Blood smear

Definition

血液涂片是一种血液检查，可以提供有关血细胞数量和形状的信息. 它通常作为全血细胞计数(CBC)的一部分或与CBC一起进行。.

Alternative Names

Peripheral smear; Complete blood count - peripheral; CBC - peripheral

How the Test is Performed

A blood sample is needed.

The blood sample is sent to a lab. 在那里，实验室技术人员在显微镜下观察它. 或者，可以用自动机器检查血液.

The smear provides this information:

• The number and kinds of white blood cells (differential, or percentage of each type of cell)
• 畸形血细胞畸形血细胞的数量和种类
• 白细胞和血小板计数的粗略估计

How to Prepare for the Test

No special preparation is necessary.

How the Test will Feel

当针头插入抽血时，有些人会感到中度疼痛. Others feel only a prick or stinging. 之后，可能会有一些悸动或轻微的瘀伤. This soon goes away.

Why the Test is Performed

这个测试可以作为一般健康检查的一部分来帮助诊断许多疾病. 或者，如果您有以下迹象，您的医疗保健提供者可能会建议您进行此测试:

• Any known or suspected blood disorder
• Cancer
• Leukemia

血液涂片也可用于监测化疗的副作用或帮助诊断感染, such as malaria.

Normal Results

红细胞(rbc)通常大小和颜色相同，中心颜色较浅. The blood smear is considered normal if there is:

• Normal appearance of cells
• Normal white blood cell differential

不同实验室的正常值范围可能略有不同. 一些实验室使用不同的测量方法或测试不同的样品. 与您的十大赌博平台排行榜谈谈您的具体测试结果的含义.

What Abnormal Results Mean

异常结果意味着红细胞的大小、形状、颜色或涂层不正常.

Some abnormalities may be graded on a 4-point scale:

• 1+ means one quarter of cells are affected
• 2+ means one half of cells are affected
• 3+ means three quarters of cells are affected
• 4+ means all of the cells are affected

靶细胞的存在可能是由于:

• Abnormal hemoglobin红细胞中携带氧气的蛋白质(血红蛋白病)
• 缺乏一种叫做卵磷脂胆固醇酰基转移酶的酶
• Iron deficiency
• Liver disease
• Spleen removal

Presence of sphere-shaped cells may be due to:

• 红细胞数量少，因为身体会破坏它们(immune hemolytic anemia)
• 红细胞数量少，因为有些红细胞呈球形(hereditary spherocytosis)
• Increased breakdown of RBCs

Presence of RBCs with an oval shape may be a sign of hereditary elliptocytosis or hereditary ovalocytosis. 这是红细胞形状异常的情况.

碎裂细胞(也称为裂细胞)的存在可能是由于:

• Artificial heart valve
• 一种血液疾病，导致全身小血管中形成血块，导致血小板计数低(thrombotic thrombocytopenic purpura)
• 控制血液凝固的蛋白质过度活跃的疾病(disseminated intravascular coagulation)
• 消化系统感染，产生破坏红细胞的有毒物质, causing kidney injury (hemolytic uremic syndrome)

一种称为正母细胞的未成熟红细胞的存在可能是由于:

• Blood disorder called erythroblastosis fetalis that affects a fetus or newborn
• Cancer that has spread to bone marrow
• 血红蛋白过度分解的疾病(thalassemia)
• 骨髓紊乱，骨髓被纤维性瘢痕组织所取代(myelofibrosis)
• Removal of spleen
• Severe breakdown of RBCs (hemolysis)
• 通过血液从肺部扩散到身体其他部位的肺结核(miliary tuberculosis)

毛刺细胞的存在可能表明:

• 血液中氮废物含量异常高(uremia)

骨刺细胞的存在可能表明:

• 不能通过肠道完全吸收饮食中的脂肪(abetalipoproteinemia)
• Severe liver disease

The presence of teardrop-shaped cells may indicate:

• 由于毒素或肿瘤细胞导致骨髓不能产生正常血细胞而引起的贫血(骨髓增生过程)
• Cancer in the bone marrow
• Myelofibrosis
• Severe iron deficiency
• Thalassemia major

Howell-Jolly小体(红细胞内的一种颗粒)的存在可能表明:

• 骨髓不能产生足够的健康血细胞(骨髓发育不良)
• Sickle cell anemia
• Spleen has been removed

亨氏小体(少量改变的血红蛋白)的存在可能表明:

• Alpha thalassemia
• Congenital hemolytic anemia
• 当身体暴露于某些药物或因感染而受到压力时，红细胞会分解的疾病(G6PD deficiency)
• Unstable form of hemoglobin

稍微不成熟的红细胞的存在可能表明:

• Anemia with bone marrow recovery
• Hemolytic anemia
• Hemorrhage

嗜碱性点(斑点状)的出现可能表明:

• 骨髓疾病，骨髓被纤维性瘢痕组织所取代(骨髓纤维化)
• Lead poisoning

镰状细胞的出现可能提示镰状细胞性贫血.

风险

抽血没有什么风险. 静脉和动脉的大小因病人而异，从身体的一边到另一边也不同. 从某些人身上获得血液样本可能比从其他人身上获得更困难.

其他与抽血相关的风险很小，但可能包括:

• Excessive bleeding
• Fainting or feeling lightheaded
• Multiple punctures to locate veins
• Hematoma (blood buildup under the skin)
• 感染(任何时候皮肤破裂都有轻微风险)

References

Bain BJ. The peripheral blood smear. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 148.

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Blood disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM，编. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 124.

Merguerian MD, Gallagher PG. 遗传性椭圆形细胞增多症、遗传性焦样细胞增多症及相关疾病. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM，编. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 486.

Natelson EA, Chughtai-Harvey I, Rabbi S. Hematology. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 39.

Warner EA, Herold AH. Interpreting laboratory tests. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 14.