marrow culture, bone marrow proliferative activity and bone marrow neutrophil reserve, to help identify the direct toxic effects of drugs or immune factors inhibiting granulocyte production;Adrenaline testTo help identify whether it is pseudogranulocytopenia, and if the result is positive, it is abnormal granulocyte distribution;Antineutrophil antibodyDetermination to help identify whether it is immune granulocytopenia;Determination of serum lysozyme: the increase of lysozyme indicates the increase of granulocyte destruction, and the normal or low level indicates the decrease of granulocyte production[3]。
Handling principles
1. Etiological treatment Try to find out the cause and take corresponding treatment measures.Stop contacting possible pathogenic factors immediately, stop using suspicious drugs, and control infection.For patients secondary to other diseases, actively treat the primary disease. After remission or control of the disease, granulocytes can return to normal.For those with slight granulocytopenia and no infection tendency, and no obvious abnormality in bone marrow detection, follow-up observation is the main method[3]。
2. Prevention and treatment of infection is both the cause and result of granulocytopenia and deficiency.Antibiotic treatment should be taken immediately for patients with infection.Those with slight reduction do not need special protective measures;If the infection rate of the moderately reduced patients increases, the frequency of entering and leaving public places should be reduced, and oral and skin hygiene care should be strengthened to removeChronic infectionthe focus.Granulocytopenia is a critical disease in internal medicine. It should be actively rescued, sterile isolation measures should be taken, and nursing care should be strengthened to prevent cross infection.useBroad-spectrum antibioticExperiential treatment shall be carried out, and bacterial culture andDrug susceptibility test。After the results of drug sensitivity test are available, sensitive antibiotics should be used for treatment, and attention should be paid to adjusting the drug dosage and course of treatment to prevent double infection, such as fungi, anaerobes, etc.If the treatment fails, antifungal drugs can be added.Virus infection should be addedAntiviral drugs。Anti infection treatment for patients with agranulocytosis is often the key to the success of treatment, and early, broad-spectrum, combined and adequate treatment should be achieved[3]。
3. Support treatment Inject gamma globulin, 10-20 g/d, give sufficient water and energy, and maintain water electrolyte balance.
4. Drug treatment For patients with mild granulocytopenia who have no obvious symptoms, no tendency to infection, and long-term stability, follow-up observation can be made without relying on drug treatment.For patients with obvious granulocytopenia and corresponding symptoms, granulopoiesis promoting drugs such as lithium carbonate and vitamin B should be used while preventing infectionfour, Lixuesheng, etc., as well as hematopoietic growth factors such as shark liver alcohol, recombinant human granulocyte colony stimulating factor (rhG-CSF) and recombinant human granulocyte macrophage colony stimulating factor (rhGM-CSF).In addition, glucocorticoids are available for granulocyte deficiency caused by autoimmune granulocytopenia and immune abnormalitiesImmunosuppressantTreat.However, glucocorticoid should not be used for granulocytopenia caused by other reasons.See the "medication plan" for specific medication methods[3]。
Medication plan
1. One or two drugs with different mechanisms of action should be used together to promote granulopoiesis.If the treatment is still ineffective for 1-2 months, the treatment plan should be adjusted in time.
(1) Lithium carbonate stimulates bone marrow to generate granulocytes, but has no effect on chronic bone marrow failure.Adult oral dose: 300mg, 3 times/day;After taking effect, the dosage was reduced to 200mg twice a day for 2-4 weeks.It can produce mild heartburn, diarrhea, pruritus, edema, nausea and fatigue and other adverse reactions.Use with caution for patients with kidney disease.
(2) Vitamin Bfourvitamin BfourIt is a component of nucleic acid and participates in the synthesis of RNA and DNA in the body. It can promote the proliferation of white blood cells when white blood cells are lacking.It is used to prevent and treat leukopenia caused by various reasons andAcute agranulocytosisSyndrome, especially leukopenia caused by benzene poisoning.The oral dose is 10-20mg, 3 times/day;The oral dose for children is 5-10mg, twice a day.When combined with tumor radiotherapy and chemotherapy, vitamin B should be consideredfourWhether it is possible to promote tumor development.
(3) Lixuesheng is a cysteine derivative, which can enhance the hematopoietic function of bone marrow.The oral dose is 20mg, 3 times/day.
(4) Squarenol, namely α - octadecylglycerol ether, is a hematopoietic factor in the body. It has more content in the hematopoietic system and can promote the growth of granulocytes.Adult oral dose 25-50mg, 3 times/day, 4-6 weeks as a course of treatment;Children's oral dose is 1-2 mg/kg, twice a day.For patients with shorter course of disease, lighter condition and better bone marrow function, the curative effect is better.
(5)Sodium deoxynucleotideIt is a compound preparation.Intramuscular injection 50 ～ 100mg/d;Intravenous infusion of 50-150mg/d for 30 days is a course of treatment.
(6) RhG CSF and rhGM CSF can induce hematopoietic stem cells to enter the proliferation cycle, promote granulocyte proliferation, differentiation and maturation, release from bone marrow to peripheral blood, and enhance the chemotactic, phagocytic and bactericidal activities of granulocytes.The treatment of agranulocytosis has a clear effect and can be used as the first choice.The dosage is 100~300 μ g/d, subcutaneous injection or intravenous drip, and the course of treatment is about 1 week. After the granulocyte count rises, the dosage can be reduced or the drug can be stopped as appropriate.Appetite, fever, chills, muscle soreness, bone and joint pain and other adverse reactions may occur[3]。
2. Immunosuppressants are effective for some patients with immune granulocytopenia, but they cannot be abused because they can inhibit normal granulocyte function.
(1) Glucocorticoid: applicable to granulocyte deficiency or critical patients caused by immune factors.It can be used for a short time while sufficient effective antibiotics are applied.dexamethasoneThe dosage is 5-10mg/d, and the course of treatment is about 1 week.
(2)Azathioprine(azathioprine, Yimulan): When glucocorticoid application is ineffective, it can be selected with caution.The oral dose is 50mg, 2-3 times/day.[3]
proposal
Such diseases should be actively taken preventive measures.For workers exposed to radiation, benzene and other chemical poisons, a strict protection system must be established and regular blood routine examination must be carried out.Drugs that may cause leukopenia, such as chloramphenicol, sulfonamides, antineoplastic drugs, antipyretic and analgesic drugs, should be avoided as far as possible. If they need to be used, blood routine tests should be closely monitored under the guidance of doctors, and long-term use of large doses should be avoided.For patients using cytotoxic drugs, blood routine examination should be conducted once every 1-3 days, and the dosage and course of treatment should be adjusted according to the granulocyte count[3]。
The prognosis of these diseases is related to the etiology, degree, duration, progress of neutropenia, whether infection can be controlled and eliminated in time, and the recovery of neutrophils.Especially for agranulocytosis, which has a high mortality, it should be actively rescued. In addition to aseptic isolation and supportive treatment, corresponding drugs should be used as soon as possible.[3]
Sort Count
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The National Operating Procedures for Clinical Examination compiled by the Department of Medical Affairs of the Ministry of Health of China, concerning adultsDifferential white blood cell countNormal reference values are as follows[4]：
In case of acute suppurative infection,NeutrophilsThe degree of increase depends on the type of infection microorganism, the range of infection focus, the severity of infection, and the responsiveness of patients.If the infection is very limited and slight, the total number of white blood cells can still be normal, but the percentage of lobulated nuclei can be increased during classification examination;In moderate infection, the total number of white blood cells increases by more than 10 × 10nine/50. Accompanied by slight left shift of nuclear image;In severe infection, the total number often increases significantly, up to 20 × 10nine/L above, with obvious left shift of nuclear image;After the rupture of spleen or fallopian tube of ectopic pregnancy, the white blood cells increase rapidly, often reaching (20-30) × 10nine/L。The increased cells are mainlyNeutrophil。This may be related to stress state, internal bleeding and transient hypoxia;When chemical drugs such as sleeping pills and dichlorvos are poisoned, the number of white blood cells often increases, even up to 20 × 10nine/L or higher.Metabolic poisoning such asDiabetic ketoacidosisandchronic nephritis Leukocytosis is also common in uremia.All of them were mainly neutrophils.Leukocytes increase continuously for a long time, most commonly in myeloid leukemia, and secondly in the late stage of various malignant tumors. At this time, the total number often reaches (10-20) × 10nine/L or more, and there may be obvious left shift phenomenon of nuclear imageLeukemoid reaction。[5]
Neutropenia
Some infections, such as typhoid, paratyphoid, malaria and influenza, can cause leukopenia;Some blood diseases, such as aplastic anemia, show "three little" performance;Ionizing radiation (such as X-ray, etc.) and long-term administration of chloramphenicol can inhibit the mitosis of bone marrow cells and cause leukopenia;Autoimmune diseases such asSystemic lupus erythematosusAnd so on, due to the destruction of white blood cells caused by autoimmune antinuclear antibodies;Leukopenia can be seen in splenomegaly caused by various reasons.[5]
Eosinophils
It has phagocytosis and chemotaxis,EosinophilsIncreased reactivity is seen in bronchial asthma, angioneurotic edemafood allergyThe number of eosinophils in the blood was increased in all patients with psychosis.When the intestinal parasite antigen contacts with the mast cells that bind IgE in the intestinal wall, the latter will degranulate and release histamine, leading to the increase of eosinophils.Prognosis of surgical and burn patients and determination of adrenocortical function.Tumor like increase is found in malignant diseases of the lymphatic system, hematopathyChronic leukemiaEtc.Eosinophils in patients with chronic myeloid leukemia can often be as high as 10% or more, and infantile type can be seen.Eosinophilia is found in typhoid fever, paratyphoid fever, severe tissue damage after surgery and its applicationAdrenocortical hormoneOr adrenocorticotropic hormone, the general clinical significance is not great.[5]
Basophil
It has chemotaxis and weak phagocytosis.Increased inChronic myeloid leukemiaHodgkin's disease, cancer metastasis, lead and bismuth poisoning, etc.RareBasophilThe abnormal increase of sex leukemia can reach more than 20%, most of which are infantile.Bone marrow fibrosis and some metastatic cancer can also be seen increased.[5]
lymphocyte
lymphocyteIts main function is to participate in humoral immunity, cellular immunity and secretionLymphokine。Lymphocytosis is seen in acuteChronic lymphocytic leukemia；Some infections: such as viral infectious diseases, bacterial infections (such as whooping cough), tuberculosis infection recovery period, etc.When rejection occurs after kidney transplantation, the absolute value of lymphocytes increases at the early stage of rejection.Lymphocytic leukemia, leukemicLymphosarcomaIf the former is of chronic type, it is mainly leukemic mature lymphocytes, and if it is of acute type, it is mainly protoblastic lymphocytes, which can increase the total number of white blood cells;The latter is mainly composed of protolymphocytes and juvenile lymphocytes.The number of newborn babies and children increases physiologically.
Lymphopenia is mainly seen in the population after long-term exposure to radiation and treatment with adrenocortical hormone or adrenocorticotropic hormone.In severe suppurative infection, the number of neutrophils increases significantly, resulting in a relative decrease of lymphocytes.[5]
monocyte
In normal children's peripheral bloodmonocyteIt is slightly more than that of adults, with an average of 9%. The number of physiological monocytes in infants 2 weeks after birth can reach more than 15%.
Pathological increase is seen in some infections.asSubacute infective endocarditis, malaria, kala azar, etc;Acute infectionThe number of monocytes also increased during the recovery period;stayActive pulmonary tuberculosisIn case of severe infiltrative and miliary tuberculosis, monocytes in blood may increase significantly.During the recovery period of agranulocytosis, the common monocytes increase temporarilyMalignant histiocytosisIn lymphoma, the number of immature monocytes increased, and that of mature monocytes also increased.In addition to anemia and leukopenia in myelodysplastic syndrome, nuclear cells increase is common in leukocytosis classification.[5]
