What are neutrophilsEverybody knows an experienced doctor. Segmented neutrophils (neut) - variety of leukocytes. These white blood cells are the most numerous (50-70% of total white blood cells). Neutrophils are presented mature cells with nuclei, divided into several segments. This is the main difference from the band neutrophils. Reduction or increase in the blood of these cells may be an indication of dangerous diseases (leukemia, diabetes, malignant tumor).
What do the
Segmented neutrophil functions are:
- Active movement throughout the body.
- Participation in immunity.
- The ability to phagocytosis (uptake of foreign microbes). Neutrophils are capable of movement. Reaching goals, they envelop the bacteria and destroy it. Neutrophil himself while dies.
- Isolation of specific substances (cytokines) that indicate the attack of the body, the penetration of foreign agents and provide an antibacterial effect.
that show
These blood cells show the status of cell-mediated immunity (immune response) during bacterial infection. The more, the reaction is stronger.
Blood analysis
The number of segmented neutrophils defined in the general blood tests, and their percentages - during counting leukocyte. The main phase of the analysis are:
- fence material (capillary or venous blood);
- preparation of equipment and inventory;
- preparation of smears for further research;
- their fixation and staining;
- leukocyte count.
Blood is taken from the fourth (nameless) left thumb (for right-handed) or right (for left) hand. Some of the material is taken from a vein. In the first case treated cotton thumbs alcohol swab. Wear sterile disposable gloves. Take the new scarifier and pierce a finger. Puncture depth of 2-3 mm. Scarifier holding steady finger and thumb.
The first drop of blood is removed by cotton wool, then blood sampling is performed with a special glass tube. The blood is placed in a sterile tube, signed and sent to the laboratory. When the material is taken from a vein in the general analysis of blood puncture made in the area of the elbow. The needle is inserted at an angle of 45º, and then almost parallel to the skin. Pre-applied shoulder harness.
Thereafter, smears are prepared for microscopy. Use sterile glass slides. Further research may be carried out in special analyzers. Counting the total number of leukocytes is conducted in the Goryaev camera. Segmented neutrophil larger than red blood cells and has several large granules, which are painted in purple. If neutrophils are seen, the segment may not be 1 (4-5). The number of segmented neutrophils recorded in relative values (percentage).
normal levels
Norma segmented neutrophils depends on a person's age. Neonates content of these cells is normally 47-70%. For children 1-2 years old, the figure is 28-48%. In 2-5 years, the content of segmented neutrophils should be 32-55%, and in 6-7 years - 38-58%. In children 8-15 years of neutrophils equal to 41-60%. Adolescents over 16 years of age and adults of normal content of these cells in the blood of 50-70%.
The causes of variances
The content of segmented neutrophils in the blood count is above or below normal may be caused by external factors (exposure to ionizing radiation, poor diet) or different diseases. If segmented neutrophils increased, it is also called leukocyte formula shift to the right.
elevated levels of
Causes leukocytosis are:
- Stress.
- Physical exhaustion.
- Poisoning and intoxication (drugs, plants, food, chemicals, alcohol).
- Introduction immunological drugs (vaccination).
- Uncontrolled medication reception (systemic corticosteroids).
- The postoperative period.
- Malignancies, including cancer. Increase segmented neutrophils possible for tumors of various organs (skin, stomach, intestines, lungs, brain, reproductive organs). When this pathology large number of atypical cells formed in the body, which begin to share uncontrollably. Clinically it is expressed in violation of the functions of the affected organ and symptoms of cancer intoxication (weight loss, weakness, malaise, low-grade fever). Along with leukocytosis is often increased erythrocyte sedimentation rate.
- Admission immunomodulators. These drugs can stimulate the formation of segmented neutrophils.
- Bacterial diseases of the upper respiratory and ENT (sinusitis, tonsillitis, acute exacerbation of chronic tonsillitis, pharyngitis, laryngitis).
- Purulent diseases of soft tissues and bones (osteomyelitis, cellulitis, abscesses, gangrene). In this case, segmented neutrophils increased due to the growth of bacteria (streptococci, staphylococci).
- Acute intestinal infection caused by bacteria (typhoid, cholera, salmonellosis, dysentery).
- Bacterial infections of the lower respiratory tract (pneumonia, bronchitis, tracheobronchitis, tuberculosis).
- Inflammatory diseases of other organs (arthritis, pancreatitis, cholecystitis, acute and subacute thyroiditis, peritonitis).
- Myocardial organs (brain, heart, kidneys, adrenal glands, spleen). This pathology develops in the blood disorders and is characterized by the formation area of tissue necrosis.
- Hyperglycemia (elevated blood glucose). This condition is seen in people with diabetes. If it is disturbed insulin production in the pancreas, or decreased sensitivity to cells. This results in metabolic disorders.
- Systemic inflammatory disease (rheumatoid arthritis).
- Parasitic infections (acute phase of ascariasis).
- Food allergy.
- Endocrine pathology (disease thyroid and adrenal glands).
- Uremia. This extreme degree of renal failure in which blood accumulates products of nitrogen metabolism (ammonia, urea), phenol, acetone and indole. This leads to multiple organ failure. In patients with increased neutrophils in the blood, as well as greatly exceeded the concentration of urea. Neutrophilia combined with dysproteinemia, albumin levels fall, decrease in calcium and sodium in the blood, increased ESR and normochromic anemia.
- Eclampsia. This is a severe form of preeclampsia (toxemia of pregnancy), in which there are convulsions and loss of consciousness. Most often it occurs in the later stages. risk factors are hypertension in the expectant mother, diabetes, obesity, somatic pathology and burdened obstetric and gynecological history.
- Thermal tissue injury (burns, frostbite). If segmented neutrophils in the blood are elevated, it speaks about the death (necrosis) of the cells, and a bacterial infection.
- Autoimmune disorders.
- Blood loss.
- Sepsis.
- Leukemia (blood cancer). These people have broken the formation of red blood cells in the bone marrow.
- The transfusion of blood components (leukocyte mass).
- Severe premenstrual syndrome.
- child nurturing. Elevated levels of neutrophils segmented in women during pregnancy is the norm.
reduced content
Decrease in segmented neutrophils contribute to:
- Acute viral infections (hepatitis, SARS, influenza, herpes infection, adenovirus infection, parainfluenza, measles, rubella, chickenpox, shingles, rhinovirus infection, respiratory syncytial infection).
- Pathology of blood (aplastic anemia). At this pathology is due to low levels of neutrophil inhibition of hematopoiesis. Anemia is congenital and acquired. risk factors include exposure to radiation, viral infections, toxic effects on the body drugs (tetracycline, Analgin, chloramphenicol) and chemicals (benzene, pesticides), hormonal violations. At this pathology neutropenia combined with a fall in hemoglobin, decrease in red blood cells, platelets and white blood cells. The number of neutrophils from 0 to 40%.
- The acute form of leukemia (lymphocytic). If segmented neutrophils dropped, which means that a person has blood cancer. The underlying hematopoietic cell mutation. Most often children are ill. Leukopenia in acute leukemia is rarer leukocytosis. Along with neutropenia observed drop in platelet count, anemia and presence of blasts.
- Congenital (immunodeficiency, agranulocytosis, dyskeratosis, chondrodysplasia).
- Systemic lupus erythematosus.
- HIV infection.
- Receiving medicines (diuretics, NSAIDs, penicillins, cephalosporins, sulfonamides, neuroleptics, cytostatics).
- Acute allergic reactions (anaphylaxis).
- Hypersplenism. It contributes to the accelerated destruction of neutrophils.
- Thyrotoxicosis.
- Radiation and chemotherapy.
- Protozoal infections (malaria, toxoplasmosis).
- Fungal infections.
- Exhaustion (cachexia).
- Lack of folic acid and cyanocobalamin (vitamin B12).
What to do if there is a fault
If increased neutrophils in the adult or lowered, it will require additional studies (ultrasound, CT, MRI, biopsy sample, biochemical analysis, bacteriological and virological studies, serodiagnosis, X-rays). Therapeutic strategy depends on the causes of changes in the level of neutrophils.
In mild asymptomatic neutropenia (decrease in segmented neutrophils) therapy is not required. If the cause was a viral infection, it shows antivirals (ribavirin, Ingavirin, Tamiflu, Acyclovir Zovirax, Valtrex) and immunostimulants. If segmented neutrophils are reduced, they can be administered stimulants lymphopoiesis. These include Tevagrastim, leucite, Neypomaks and Neupogen.
These drugs are contraindicated in severe congenital neutropenia, intolerance and simultaneous radiotherapy and chemotherapy. These medicaments are used in the form of solution for injection. At lower segmented neutrophils with acute leukemia require chemotherapy, anti-bleeding, normalization of blood clotting and increase hemoglobin.
With increased segmented neutrophils in the background of the bacterial disease is the mainstay of therapy use of systemic antibiotics (penicillins, macrolides, fluoroquinolones, carbapenems, cephalosporins). When foci purulent infection (abscesses) and tumors require surgery.
Ancillary aspects of therapy are normalization of the mode of the day, with the exception of stress, giving up reception of toxic drugs, normalizing blood sugar levels and maintenance of vital authorities.
