See also: NFS
The hémogramme or " numeration formulates blood " ( NFS ) or " complete hematologic examination " or " hémato complete " is the quantitative analysis (numeration) and qualitative (formula) of the illustrated elements of blood: red globules ( érythrocytes or red blood corpuscles ), of the white globules ( leucocytes ) and of the Plates ( thrombocytes ).
Information collectedIt is made by means of a simple catch of Sang then the analysis is carried out by an automat which measures the number of érythrocyte S, the rate of Hémoglobine and the Hématocrite then calculates the VGM, the CCMH then the TCMH.
The results of the hémogramme vary physiologically according to the sex, of the age and the ethnos group. The following standards are those of an adult but, in the children or the expectant mothers, the standards differ.
A good technique of examination improves quality of the results of the hémogramme. It is carried out by frank venous puncture, at a subject not with jeun but remotely of an ingestion of greasy substance, normohydraté. The taking away is carried out on tube containing an anticoagulant substance which will prevent the blood of " gélifier". If one operates multiple taking away, the taking away intended for the hematologic-hémogramme analyzes and coagulation-must be realized in first. The taking away should not be realized in a perfusée vein or starting from a line of perfusion (risk of dilution of blood by the product of perfusion). If a hémogramme is carried out on catheter, a preliminary purging of the line of perfusion must be realized beforehand. The tubes are gauged for taking away of 5 ml.
Quantitative studyThe examination informs about several points:
- VGM α Hématocrite/Érythrocyte: give the average volume of a érythrocyte (higher than 1OO fl reveals gives a problem macrocytaire, lower than 80 fl reveals a problem microcytaire)
- CCMH α Hémoglobine/Hématocrite: on average give the concentration of hemoglobin in the érythrocytes (a value higher than 36 mark an error of measurement, because unsuited to the life of the érythrocyte)
- TCMH α Hémoglobine/Érythrocyte: give the average mass of hemoglobin in a érythrocyte
- the defect of réticulocytes sign a arégénérative anemia, since the reticulocytes are red globules have just been synthesized.
- blood Smear allowing:
- to detect anomalies of form:
- of the érythrocytes: One thus detects the Sphérocytose S, the Schizocyte S, the presence of rollers, the Réticulocyte S, etc
- of the leucocytes: One thus detects the Anomalie of Pelger-Huet, the " Virocyte s", etc
- of the leucocytes: One thus observes the variations of the aspect of thrombocytes, etc
- to discover blood parasites, in particular various the Plasmodium , agents of the Paludisme, or Borrelia recurrens .
The variations of coloring of the red blood corpuscle (the normal red blood corpuscles examined after usual coloring have a pronounced rosy aspect and a pale aspect of red blood corpuscle is noted in the event of defect of synthesis of hemoglobin (hypochromy) as well as inclusions intraérythocytaires allow also a reliable tracking.
One can also make an examination of the plates by their numerations and their formulations for a better tracking of diseases.
InterpretationIt is necessary to keep in mind that only the number of red globules, the number of white globules, the rate of hemoglobin and the hématocrite are measured with the hémogramme. The other values are only deduced. The values out-standards make it possible to detect specific affections hematologic S but also the blood expression of another diseases (in particular various infections, deficiencies, certain cancers, etc) But it is only while proceeding by various quite precise stages that one can have best interpretation: it is initially necessary to determine the rate of hemoglobin and the rate of hématocrite, then to determine average globular volume (VGM) and finally to determine the rate of the réticulocytes if required.
Red line or anomalies of the hémogrammeA Anémie is defined by a rate of hemoglobin lower than the standard. Its clinical expression depends less value on hemoglobin than of its speed of installation. One can tolerate perfectly rates of 7 G Hb/100 ml in so far as the losses are chronic.
There exist various forms of anemia as isolated anemia, anemia microcytaire, nonregenerative anemia normocytaire, regenerative anemia normo, macrocytaire or acute anemia.
Conversely, a Polyglobulie is defined by a rate of hemoglobin supranormal which appears by a red facies (“red-faced man”, “purply”, “plethoric”). The polyglobulie is diagnosed when the rate of hemoglobin is higher than 18g/dl for the men and 17g/dl for the women. The most current cause of polyglobulie is the Tabac in answer to a chronic hypoxia. Another polyglobulie secondary is the reaction to the stay prolonged in altitude . The primary polyglobulie, polycythemia will vera or Maladie of Be occupied, is a specific Syndrome myelodysplasic of the red line. Other syndromes myelodysplasic cause a polyglobulie. The polyglobulie increases the Viscosité of blood, and represents a risk factor of Thrombose.
External bondsEven Also: Average globular concentration in hemoglobin (CGMH) Concentrate of red globules (CGR) Concentrate érythrocytaire phenotype (STOCK) Concentrate of red globules phenotype (CGRP)
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