The indicator of erythrocyte heterogeneity in terms of volume rdw is increased. Width of distribution of erythrocytes. hard physical labor

When the disease appears, the erythrocyte count does not remain in place. In the first and subsequent stages, changes occur. For example, at the beginning, the width indicator may be normal, and hemoglobin may be greatly reduced, even reaching critical values. Of course, the very first thing you need to bring to . This can be achieved by , in which it is enough a large number of gland.

The increased content of erythrocytes can be absolute and relative.

Absolute erythrocytosis is manifested in the following diseases:

• Wakez disease, or chronic leukemia.
• Secondary erythrocytosis, which manifests itself in the form of hypoxia. Occurs due to oxygen starvation due to birth defect heart, elevated levels of certain hormones, and cancer of the kidneys and liver.

Relative erythrocytosis is a pathological condition that occurs due to:

• dehydration;
• stress
• arterial hypertension;
• smoking and alcohol abuse.

Distribution Width Reduction

A situation may arise when analyzes have shown that the width of the distribution of erythrocytes by volume is below normal. This happens much less often than increasing the width.

• big blood loss;
• lack of iron;
• lack of vitamins;
• destruction of erythrocytes.

The distribution of erythrocytes by volume may be reduced due to the occurrence of:

• malignant tumors;
• leukemia, myeloma;
• hemolysis.

When conducting research on the analyzer, you will see either an increase in the width of the distribution of red blood cells or the norm. This is due to the fact that very rarely the width of the distribution of erythrocytes is reduced. For more exact result The doctor will ask you to donate blood again.

In order to prevent the occurrence of anemia, you need to listen to your body and lead a proper lifestyle. In case of manifestation of the first signs of poor health, you should consult a doctor. There is such a thing as the average width of the distribution of red blood cells. It shows how different it is. Having passed the tests, you can find out this figure.

Violation of the width leads to various serious diseases that are complicated in the course of the course. After all, if there is a failure of one important element organism, it can lead to a malfunction of the entire system.

How to take a general blood test and what is needed for this?

There are no complex, strict regulations regarding this testing, but there are some rules:

• For this survey use capillary blood, which is taken from a finger. Less commonly, according to the doctor's instructions, blood from a vein may be used.
• The analysis is carried out in the morning. The patient is forbidden to eat food, water 4 hours before taking a blood sample.
• The main medical supplies that are used for taking blood are a scarifier, cotton wool, and alcohol.

The algorithm for taking capillary blood is as follows:

• The finger from which blood sampling is planned is treated with alcohol. For better blood sampling, it is useful to rub your finger first to ensure a better blood flow to it.
• A scarifier is used to pierce the skin on the finger.
• Blood is collected using a small pipette. The sample is placed in a sterile tube.

What the general blood test shows - deciphering the general blood test of a child and an adult, the norms in the tables and the reasons for the deviation from the norms.

Everyone has gone through this in their life. painless procedure like donating blood from a finger. But for the majority, the result remains only a set of numbers written down on paper. Explanations of this analysis will enable each patient to navigate the deviations that are detected in the blood, the reasons that caused them.

Complete blood count - the content of hemoglobin in the blood.

This blood component is a protein through which oxygen enters all internal organs / systems. The amount of this component is calculated in grams, which is in 1 liter of blood.

• Norms of hemoglobin content in the blood in children and adults.

This indicator will depend on the age of the patient, his gender:

• Reasons for increased and reduced level hemoglobin in children and adults.

Elevated hemoglobin levels are observed with:

1. Diagnosis of heart disease.
2. Diseases of the kidneys.
3. The patient has pathologies associated with hematopoiesis.

A low hemoglobin level may be the result of:

1. Vitamin/iron deficiency.
2. Significant blood loss.
3. Blood cancer.
4. anemia.
5. Rigid diet that led to exhaustion.

Erythrocytes in the general blood test.

Inside the components under consideration contains hemoglobin. The main purpose of erythrocytes is to carry oxygen to the internal organs. Often in the table, instead of the unit of measurement of erythrocytes, you can see the abbreviation RBC.

• The norm of the content of erythrocytes in the blood in children and adults.

The given indicator must be multiplied by 1012. The result will be equal to the number of red blood cells that are present in 1 liter. blood:

• In newborns on the 1st day of life: not less than 4.3, not more than 7.6.
• In infants up to a month, this figure decreases: 3.8-5.6.
• 1-6 months: 3.5 to 4.8.
• Up to 1 year: not higher than 4.9, not lower than 3.6.
• 1 to 6 years: 3.5 to 4.5.
• In the age range of 7-12 years bottom line allowable rate increases to 4.7.
• In adolescence (up to the age of 15): 3.6-5.1.
• From the age of 16 (men): not higher than 5.1, not lower than 4.
• From 16 years old (women): from 3.7 to 4.7.

• Causes of increased and decreased levels of red blood cells in children and adults.

The factors that provoke an increase / decrease in the number of red blood cells in the blood are similar to those that cause an increase / decrease in hemoglobin.

The width of the distribution of erythrocytes in the general blood test.

This parameter directly depends on the size of erythrocytes: if a large number of erythrocytes of different sizes are detected in a taken blood sample, one can speak of a high width of the distribution of erythrocytes.

• The norm of the width of the distribution of erythrocytes in the blood in children and adults.

This indicator is identical for children, adults, and can vary from 11.5 to 14.5%.

• Causes of increased and decreased levels of the width of the distribution of erythrocytes in children and adults.

Deviation from the norm of the indicator under consideration may occur against the background of not proper nutrition, anemia, dehydration.

The average volume of erythrocytes in the general blood test.

This blood parameter helps to obtain information about the size of red blood cells. It is measured in femtoliters / micrometers cubed. This volume is calculated using a simple formula, for which you need to know the percentage of hematocrit, the number of red blood cells.

• The width of the distribution of erythrocytes is the norm in children and adults.

Regardless of age, gender patient, normal the considered blood parameter (MCV) should not be higher than 95 fl, not lower than 80 fl.

• Causes of increased and decreased indicators of the width of the distribution of erythrocytes.

Lowering the rate often occurs due to a lack of iron.

Increase in indicator MCV indicates a deficiency of certain micronutrients.

The average content of hemoglobin in an erythrocyte - a complete blood count, norms and deviations.

The resulting indicator (MCH) displays the amount of hemoglobin that is contained inside the 1st erythrocyte. It is calculated according to a certain formula, for which you need to know the amount of hemoglobin + erythrocytes. The specified parameter is measured in picograms. The MCH norm is the same for men, women, children: 24-33 pg.

Lowering the rate often occurs due to iron deficiency anemia.

Increase in indicator MCH is the result of a deficiency folic acid/vitamin B12.

The average concentration of hemoglobin in an erythrocyte - a complete blood count, norms and deviations.

The parameter in question (MCHC) is obtained by mathematical calculations using hemoglobin+hematocrit. The unit of measure is %. The norm of hemoglobin content in an erythrocyte varies within 30-38%.

There are several factors that can cause a decrease in the indicator in relation to the specified norm:

1. Diseases of the blood.
2. iron deficiency.

The probability of an increase in the indicator under consideration is scanty.

Erythrocyte sedimentation rate in the general blood test.

This indicator (ESR) is obtained by settling the taken blood sample. It is determined by the number, shape of red blood cells, measured in mm / h. The process under consideration is also influenced by the amount of proteins in the plasma.

• The rate of erythrocyte sedimentation in the blood in children and adults.

This parameter does not change much with age, but there are differences:

• 1st day of life: 2-4.
• In babies up to a month: from 4 to 8.
• In the period up to 6 months. the ESR norm is 4-10.
• From 1 to 12 years: not higher than 12, not lower than 4.
• From 13 to 15 years, the lower limit of the norm increases to 15.
• From 16 years old (men): 1-10.
• From 16 years old (women): 2-15.

• Causes of increased and decreased erythrocyte sedimentation rate in children and adults.

The upward deviation from the norm is the result of such phenomena:

• body infection.
• Pregnancy.
• Anemia.

A decrease in ESR is the result of blood diseases.

Leukocytes in the general blood test.

These are living cells of the body that are produced in the lymph nodes, bone marrow perform a controlling function. There are several varieties of blood components under consideration: neutrophils, monocytes, eosinophils, lymphocytes, basophils.

• The norm of leukocytes in the blood in children and adults.

The result will correspond to the percentage of leukocytes that are normally present in 1 liter of blood:

• On the 1st day of life: from 8.5 to 24.5.
• In babies up to 1 month: from 6.6 to 13.8.
• In the first six months, the norm should not exceed 12.5, it cannot be less than 5.5.
• In the age range from 1 month. up to 1 year: 6 to 12% per liter of blood.
• From 1 to 6 years: no more than 12, no less than 5.
• At the age of 7-12 years: from 4.4 to 10.
• In adolescence (after the age of 15): not higher than 9.5, not lower than 4.4.
• From 16 years old (men/women): from 4 to 9.

• Causes of increased and decreased levels of leukocytes in children and adults.

An increase in the rate can occur due to the influence of several factors:

• Inflammatory phenomena in the body. This includes postoperative period, ENT diseases, diseases of the lower respiratory tract, damage to the skin as a result of injury / burns. With cancer, general blood testing will also show an elevated level of leukocytes.
• Pregnancy.
• Menstruation.
• Vaccination.

The level of leukocytes can be reduced under the influence of such phenomena:

• Vitamin B12 deficiency.
• Diseases of the blood.
• A specific group of infectious diseases: malaria, viral hepatitis, typhoid fever.
• The influence of radiation.
• Systemic lupus erythematosus.
• Taking certain medications.
• Conditions in which immunodeficiency occurs.

Platelets in the general blood test.

These are small non-nuclear cells, inside which microelements are contained, which ensure blood clotting.

• The norm of platelets in the blood in children and adults.

The given indicator must be multiplied by 109 .. The result will correspond to the number of cells that are normally present in 1 liter of blood:

• 1st day after birth: 180-490.
• In children from 1 month. up to 1 year: not higher than 400, not lower than 180.
• From 1 to 6 years: 160-390.
• In the age range of 7-12 years: not higher than 380, not lower than 160.
• In adolescence (up to 15 years old inclusive): from 160 to 360.
• From 16 years old (men / women): from 180 to 320.

• Causes of high and low platelets in children and adults.

An increase in the norm can occur under the influence of several phenomena:

• Inflammatory reactions (including the postoperative period).
• Oncological diseases.
• Significant blood loss.
• Diseases of the blood.

A low level of platelets is observed against the background of the following pathologies:

• Defects in the work of the bone marrow.
• Cirrhosis of the liver.
• Blood transfusion.
• Disorders associated with the functioning of the immune system.
• Diseases of the blood.

Hematocrit in the general blood test.

By means of this parameter, the volume of erythrocytes is compared with the volume of blood. The unit of measure for hematocrit is percent.

• Hematocrit in the blood and its norm in children and adults.

With age, this parameter undergoes certain changes:

• On the 1st day after birth: 40-66%.
• In children up to a month: from 34 to 55%.
• In infants in the age range of 1-6 months: 32-43%.
• From 1 to 9 years: 34-41%.
• From 9 to 15 years: 34-45%.
• From 16 years old (women): no more than 45%, no less than 35%.
• From 16 years old (men): 39-49%.

• Low and high hematocrit in children and adults.

An increase in the considered blood parameter occurs when:

• Heart/lung failure.
• Dehydration.
• Some blood diseases.

A decrease in hematocrit may indicate the following phenomena:

• III-IV trimester of pregnancy.
• Anemia.
• Renal failure.

Granulocytes in the general blood test.

This blood parameter is represented by several groups of cells: basophils, neutrophils, eosinophils. These granule bodies are indispensable participants in the fight against infections and microbes.

• The norm of granulocytes in the blood in children and adults.

There are two options for presenting this blood parameter:

• Absolute score. It will be referred to as GRA# on the blood test result tables. In this context, the rate of granulocytes can vary from 1.2 to 6.8 * 109 cells per 1 liter.
• The percentage of granulocytes to leukocytes. Has the designation GRA%. The norm should not be more than 72%, less than 47%.

• Causes of an increase and decrease in granulocytes in the blood in children and adults.

With inflammatory phenomena in the body, an increase in granulocytes in the blood occurs.

A decrease in the number of considered elements in the blood can occur for several reasons:

1. Malfunctions in the bone marrow, which are associated with the production of blood cells.
2. The patient is diagnosed with systemic lupus erythematosus.
3. Taking certain medications.

Monocytes in the general blood test.

Important components of the immune system. Their duties include the recognition of microorganisms dangerous to the body, the fight against inflammatory foci. Their number is limited.

• The norm of monocytes in the blood in children and adults.

The given indicator (MON%) displays the percentage of monocytes in the total number of leukocytes:

• Babies up to 1 year old: 2-12%.
• From 1 to 15 years: not more than 10%, not less than 2%.
• From 16 years old (women/men): from 2 to 9%.

• Causes of an increase and decrease in monocytes in the blood in children and adults.

The increase in the rate can be due to several factors:

The decrease in monocytes occurs against the background of the following phenomena:

• Childbirth.
• Postoperative rehabilitation.
• Taking anticancer drugs.
• Inflammatory-purulent phenomena.

Neutrophils in the general blood test.

These cells help the body cope with infections, eliminate its own extinct microparticles. According to their structure, they are divided into two groups: mature, immature.

• The norm of neutrophils in the blood in children and adults.

The indicator under consideration displays the percentage of stab, segmented neutrovils in the total number of leukocytes. Consider the rate of stab in the blood in children, adults:

• On the 1st day after birth: 1-17%.
• In children from 1 month up to 1 year: from 0.5 to 4%.
• Age group 1-12 years: 0.5-5%.
• From 13 to 15 years old: not more than 6%, not less than 0.5.
• From 16 years old (women/men): 1-6%.

The indicators of the norm of segmented nuclei in the blood are as follows:

• In newborns on the 1st-3rd day of life: not more than 75-80%, not less than 45%.
• Babies from 1 month up to 1 year: from 15 to 45%.
• Age group 1-6 years: 25-60%.
• From 7 to 12 years old: no more than 66%, no less than 34%.
• In adolescence (up to 15 years inclusive.): 40-65%.
• 16 years old (women/men): 47-72%.

• Reasons for the increase and decrease in neutrophils in children and adults.

An increase in the number of neutrophils can be triggered by such phenomena:

• body infection.
• Oncological diseases.
• Vaccination.
• inflammatory phenomena.

A decrease in neutrophils in the blood may occur due to:

1. Treatment aimed at eliminating cancer: chemotherapy, medication. Taking other drugs that inhibit the protective capabilities of the body.
2. Errors in the work of the bone marrow.
3. Irradiation.
4. "Baby" infectious diseases(rubella, measles, etc.).
5. An excess of hormones that are produced by the thyroid gland.

Eosinophils in the general blood test.

The given indicator displays the percentage of eosinophils in the total number of leukocytes:

• On the 1st day of a baby's life: 0.5-6%.
• In the age range of 1 month-12 years: not more than 7%, not less than 0.5%.
• Age group 13-15 years: not more than 6%, not less than 0.5%.
• From 16 years old (women/men): from 0 to 5%.

• Reasons for the increase and decrease in eosinophils in children and adults.

An increase in the number of these cells can occur against the background of:

A decrease in eosinophils can be triggered by:

• Childbirth.
• Infection of the body (including the postoperative period).
• Chemical poisoning.

Basophils in the general blood test.

When testing the blood, these cells may not be detected: the fewest elements of the immune system. Consist of microparticles that provoke the occurrence inflammatory phenomena in tissues.

• The norm of basophils in the blood in children and adults.

Displays the percentage of eosinophils in the total white blood cell count. For children of any age, male/female patients, the number of eosinophils should be 0-1%.

• Reasons for the increase and decrease in basophils in children and adults.

An increase in the considered component of the blood occurs when:

• Allergic conditions.
• Lack of hormones: errors in work thyroid gland taking hormonal drugs.
• Chicken pox.
• Pathologies of the lymphatic system.

A decrease in basophils can be caused by:

• Pregnancy/ovulation.
• An increase in the number of hormones.
• Stress.

All norms of a general blood test for children and adults in tables

Table 1: Norms clinical analysis children's blood different ages

Like

red bodies

Red blood cells are blood cells that stain it in a characteristic color. In healthy people, they are the same in volume and shape. Red cells perform the following tasks:

• ensuring a normal acid-base environment;
• oxygen saturation;
• isotonic support;
• removal of carbon dioxide from tissues.

The proper functioning of red cells depends on their volume in the blood.

Violation of the level of red blood cells is caused by the development of any pathology in the body.

The main constituent of red cells is hemoglobin.

Blood test

When an increase in the width of the distribution of red cells is determined, then first of all, experts judge a pathology called "iron deficiency anemia". This disease is the most common. At different stages, the level of width is increased in different ways. On the initial stage pathological course the density coefficient may correspond to the norm, and the hemoglobin content may be reduced.

With the development of the disease, there is an increase in the width of the distribution of bodies, that is, some red blood cells become larger in parameters. The hemoglobin index in cells, on the contrary, falls, sometimes even to a critical level. Treatment of this type of pathology is associated with the normalization of its level. Basically, therapy involves the use of medications containing a large amount of iron.

An increase in RDW in adults, children, during pregnancy can occur when anemia develops, the body lacks vitamins, and there are liver pathologies.

If there is an increase in the width of the distribution of cells, heterogeneity of erythrocytes is often observed. In the blood there are bodies that differ significantly in size. Also, the factors of this pathological course can be various chronic liver diseases, vitamin B12 deficiency, any neoplasms, cancerous tumors And so on.

In an adult, a blood sample is taken from a vein in morning time on empty stomach. In a child, analysis is usually taken from a finger.

Symptoms

When the relative width of the distribution of erythrocytes increases, various symptoms may appear.

So, for example, yellowing of the skin is observed, since in this case a serious effect on the functioning of the liver and spleen, an increase in temperature is carried out. As with many other diseases, the patient's sweating increases, the person becomes drowsy, easily fatigued, and weak. Due to the effect on the nervous system, the patient experiences frequent change Moods: Excitement abruptly changes to renunciate behavior. In each situation, the symptoms cannot be accurately described, since changes in red blood cells affect many organs of a person.

From this it follows that a change in the width of the distribution of bodies sometimes becomes the cause of pathologies of a diverse nature and severity of development, since the body is a rather complex system with a ruler interrelated bodies between themselves. The malfunctioning of any of them can cause a malfunction of the whole organism.

This indicator shows the size and shape of red blood cells.

Red blood cells realize the function of transportation, thereby assisting in the penetration of oxygen into all tissues and organs, while taking away toxins and carbon dioxide accumulated in cells. AT normal condition red blood cells are approximately the same size, which allows them to quickly stick together, forming blood clots.

The indicator of red blood cells in the blood can reflect the presence of pathological processes in the body, especially if the sizes of these cells vary significantly. Next, we will talk about the situations in which the red blood cell distribution index decreases, how it manifests itself and what it indicates.

Reduced RDW: norm and pathology

In a person with good health red blood cells of the same shape, density and color. In the event of a deviation, especially if there is autoimmune diseases or oncology, a failure occurs at the level of microcells, when young cells do not receive a certain number of components, which, in fact, slows down their performance. Thus, anemia occurs - a pathology during which the body does not receive the right amount oxygen, in other words, the metabolic function in erythrocytes is disturbed.

What does RDW mean in a blood test?

During a general blood test, the distribution index of erythrocytes is determined. If a specific disease is suspected, a blood test is prescribed to determine only this indicator.

Most often, the width of the distribution of erythrocytes by volume is determined in conjunction with MCV. This is the average volume of erythrocytes. This happens because these indexes (by number and volume) are closely related and help in determining the type of anemia.

It happens that the distribution index of erythrocytes is lowered. What does it mean? The thing is that for a qualitative judgment about the state of erythrocytes, not only their concentration in the blood is important, but also their shape. An increased distribution of erythrocytes is observed in 1 of the cases, but if the RDW index is lowered, which is much less common, we are talking about availability serious problems in the human body.

A blood test to determine the distribution index of erythrocytes can be carried out both during medical examinations (scheduled) and as prescribed, if there are suspicions of any deviations in the hematopoietic function. The analysis is carried out necessarily before surgery, during pregnancy and in childhood.

Why is it necessary to do an analysis on RDW?

It has already been said above that the distribution index of erythrocytes in the blood makes it possible to conduct a qualitative assessment of the composition of red blood cells, given their size.

But why is this necessary? The thing is that these cells are very similar to each other, which gives them the opportunity to replace each other or form blastulae. An increase in cell size entails an increased need for nutrition and, in addition, this means that their lifespan is reduced. All this directly affects total score red blood cells in the blood and human condition.

When a large number of red blood cells die, iron is released and there is more bilirubin, which affects the liver increased load, and as a result, it cannot process these substances.

The RDW index is directly related to the pathological process during which the dimensions of red blood cells change (anisocytosis). This condition is a complex chemical process that causes all blood cells to suffer.

How is it calculated?

The RDW indicator is calculated as a percentage, the norm of which is the limit from 11.5 to 14.8. The distribution index of erythrocytes is determined using a mathematical equation, which is the ratio of modified red blood cells and their total mass.

At present, laboratories use computer technology that allows you to calculate the percentage of deviation from the established norm. The results of the calculation are presented in the form of a histogram depicting a curve that indicates the likely changes in the size of red blood cells.

Normal performance

The norms of the erythrocyte distribution index depend on gender, age and the presence of certain conditions that occur in the human body. For children under one year old, the normal rate is 11.5-18.7%. AT one year old and older values ​​rush to the generally accepted norm of 11.5-14.5%.

For the female half of humanity, the upper limit shifts to 15.5%, because their hormonal levels change too often: during pregnancy, lactation, taking oral contraceptives, menopause.

For analysis, blood is taken on an empty stomach in the morning (until 9 am). It is very important that before this procedure a person does not take any medications, and also stays in a balanced internal state.

Raise RDW

The level of RDW in some situations is elevated. The most common cause of this pathology is iron deficiency anemia. The indicator can change at different stages of the development of pathology, which clearly reflects the histogram of erythrocytes:

• The initial stage of the development of anemia is characterized by normal indices, but hemoglobin will be greatly reduced. This is the result of healthy functioning of the spinal cord.
• The next stage of development in the histogram will show increase in RDW. When there are problems with hemoglobin, indicators such as the average concentration and content of hemoglobin in the blood cell, the average volume of red cells decrease.

In the treatment of IDA, it is necessary to normalize the level of iron-containing protein concentration and its characteristics in human blood.

What do low scores mean?

Patients often ask what it means: "erythrocyte distribution index is lowered." Since the erythrocyte distribution index cannot be estimated without a volume indicator, it is necessary to familiarize yourself with all options for underestimated indicators with their relationship:

1. RDW is low, and MCV is below average - indicates the presence of problems with the spleen and liver.
2. RDW down and MCV up normal level- indicates the presence of oncological pathologies, mainly the development of metastases in the bone marrow.

The fact that the distribution index of erythrocytes RDW sd is lowered, with biological point vision, cannot, in principle, be observed. For this reason, most often the patient is offered to donate blood again, observing the following conditions:

• stop smoking and drinking alcohol within 24 hours before blood sampling;
• before the analysis, do not take any medications;
• refuse to eat smoked and salty foods the day before.

In the case when the distribution index of erythrocytes RDW sd is really lowered, which is necessarily confirmed by deviations from the norm of the MCV indicator, this indicates the occurrence of certain pathologies. These include:

• Hypochromic microcytic anemia - sometimes also called anemia. A condition in which irregularly shaped red blood cells die because they have no biological value in the body.
• Malignant tumors - usually in this case we are talking about mastopathy, bone marrow and lung cancer.
• Hemolysis of red blood cells is the process during which red blood cells die before reaching their target. As a result, active hemoglobin is released.

The reasons

So, the distribution index of erythrocytes is lowered - what does this mean? There are several reasons that can reduce RDW:

• Acute blood loss in trauma and pathological bleeding.
• Frequent operations.
• A metabolic disorder in which the food consumed is not completely digested.
• Hormonal failure, which is most common in women.
• Deficiency in the body of B vitamins and iron.
• Blood diseases characterized by rapid destructive processes.

What measures to take?

What to do when the erythrocyte distribution index is lowered?

A highly qualified doctor at the consultation will most likely ask the patient to take the test again, because the RDW indicator is almost never underestimated. Since this suggests that all cells are ideal in their parameters, and this, in principle, cannot be. If the indicator is confirmed upon re-analysis, then a complete study of the state of the body is carried out, paying special attention to oncological examinations.

Preventive measures

You can prevent a low RDW by following these simple rules:

• The diet should be balanced, which includes a lot of fresh fruits, lean meat and vegetables.
• It is recommended to breathe fresh air as often as possible.
• An active lifestyle will help prevent the RDW index from dropping.
• It is very important not to miss scheduled medical examinations, during which serious deviations from the norm are most often detected that do not have external symptoms.

As a result, we learned that the distribution index of erythrocytes reflects their dimensions relative to each other and makes it possible to learn about their biological value. A decrease in the RDW is very rare, but if the distribution index of erythrocytes is low, this means that various pathologies are possible.

The index is calculated based on the results of a general blood test, but it can only be fully valid in conjunction with the MCV indicator, since they are closely interconnected.

The distribution width of erythrocytes (RDW index): what is it, the norm, increased and decreased

To determine different populations of red blood cells, an indicator (erythrocyte index) is used - the width of the distribution of erythrocytes - RDW or the degree of erythrocyte anisocytosis, which is included in the list of all components of the general blood test (CBC), that is, this parameter is usually not assigned on its own and not tested in the laboratory.

So what does such an erythrocyte index as RDW mean, what information does it carry to specialists and why is it used?

Distribution of erythrocytes by volume

If we examine under a microscope the red blood cells present in the blood of a patient suffering from a certain hematological pathology, we can find that the erythrocytes (Er) are not all the same in volume. Among all non-nuclear biconcave forms, there may be cells that differ significantly in size from normal erythrocytes:

• Large cells - macrocytes;
• Just giants - megalocytes;
• Lilliputian cells, which are called microcytes.

And here it is not necessary to be a specialist in this field in order to understand that red blood cells that have changed their volume will not be able to fully fulfill their physiological functions(transfer of oxygen and nutrients, regulation water-salt metabolism and acid-base balance, participation in blood coagulation, etc.), which, of course, will affect the overall health of the body.

Meanwhile, one should not attach too much importance if ugly forms are present in single copies, it is another matter if they claim an equal position with normal erythrocytes. In order to find out how many in the general population of erythrocytes there are bizarre shapes characteristic of a particular type of anemia, and calculate the width of the distribution of erythrocytes (erythrocyte index RDW).

many doctors laboratory diagnostics and hematologists take RDW as a coefficient of variation, indicating how much the average red blood cell volume (MCV) deviates from the generally accepted norm, and calculate it by the formula:

where SD denotes the standard deviation of the mean volume of red blood cells, and the MCV index corresponds to their mean volume.

Is it always possible to believe the norm?

Range normal values distribution of erythrocytes by volume varies within 11.5 - 14.5% (in children up to six months, the norm, in general, differs markedly and ranges from 14% to 18.7%, although from 6 months the values ​​\u200b\u200bof the indicator are already beginning to tend to adult norm).

An elevated RDW in a blood test indicates the degree of heterogeneity (heterogeneity) of red blood cell populations or indicates the presence of several blood cell populations in the sample, which occurs, for example, after a recent blood transfusion.

It is hardly possible to apply the term " reduced value RDW", since this option reflects, as it were, the norm, and therefore cannot be taken as laboratory indicator characterizing some phenomenon unusual for these blood elements. The less unnatural forms (due to an increase or decrease in volume) of erythrocytes in the blood, the more representatives of the population for this trait are within the normal digital values. And yet, if this happens (RDW - lowered), then, most likely, the analyzer made a mistake, and in order to correct this oversight, the patient will have to provide a finger for a puncture again, and the laboratory staff will have to calibrate the device.

In addition, it should be taken into account that RDW, which is within the norm, is not always evidence full health, because in some cases the indicator of the distribution of erythrocytes by volume is not increased, but clinical manifestations and laboratory tests confirm the presence of the disease (anemia).

Increased RDW

An elevated index is quite a suitable indicator even for differential diagnosis some types of anemia, it allows you to distinguish between their forms:

1. Megaloblastic and macrocytic, a typical representative is B12 / folic / -deficiency anemia. In the blood test: hyperchromia, the average volume of Er is above 160 fl, the cell diameter is more than 12 microns, RDW is increased (anisocytosis), different shape erythrocytes (poikilocytosis);
2. Normocytic: aplastic anemia, as well as anemia caused by chronic pathology(tuberculosis, pyelonephritis, collagenosis, liver disease), malignant process or caused by dysfunction of the endocrine system;
3. Microcytic (iron deficiency anemia, in the blood test: hypochromia, anisocytosis towards microcytosis).

True, in such cases, in addition to RDW, the diagnosis also relies on another erythrocyte index - MCV, which characterizes a red blood cell as a normocyte (at 80 x / l - 100 x / l or 80 - 100 femtoliters), microcyte (at - below 80 fl), macrocyte (if the average volume is more than 100 fl).

In addition, when testing blood samples in order to calculate the values ​​of erythrocyte indices (including RDW), it is very important to compare the results obtained with the histogram of erythrocytes, which, after completing their work, is usually issued by modern hematological systems with software.

In this way, increased rate RDW with values ​​of the mean volume of erythrocytes (MCV) above 100 fl may indicate the following pathological conditions:

• IDA (iron deficiency anemia) - the most common anemic condition (IDA accounts for up to 80% in the entire group of diseases of this kind)
• Sideroblastic anemia (a heterogeneous group of hypochromic microcytic anemias);
• Macrocytic and megaloblastic anemia;
• Myelodysplastic syndromes, which are a hematological pathology that combines a group of heterogeneous diseases with characteristic features reduction in the number of individual populations of cellular elements in the blood (cytopenia) and clonal disorders of hematopoiesis in the bone marrow (dysplasia). Myelodysplastic syndrome is different high risk transformation into a malignant process;
• Bone marrow metaplasia;
• Metastases of malignant tumors in the bone marrow.

Obviously for a certain circle pathological conditions calculation of the width of the distribution of erythrocytes has a very important diagnostic value.

Why is RDW a new indicator for patients?

Before, while everyday life The laboratory service did not include automated hematological systems, the degree of anisocytosis was determined visually, when viewing a smear using optical equipment. And the distribution width of erythrocytes was not called RDW and was not calculated by a device designed for automatic hematological analysis. The calculation was carried out by a different method - using the Price-Jones curve, which, as it turned out later, did not coincide with the erythrocytometric curves performed by the “smart” machine with maximum accuracy, but it took a lot of effort and time for doctors and laboratory assistants to conduct the study. Now, having placed the sample in the "smart" apparatus, no one asks him one question - to work only on a separate test. The analyzer will simply calculate everything that is provided for by the program and is embedded in it, so patients began to see new indicators, which, when processing samples manually and was not in sight.

And such studies were previously of interest mainly to hematologists to clarify the nature of anemia, who, if necessary, applied to the laboratory with a note in the direction: morphological study erythrocytes, calculate and present graphically (Price-Jones erythrocytometric curve) the ratio of the number of red cells with different diameters. Of course, not all blood samples were subjected to such testing, but only samples taken from specific patients. Now, in principle, nothing has changed, this indicator is likely to be of interest to a separate circle of specialists. Well, if RDW is present in the blood test, then patients have the right to ask questions.

Currently, an automatic hematology analyzer successfully copes with the calculation of RDW in a blood test, which quietly, quickly and efficiently solves the problem. And makes RDW everyone.

Reasons for increasing and decreasing the width of the distribution of erythrocytes by volume

As you know, blood is formed not only by liquid (plasma), but also by various cellular elements such as erythrocytes, leukocytes and platelets. All of them must have a certain size, volume (cv) and shape for normal functioning.

Any change in these parameters affects the usefulness and functional activity of cells, which can lead to various disorders of homeostasis. It was in order to be able to evaluate these cells that a special index was created - the distribution width of erythrocytes (RDW).

What does indicator mean?

This term is understood as an index that allows you to get an idea of ​​the distribution of cells of various sizes or shapes in the blood. Simply put, the width of the distribution of erythrocytes provides information about what percentage of erythrocytes in the blood, the size or volume of which is reduced or, conversely, more than necessary. Usually, it is used to evaluate the form, however, there is also its version for evaluation by volume - RDW-CV.

As you know, in order to supply oxygen to every cell of the body, an erythrocyte must pass even into the most small vessels. That is why, physiologically, in size and size, the cells must correspond to the lumen of the vessels. If too large or vice versa, too small cells appear in the blood, this leads to the development various violations at the cellular and subcellular levels. As a result, it becomes necessary to determine the cellular composition of the blood using the RDW-CV indicator.

The distribution index of erythrocytes by volume in an adult is from 11 to 14.5%.

It is with this ratio of “atypical” cells that adequate blood supply is still achieved. internal organs and fabrics. Reducing it below normal negatively affects the condition of the cells. In children, the norm of this indicator is slightly higher and can be up to 20%.

In addition to determining their volume, the calculation is also shown standard deviation(SD). It quantifies the difference between the largest and smallest cell in an assay (usually referred to as RDW SD in assays).

Given all the variability and possible subsequent violations, it is necessary to understand in which cases an increase in RDW occurs, and when this index is lower than necessary.

Reasons for increasing the width of the distribution

The distribution width of erythrocytes is increased when the percentage ratio between small and large erythrocytes increases towards larger cells. Due to the redistribution of hemoglobin, which is the main molecule of the erythrocyte, a smaller amount of them is synthesized in the body, which leads to the development of anemia, as well as anisocytosis, a condition in which most of red blood cells is different from each other.

A characteristic feature of such cells, as mentioned above, are excessively large sizes, as well as a lifespan below the physiologically programmed. As a result, when they mass death(apoptosis in the spleen), a large amount of bilirubin is released, which negatively affects the condition of the liver and other internal organs.

The distribution of red blood cells by volume may be higher than normal as a result of:

• lack of iron, folic acid and some B vitamins. It is a fairly common cause of anisocytosis, which leads to an increase in the width of the red blood cell distribution.
• oncological diseases. Most common cause formation in the blood of red blood cells that differ in size and volume. Usually affects other hematopoietic sprouts.
• heavy metal poisoning. Most often, the width of the distribution of erythrocytes changes with lead intoxication of the body.

All of these causes require competent and qualified treatment. Otherwise, all of them can cause significant harm to the body, even death.

Reasons for the decline

If a patient's RDW-CV is below normal, then all blood cells have same size(i.e. no significant differences in cell volume).

If the distribution width of erythrocytes by volume is reduced, the most likely diagnosis is microcytosis, in which all formed erythrocytes are small and cannot adequately supply tissues with oxygen.

Thalassemia is one of the most common diseases accompanied by the synthesis of small erythrocytes and, accordingly, a decrease in the RDW norm. This disease is hereditary, and manifests itself as a violation of the synthesis of normal hemoglobin chains, the activity of which in relation to oxygen is lower. At the same time, the blood loses its ability to normal and adequate exchange of gases (the index of the ratio of oxygen and carbon dioxide is lowered), which as a result leads to a violation of the functions of internal organs.

Characteristic of this disease is a change in the morphological properties of erythrocytes with a decrease in their size, as well as the appearance of "target" erythrocytes, the activity of which is reduced. Clinically, the disease is characterized by a deformity of the skull, an increase in internal organs (especially the liver and spleen), as well as the appearance of icteric skin color.

Another, no less common disease, in which RDW becomes below normal, is the development of microspherocytosis. This disease is hereditary, and its relative frequency of occurrence does not exceed a tenth of a percent.

With its development, an increase in the number of small and spherical erythrocytes in the patient's blood is observed, and the RDW index is lower due to their short lifespan. At the same time, due to the inferiority of their membrane, the current of sodium ions inside the cell increases, which leads to intravascular death of erythrocytes and the development of hemolysis. Clinically, this is manifested by the development of a feeling of weakness, anemia, jaundice and disruption of the internal organs.

If a patient has any of these symptoms, then it is necessary to carry out as soon as possible comprehensive examination the whole organism.

What does it mean if the distribution index of erythrocytes is lowered

The distribution index of erythrocytes is lowered - what does this mean? An important indicator of the general blood test is - RDW. It allows you to determine the volume, shape and size of red blood cells. blood cells are responsible for the distribution of oxygen throughout the body, and also remove carbon dioxide and toxins. If rdw is reduced, this indicates a pathological deviation of the organ or system.

Therefore, it is important to understand what to do when the erythrocyte distribution index is low, and what this means for health. Some diseases can be diagnosed using the RDW index.

What is RDW?

Blood is based on cells that are produced by the bone marrow. There are three types of cells: blood, white and red bodies. It is red cells that are called erythrocytes, their condition is determined using a blood test.

In healthy people, the cells are the same in volume, shape and color. The analysis indicator may fluctuate slightly, experts call this coefficient - the width of the distribution of erythrocytes by volume.

There are two types of this indicator:

• rdw cv, shows the distribution of erythrocytes by volume as a percentage;
• rdw sd - allows you to evaluate the degree of deviation.

A pathological abnormality in the size of red blood cells is called anisocytosis.

A blood test is carried out with a special apparatus, the coefficient is determined as a percentage. The normal RDW in adults ranges from 11 to 15%, any deviation indicates a pathological process in the body. An increased index means that red blood cells differ in size, their vital activity is reduced. If the indicator of the distribution of erythrocytes by volume is lowered, more often this indicates anemia of varying degrees.

Only an experienced doctor can correctly decipher the blood test, establish the cause of the disease. In case of violations of the norm, the patient is recommended an additional study, which will determine the cause of the disease.

A reduced result is very rare and more often the patient is sent for re-blood sampling. After all, a hematological device can only show a high or normal level.

Such a blood test is often prescribed at the first stage of diagnosis in conjunction with other indicators.

Blood sampling is carried out when the patient is placed in medical institution or before surgery.

And also a blood test is regularly carried out to assess the patient's condition in dynamics in order to determine the effectiveness of treatment.

Blood sampling is carried out in the morning, from 8 to 11 o'clock, before the manipulation, you can not eat food, coffee, tea, cigarettes. After the last meal, at least ten hours should pass. Do not be nervous before the procedure.

Taking a blood sample, the specialist places it in a centrifuge, this will separate the liquid from the cells. Then the obtained sample is placed in the analyzer, where the equipment independently counts the cells, their condition and issues a conclusion.

The doctor receives the result in the form of a histogram. If the result is positive, the manipulation must be repeated to exclude a false indicator.

Causes and signs of low RDW

A low erythrocyte distribution index coefficient can be observed for the following reasons:

1. Too much severe blood loss with injuries or other pathologies. Particularly dangerous is uterine or gastric internal blood loss. In such cases, there is little chance of saving a sick person.
2. Surgery to remove an organ.
3. metabolic disorders, undigested food begins to ferment in the stomach, which causes putrefaction.
4. Hormonal failure, more often observed in women.
5. Deficiency of vitamins, iron.
6. Pathological blood diseases in which red blood cells lose their biological function.

If a person has a low erythrocyte distribution index, then characteristic symptoms anemia:

• the patient constantly feels lethargy, quickly gets tired without physical exertion;
• dizziness;
• constant fatigue, decreased performance;
• shortness of breath, dry cough;
• high blood pressure;
• cardiopalmus;

Such negative manifestations observed due to violation biological process. The blood cells become small and poorly carry oxygen throughout the body. First of all, the nervous system, which is responsible for impulses, suffers.

At the first ailments, it is necessary to consult a doctor. The specialist will prescribe a blood test, conduct an additional study, which will help prescribe adequate treatment.

Increased value of the indicator

More often, patients experience increased value distribution width of erythrocytes by volume. Such a deviation, anisocytosis, is not independent disease, more often it is a sign of a pathological process.

With such a deviation, the spleen enlarges, which causes a violation of the functionality of other organs.

The main reasons for the increase in RDW:

• serious liver problems;
• lack of vitamins of groups A and B12 in the body;
• deficiency of iron and folic acid;
• malignant tumor;
• alcohol abuse;
• leukocytosis.

And also a pathological increase is observed in case of chemical poisoning, diseases of the cardiovascular system.

Increasing the RDW ratio leads to yellowish color persons due to disruption of the liver, spleen.

A person has a breakdown, fatigue, increased sweating. Due to violations in nervous system the patient's mood changes dramatically, the excited state is replaced by indifference and alienation.

Shortness of breath is observed, the heartbeat becomes more frequent, the color of the nails and eyeballs changes.

In order to troubleshoot problems, it is important to establish the cause of the deviation. Except, drug treatment You need to adjust your diet and lifestyle.

If you follow all the prescriptions of doctors, you can normalize the state of red cells, their normal functioning. You need to take a complex of vitamins containing B12, folic acid, monitor hemoglobin.

How to prevent the problem?

The value of the indicator below the norm is extremely rare, and it is quite difficult to prevent it. It is important to take regular preventive examinations, follow up general condition health. To avoid false blood test results, you must follow the doctor's recommendations.

But it is important to adhere to the elementary preventive rules that doctors advise:

• eat properly and balanced, fresh vegetables and fruits should be present in the diet;
• take walks in the fresh air;
• lead an active life;
• do gymnastics;
• at the first symptoms of malaise, contact a medical institution.

Many serious illness pass latently and do not manifest severe symptoms. Only a thorough examination can reveal pathological deviation in the body. Having determined the cause of the violation, the doctor will be able to correctly prescribe drug therapy. Self-medication will only aggravate the situation, often lost time leads to serious consequences.

How often do you need to check for RDW? And at what age should you start worrying about it? It's just that my mother has hepatitis C and I don't know if I need to check the RDW? And what is the most important thing to do from the above in order to avoid problems with RDW?

In what cases can a child of 11 years old have an unstable RDW? Is it worth sounding the alarm?

When diagnosing various diseases, the RDW of the blood is necessarily determined. When the patient sees this parameter in the decoding, he is worried about what it is, what the norm should be, and what the result in the form says.

This article will explain what this indicator means, how deviations are determined.

What is RDW in blood

In medicine, RDW stands for the relative width of the distribution of erythrocytes by volume. The study allows you to determine the heterogeneity of red blood cells and the range of their sizes. RDW sets the ratio of cells of normal and abnormal size.

In the analysis, 2 types of values ​​are defined:

• indicator RDW cv (percentage distribution by value);
• RDW sd (range between large and small erythrocytes).

This is an important indicator of blood composition, it helps to identify various pathological changes in the human body.

Any deviation from the norm by more than 15 percent indicates anisocytosis (deformation of red blood cells). Normally, red blood cells are almost the same size.

Diagnostics

You can determine the value of RDW by doing general analysis blood in the hospital or private clinic. The patient is given a referral for research.

Diagnosis is carried out in the laboratory. small pillow ring finger disinfect and make a puncture in it with a special needle, which is called a scarifier.

After that, using special device, similar to a pipette, are gaining required amount blood from a finger and poured into a test tube.

Using various reagents and a microscope, a laboratory assistant examines blood counts. A form with the results of the analysis can be received in a few hours.

In some cases (if any deviations are observed), the patient needs to do a second blood test. Usually, they take biological material from a vein located in the area of ​​​​the elbow bend.

In small children, blood is taken from the finger.

In the analysis, the distribution index of erythrocytes in the blood is determined. The interpretation of the study is carried out by an experienced specialist.

Currently, modern analyzers are used to determine the result with maximum accuracy.

When is an analysis ordered?

The study is carried out with planned medical examinations and before surgical treatment.

Analysis in without fail prescribed for the diagnosis of diseases. On the this study The patient is referred for the following complaints:

• heat body in the absence of specific causes (when other symptoms of diseases are not observed);
• loss of habitual working capacity;
• increased sweating;
• yellowness of the skin and eye sclera;
• constant fatigue;
• sleep disturbances (a person has drowsiness, although he gets enough sleep at night).

If a person is often irritated, becomes aggressive, he has apathy and fatigue, his mood often changes, he is also shown this diagnosis.

Analysis allows you to differentiate different types anemia and determine what treatment will do patient in each individual case.

This diagnosis is mandatory for women when carrying a child.

Study preparation

To obtain a reliable and accurate result, it is important to follow the recommended rules for preparing for analysis. Therefore, experts advise to adhere to the following recommendations:

1. Donate blood on an empty stomach. The interval between food intake and biomaterial sampling should be at least eight hours. Therefore, doctors advise taking it in the morning.
2. Avoid drinking before analysis alcoholic beverages the day before.
3. A few hours before the diagnosis, it is recommended not to smoke.
4. An hour before the manipulation, it is important to exclude physical and emotional overstrain. Immediately before the procedure, you must sit quietly for at least 15 minutes.
5. If a person took the day before medications, it is important to inform the laboratory assistant about this.
6. After some diagnostic procedures, for example, after rectal examination, it is desirable to donate blood after a certain time.

Normal values ​​for men and women

In adults, the rate within the normal range is almost the same.

Norm RDW for the weaker sex

The norm for women is from 11 and a half to 14 and a half percent. The value may change during pregnancy.

The norm for the stronger sex

The RDW for men should be no lower than 11.5 percent and no higher than 15 percent.

Norm during pregnancy

During the period of bearing a child, the parameter in question must be constantly monitored.

Typically, pregnant women experience low rates. This is due to a change in habit hormonal background.

Often deviations in pregnant women occur in a big way. This is especially dangerous because it can indicate anemia.

Normal value in children

In infants, the value is much higher than in adults. This is due to its adaptation to environment after childbirth.

Typically, a newborn has a normal percentage of 14.8 to 18.7. In the future, this figure begins to decline and becomes no higher than 14.8 and no lower than 11.6 percent. Approximately this level is already observed at the age of six months.

Reasons for downward deviations

Low values ​​of the percentage of erythrocyte size are considered in conjunction with an indicator such as , which determines the average volume of erythrocytes.

If RDW is lowered, and MCV, on the contrary, has high values, then this means that an oncological process is taking place in the bone marrow. Sometimes such a phenomenon may be evidence of metastases that have reached the organ.

If both parameters are low, then the causes may lie in the pathologies of the spleen or liver.

Decreased mean volume when RDW is normal may result from the following factors:

• thalassemia;
• blood transfusion;
• oncological diseases;
• hemorrhage;
• period after chemotherapy treatment.

Experts say that a low level is diagnosed in rare cases. Most often, this value can indicate the incorrectness of the study and medical error.

Other reasons for a low level of this blood parameter may be:

• postoperative period (when removing part of the organ);
• hormonal changes (puberty adolescents, menopause, childbearing period);
• lack of B vitamins;
• folic acid deficiency;
• blood loss;
• metabolic disorder.

Bleeding from the uterus or stomach is dangerous, since there is rapid blood loss, which is most often accompanied by a decrease in the indicator in question.

Sometimes the value is lowered if the person was a donor the day before. Downward deviations may indicate the use of some medications such as oral contraceptives.

Reduced RDW normalization

To treat such a pathology, it is important to establish it exact reason. If this oncological disease, then the therapy is prescribed by an oncologist, depending on the established diagnosis, the severity of the pathology and individual features patient.

Surgery, radiation or chemotherapy may be prescribed.

With a deficiency of certain substances in the body, special medications, vitamin-mineral complexes are prescribed. It is also necessary to adhere to proper nutrition, enriched with useful minerals and vitamins.

With changes in hormonal levels, donation and blood transfusion special treatment not required. Over time, the indicator normalizes on its own. However, it is important to comply correct mode and diets.

Why is a high rate diagnosed?

An increase in the indicator can be indicated by symptoms such as high temperature, which manifests itself systematically, loss of working capacity, drowsiness, increased sweating.

If the RDW is elevated, then this may indicate various pathologies occurring in the human body. These include:

• Alzheimer's disease;
• liver failure;
• oncological processes;
• vascular and heart disease.

Reasons for the increase may be alcohol addiction, as well as in deficiency of useful micro and macro elements, vitamins necessary for the body. Often high values ​​​​are found with a lack of iron, folic acid, vitamin B12.

Anemia of various origins is another factor that provokes an increase in the indicator. Values ​​may rise in microcytic, hemolytic, iron deficiency, and megaloblastic anemia.

How to lower the level of RAD

To learn how to normalize this indicator blood, the specialist should refer the patient for additional examinations.

After defining accurate diagnosis appropriate treatment is given.

In any case, therapy should be carried out with integrated approach, which consists in using certain medications, the use of physiotherapy procedures.

Sometimes, if necessary, surgery may be prescribed..

Thus, RDW is an important indicator that helps diagnose various pathological processes in the body. In addition, it allows you to determine the type of anemia.