What is the normal level of neutrophils in human blood and what are deviations from the norm indicated? Neutrophils: normal, above normal, below normal The content of neutrophils in the blood of a healthy person is

07.11.2019 -

Neutrophils (NEUT) occupy a special position among all white blood cells; due to their numbers, they top the list of the entire leukocyte unit and individually.

Not a single inflammatory process can occur without neutrophils, because their granules are filled with bactericidal substances, their membranes carry receptors for class G immunoglobulins (IgG), which allows them to bind antibodies of a given specificity. Perhaps the main useful feature of neutrophils is their high ability for phagocytosis; neutrophils are the first to come to the inflammatory focus and immediately begin to eliminate the “accident” - one single neutrophil cell is capable of immediately absorbing 20-30 bacteria that threaten human health.

Young, young, sticks, segments...

In addition to the main function - phagocytosis, where neutrophils act as killers, these cells in the body have other tasks: they perform a cytotoxic function, participate in the coagulation process (promote the formation of fibrin), help form the immune response at all levels of immunity (have receptors for immunoglobulins E and G, to leukocyte antigens of classes A, B, C of the HLA system, to interleukin, histamine, components of the complement system).

How do they work?

As noted earlier, neutrophils have all the functional abilities of phagocytes:

Chemotaxis (positive - having left the blood vessel, neutrophils take a course “towards the enemy”, “decisively moving to the site of introduction of the foreign object; negative - the movement is directed in the opposite direction);

Adhesion (the ability to adhere to a foreign agent);

The ability to independently capture bacterial cells without the need for specific receptors;

The ability to act as killers (kill captured microbes);

Digest foreign cells (“having eaten,” the neutrophil noticeably increases in size).

Video: neutrophil fights bacteria

The granularity of neutrophils gives them the opportunity (as well as other granulocytes) to accumulate large number various proteolytic enzymes and bactericidal factors (lysozyme, cationic proteins, collagenase, myeloperoxidase, lactoferrin, etc.), which destroy the walls bacterial cell and “deal with” her. However, such activity can also affect the cells of the body in which the neutrophil lives, that is, its own cellular structures, she damages them. This suggests that neutrophils, infiltrating the inflammatory focus, simultaneously with the destruction of foreign factors, also damage the tissues of their own body with their enzymes.

Always and everywhere first

The reasons for the increase in neutrophils are not always associated with some pathology. Due to the fact that these representatives of leukocytes always strive to be the first, they will react to any changes in the body:

Hearty lunch;

Intensive work;

Positive and negative emotions, stress;

Premenstrual period;

Expecting a child (during pregnancy, in the second half);

The period of delivery.

Such situations, as a rule, go unnoticed, neutrophils are slightly elevated, and at such a moment we do not rush to get tested.

It’s another matter when a person feels that he is sick and leukocytes are needed as a diagnostic criterion. Neutrophils are elevated in the following pathological conditions:

Any (whatever there may be) inflammatory processes;

Malignant diseases (hematological, solid tumors, metastases in bone marrow);

Metabolic intoxication (eclampsia during pregnancy, diabetes mellitus);

Surgical interventions on the first day after surgery (as a reaction to injury), but high neutrophils the next day after surgical treatment– not a good sign (this indicates that an infection has occurred);

Transfusion.

It should be noted that in some diseases the absence of the expected leukocytosis (or even worse - low neutrophils) is considered an unfavorable “sign”, for example, normal level granulocytes in acute pneumonia does not give encouraging prospects.

In what cases does the number of neutrophils decrease?

The reasons are also quite varied, but you should keep in mind: we're talking about O reduced values caused by another pathology or exposure to certain therapeutic measures, or really low numbers, which may indicate serious illnesses blood (suppression of hematopoiesis). Causeless neutropenia always requires examination and then, perhaps, the reasons will be found. These could be:

Most often the reasons decreased neutrophils are fungal, viral (especially) and bacterial infections, and against the background low level neutrophil leukocytes feel good, all bacteria that populate skin and penetrating the mucous membranes of the upper respiratory tract, gastrointestinal tract- a vicious circle.

Sometimes the granular leukocytes themselves are the cause of immunological reactions. For example, in rare cases (during pregnancy), a woman’s body sees something “foreign” in the child’s granulocytes and, trying to get rid of it, begins to produce antibodies directed at these cells. This behavior of the mother's immune system can negatively affect the health of the newborn. Neutrophilic leukocytes in the child’s blood test will be reduced, and doctors will have to explain to the mother what isoimmune neonatal neutropenia.

Neutrophil abnormalities

To understand why neutrophils behave this way in certain situations, one should better study not only the characteristics inherent in healthy cells, but also become familiar with their pathological conditions when a cell is forced to experience unusual conditions for itself or is unable to function normally due to hereditary, genetically determined defects:

Acquired anomalies and congenital defects of neutrophils do not have the best effect on the functional abilities of the cells and on the health of the patient in whose blood defective leukocytes are found. Violation of chemotaxis (lazy leukocyte syndrome), enzyme activity in the neutrophil itself, lack of response from the cell to the given signal (receptor defect) - all these circumstances significantly reduce the body's defenses. The cells, which should be the first at the site of inflammation, themselves “get sick”, so they do not know what is waiting for them or cannot complete the tasks assigned to them, even if they arrive at the scene of the “accident” in this state. That's how important they are - neutrophils.

Neutrophils (granulocytes, neutrophilic leukocytes) are lymphocyte cells that defend the body at the cost of their own existence. By dying, they prevent the spread of infection. The presence of serious bacterial or fungal infections can be confirmed by a blood test that shows elevated neutrophils.

You can find out the number of these cells from the results of a general blood test. A separate column indicates the percentage of neutrophils in relation to total number lymphocytes. To find out the absolute (abs.) value, you will already need basic mathematics skills. It is necessary to multiply the number of lymphocytes by the percentage of neutrophils and divide the resulting figure by 100.

Example: lymphocytes – 6 x 10 9 cells per liter, neutrophils – 70%.
The absolute number of neutrophil cells = 4.2 x10 9 /l. (6 x 10 9 x 70 / 100 = 4.2 x 10 9).

Just as often, the number of cells is indicated in thousands per microliter - thousand/µl, which leaves the numerical component of the indicator unchanged in both cases.

Excess neutrophil count

For diagnostic purposes, it is interesting not only the total number of neutrophils, but also their species ratio; they are segmented and band, also with serious pathologies Metamyelocytes and myelocytes can enter the blood. It is necessary to pay attention to lymphocytes in their total number: they can be reduced, be within the normal range, or exceed it. Let us take a closer look at the reasons for the increase in the level of neutrophils that are constantly present in the blood. But first, let's define the differences different forms these blood cells.

Adult granulocyte cells have a nucleus that is divided into segments, hence the name - segmented.

In cells that have not completed maturation, the nucleus is not fully formed and has the appearance of a rod - they are called stab.

Increased total neutrophil count

If a blood test indicates an increase in the number of neutrophils, this may be a sign of the following pathologies:

Bacterial infection, which is accompanied by focal or generalized (generalized) inflammatory process. In the first case, this may indicate a respiratory tract or throat infection, a purulent-inflammatory process in the ear, tuberculosis, a kidney infection in acute phase, pneumonia, etc. In the second case - cholera, peritonitis, sepsis, scarlet fever;

Processes associated with the formation of necrotic areas. The reasons lie in gangrene, stroke, myocardial infarction, large-area burns;

The presence of toxins that directly affect bone marrow functions. The agent may be alcohol or lead;

The presence of toxins of bacterial origin, without the introduction of the bacterium itself. It can often be a consequence of eating canned foods (bacteria have lost their viability, but their waste products are still present);

Malignant tumors at the stage of tissue decay.

An increase in neutrophils may also indicate the introduction of a vaccine in the recent past, a period of recovery after an infectious disease.

Standard options

In some cases, neutrophil leukocytes can increase to a level of 7–8 billion in one liter of blood and become normal value. As a rule, such indicators are typical for pregnant women. It can occur after a heavy lunch, or be the result of psychological stress, shock or physical activity. The analysis is usually performed several times in order to establish the truth of its indicators.

Degrees of excess

The condition when neutrophils are elevated is called neutrophilosis or neutrophilia. There are several stages of the process. To classify them, absolute values of indicators are used, expressed in billions of cells in one liter of blood (for convenience, the value is used to the power of 10 9).

The higher the degree of neutrophilia, the more difficult the process in the body.

Increased segmented neutrophils

Segmented granulocytes make up about 70% of all neutrophils in the blood. An increase in their number, along with an increase in the total number of leukocytes, indicates the following pathologies:

Infections in the body (encephalitis, fungal diseases, spirochetosis);

Diseases of the lower extremities;

The presence of malignant tumors;

Pathologies in the functioning of the urinary system;

Inflammatory phenomena of a rheumatoid nature, with gout, pancreatitis, arthritis, disruption of tissue integrity;

Increased glucose levels in circulating blood.

Increased band neutrophils

Band neutrophils can be increased during the acute course of the infectious process. Their sharp release into the blood is provided immune system in response to an invasion by an alien agent. And there is also an increase in the level of neutrophils by initial stages diseases (provided that segmented neutrophils are within normal limits). This is due to the fact that over a period of 5 to 48 hours, they “grow up” and form a segmented nucleus from a “rod” - they turn into segmented ones.

Reasons high rate band neutrophils:

Inflammation of the ear, kidneys or lungs;

The period immediately after surgery;

Acute skin reaction in the form of allergies or dermatitis;

Violation of the integrity of the skin;

Injuries internal organs and bones;

Burns varying degrees heaviness;

Gout;

Rheumatoid phenomena;

Tumor of benign and malignant nature;

Anemia;

Decrease or increase in ambient temperature;

Pregnancy;

Diabetes mellitus;

Allergic type reaction to intake medicines;

Major blood loss;

Bacterial infection and purulent diseases.

Physical activity, nervous overstimulation, or increased level carbon dioxide can also cause an increase in neutrophils in the body. It is known that a blood test indicates band neutrophilia after consumption medicines type of heparin. The same effect is observed from corticosteroid drugs, adrenaline or herbal preparations based on foxglove. Neutrophils are also elevated as a result of poisoning with lead, mercury or insecticides.

Neutrophils are increased against the background of a decrease in the number of lymphocytes

Options were discussed above when the level of lymphocytes increases along with the number of granulocytes. Now let's figure out why lymphocytes can be reduced with an increase in the proportion of neutrophils. A blood test can give this result in the following conditions:

Kidney failure;

Chronic long course diseases of infectious nature;

Reaction to an x-ray examination;

Reaction to a course of chemotherapy or radiation treatment;

Malignant diseases in the terminal stage;

As a result of aplastic anemia;

Long-term use of cytostatics.

This condition is observed (lymphocytes are reduced and neutrophils are increased) in women with premenstrual syndrome, in an adult, regardless of gender nervous overstrain and long-term stressful situation. In such cases, as a rule, segmented granulocytes increase.

Norm of neutrophil lymphocytes

Blood test in at different ages shows the different number of such cells in the bloodstream in relation to the total number of lymphocytes. The table below shows upper limit normal indicators . Higher numerical values indicate that neutrophils are increased.

Age Rod-nuclear, % Segmental-nuclear, %
up to 1 year 4 45
1 – 6 5 60
7 – 12 5 65
13 – 15 6 65
16 and older 6 72
In children, the minimum level of band granulocytes is at the level of half a percent. In an adult, the lower limit of band granulocytes is normally never lower than 1%.

Segmented granulocytes in children under one year of age are reduced if they fall short in relative value to 15%, from one to six years - up to 25%, up to 15 years - up to 35%, in adults, in adults - up to 47%

We remind you that you should not independently plan a course of treatment based on blood tests and other studies, even after carefully studying the information on the Internet. Only a doctor can evaluate the results: not only a one-time decrease or increase in indicators matters, but also their dynamics (comparison with earlier results). It is also necessary to take into account the level of other blood cells and the results of other studies. Leave the hard work to the professionals.

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!
Neutrophils and their significance in tests: increase and decrease in the level of neutrophils in a general blood test, in smears, as well as in sputum analysis
Neutrophils are blood cells that are members of a group of leukocytes that help protect the human body from certain infections. The largest number of these blood cells circulates in the blood for just a few hours, after which they penetrate into organs and tissues and provide them with necessary protection from infections.
Neutrophils - what are they?
Neutrophils are also called neutrophilic granulocytes . They are one of the types of leukocytes, that is, white blood cells, which tend to take an integral part in maintaining immune defense body. It is these cells that help to the human body resist various viruses, bacteria and infections.
The process of maturation of neutrophil granulocytes occurs directly in the bone marrow, after which they immediately penetrate into the blood at a speed of approximately seven million per minute. They remain in the blood for no more than two days, after which they move to tissues and organs, protecting them from infectious pathologies.
The process of destruction of old neutrophils occurs in tissues. If we talk about the process of maturation of these cells, then it occurs in exactly six stages, which follow one after another: myeloblast, promyelocyte, myelocyte, metamyelocyte, stab And segmented cell . All forms of these cells other than the segmental cell are considered to be immature. If inflammation or infection develops in the human body, the rate of release of neutrophils from the bone marrow immediately increases. As a result, cells that are not fully matured enter the human blood. The number of such immature cells indicates the presence of a bacterial infection. In addition, they provide information regarding the activity of this infection in the patient’s body.
Most main function, assigned to neutrophils, is destruction of bacteria. In case of development of acute infectious pathology the number of these blood cells increases sharply. It should be noted that these cells can perform their function even in those tissues that receive a very small amount of oxygen. These may be tissues that are affected by both swelling and inflammation.

First, these cells are identified, after which they phagocytose bacteria, as well as tissue breakdown products. Having absorbed these components, they destroy them through their enzymes. Enzymes that are released during the breakdown of these cells also contribute to the softening of surrounding tissues. As a result, there is an abscess on the face. In fact, the pus in the area of the affected areas includes just neutrophils, as well as their remains.
The normal level of neutrophils in the blood
If a person is completely healthy, then in his blood there should be from one to six percent of band neutrophils, that is, immature forms of these cells, and from forty-seven to seventy-two percent of segmented neutrophils, that is, mature forms of these cells.
The number of these blood cells in a child’s blood is determined by his age:
On the first day, the baby’s blood contains from one to seventeen percent of band neutrophils and from forty-five to eighty percent of segmented neutrophils.
In children under twelve months of age: gender - four percent of band neutrophils and fifteen to forty-five percent of segmented neutrophils.
In children aged from one to twelve years, the number of band neutrophils is half - five percent, and segmented - twenty-five to sixty-two percent.
At the age of thirteen to fifteen years, the child’s blood contains six percent of band neutrophils and forty to sixty-five percent of segmented neutrophils.

During pregnancy, the normal number of these cells is the same as in adults.
Increased level of neutrophils in the blood
Excessive numbers of these blood cells may occur in any acute inflammatory process. This can be either sepsis, otitis media, bronchitis, pneumonia, appendicitis, and so on. Especially many neutrophils can be detected in the event of the development of any purulent pathology.
Especially strong on inflammatory and purulent processes Band neutrophils react in the body. As a result, there is an increase in the patient’s blood, called in medicine a shift of the leukocyte formula to the left. With the development of complex purulent-inflammatory diseases, in which there is also a strong
Neutrophils are blood cells related to leukocytes and make up the majority of them. They received their name due to the fact that with the Romanovsky cytological staining method they intensively absorb both the main dye and the acidic dye. They have a granular structure, therefore they belong to the group of granulocytes along with basophils and eosinophils. Neutrophils are fine granules in the form of dust, which is colored pinkish-purple.

Stages of maturation

Neutrophils are formed in the bone marrow and go through six stages of maturation:

myeloblasts;

promyelocytes;

myelocytes;

metamyelocytes, or young neutrophils;

stab;

segmental nuclear.

Only segmented cells are mature, in which the nucleus is divided into lobes. The remaining neutrophils are considered immature, or young. The nucleus of mature cells usually has three to five segments, which are connected by thin bridges. The cytoplasm contains many glycogen granules and small specific granules, a small number of azurophilic granules and very few organelles.

Norm

The norm of neutrophils in the blood does not depend on gender, but differs in an adult and a child. In blood tests they are designated NEU. During laboratory research count on absolute number and relative content. Normally, the blood should contain mainly mature species and a small number of band species.

The absolute content (abs) normally looks like this:

stab - from 0.04 to 0.3X10⁹/liter of blood;

segmental nuclear - from 2 to 5.5X10⁹/liter of blood.

The relative level (percentage of all white cells) is as follows:

stab - from 1 to 6%;

segmented - from 47 to 72%.

Reasons for deviations from the norm

If the number of mature neutrophils in the blood decreases and the number of band neutrophils increases, this indicates that an infection has entered the body. The fact is that segmented cells destroy foreign microorganisms and die, the bone marrow begins to produce more neutrophils, which do not have time to mature and enter the blood immature. This can be seen in the leukocyte formula, which is calculated during a blood test.

Neutrophils, from young to mature, appear in the leukogram from left to right. Thus, with an increase in the level of band cells in the leukocyte formula, a shift to the left is observed. The intensity of the pathological process is judged by the content of immature cells. The more immature forms, the more active the pathogenic agents. A shift to the left is observed during inflammatory and infectious processes, intoxication, malignant tumors.

If the number of segmented granulocytes in the blood increases, a nuclear shift to the right occurs. In this case, neutrophils with hypersegmented nuclei are found in the blood, that is, the nucleus consists of more than 5 lobes. A shift to the right is observed both in healthy people and may be a sign of some diseases, such as Addison-Birmer anemia, polycythemia, and radiation sickness. A shift to the right during inflammation and infection is a favorable sign.

If a blood test shows qualitative changes in neutrophils, such as hypersegmentation of nuclei or toxic granulation, we may be talking about an intense inflammatory process in the body. .

Functions of neutrophils

Neutrophils, like other leukocytes, are defenders of the body. They are mainly responsible for killing bacteria. Neutrophils have a well-developed movement apparatus, thanks to which they are able to quickly migrate to the site of inflammation or infection. The choice of direction of movement is explained by the fact that the damaged tissues begin to produce chemotactic and vasoactive factors, which ensure the influx of granulocytes to the site of the reaction. The functions of neutrophils are determined by their ability to move.

Neutrophil granulocytes actively move to the site of inflammation, releasing substances and enzymes that have a strong bactericidal effect. These white blood cells usually react to bacteria.

Their main purpose is phagocytosis, or intracellular digestion of harmful microorganisms. This process consists of several stages:

recognition of a harmful agent;

movement towards it;

adhesion of a foreign element to the phagocyte and gradual immersion;

absorption of an object by a phagocyte;

digestion by enzymes;

digestion.

Phagocytosis is complete when the object is completely dissolved and the remains are expelled from the cell. The process does not complete if harmful elements multiply and destroy the phagocyte.

Neutrophils are classified as microphages because they capture small particles. Segmented forms digest up to 30 microorganisms, rod forms - up to 15. Their phagocytic activity is enhanced by antibodies and vitamins. Acetylcholine, on the contrary, slows down.

The structure of neutrophils
Along with phagocytosis, neutrophils perform following functions:

digestion inside the cell;

cytotoxic effect;

degranulation during enzyme release;

participation in blood clotting;

participation in fibrinolysis;

influence on thermoregulation.

Cytotoxic activity involves damaging the target cell at a distance. This action is carried out with the participation of a factor produced by T-lymphocytes.

Conclusion

Neutrophils are the most numerous group of leukocytes. They are the first to respond to the penetration of pathogenic bacteria into the body. Protection from bacterial infections- their main task, although they can take part in other important processes: in the formation inflammatory reaction, providing cellular nonspecific and specific immunity. A blood test and calculation of the leukocyte formula makes it possible to suspect the development of the disease, assess the stage and degree of its severity. To do this, it is necessary to consider their relative level, abs. quantity, qualitative changes in cells.

The main function of these cells is to protect the body. Mature neutrophils are the first to fight foreign agents (bacteria and viruses). They have the ability to absorb and destroy pathogenic bacteria found in the bloodstream and tissues of the body. In this regard, the number of segmented cells in the blood decreases, but the number of immature neutrophils increases. This phenomenon in medicine is called “shift of the leukocyte formula to the left.”

With a decrease in the number of mature cells, the bone marrow begins to intensively produce new young forms of neutrophils.

In addition to protecting the body, they are involved in thermoregulation and blood clotting.

The norm of neutrophils in the blood in adults and children

Neutrophils make up the majority of all leukocytes. Their number ranges from 44 to 76%.

Normally, the blood should not contain young blood cells (myeloblasts, promyelocytes, metomyelocytes). During a laboratory blood test healthy person Band and segmented neutrophils can be detected. Their number varies depending on the age of the person. It is necessary to know their norms for accurate diagnosis and assessment of the condition of the human body.

Normal neutrophil counts:

U infant(up to 1 year) – from 29 to 51%;

For a child from 1 year to 7 years – from 34 to 56%;

For a child from 7 to 12 years old – from 41 to 61%.

The ratio of band and segmented granulocytes depending on age:

Newborn baby: rod - from 5 to 13%, segmented - from 49 to 70%;

Child 1 month: rod-nuclear - from 1 to 6%, segmented - from 16 to 30%;

One-year-old child: stab - indicators like one month old baby, segmented – from 45 to 66%;

Child 4 - 5 years old: stab - from 1 to 4%; segmented – from 36 to 55%;

Child from 6 to 12 years old: band-nuclear - indicators are the same as in children 4-5 years old, segmented - from 39 to 60%;

Children over 12 years of age and adults: rod-nuclear - from 1 to 5%, segmented - from 40 to 61%.

You can find out more about the norm of neutrophils in the blood.

All indicators must be assessed by specialists.

Causes of neutrophilia

Moderate neutrophilia – up to 10;

Severe neutrophilia – from 11 to 20;

Severe neutrophilia – from 21 to 60.

An increase in neutrophils may accompany various pathological processes occurring in the patient’s body:

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Besides pathological reasons neutrophilia, experts identify several physiological ones:

Pregnancy. If a woman does not have the diseases and conditions listed above, then an increase in the number of granulocytes of this type is a variant of the norm;

Eating a large meal shortly before blood collection;

Psycho-emotional overload;

You can find out about elevated neutrophils in children.

Causes of neutropenia

How to correct neutrophil levels

The deviation of neutrophil values from the norm must be corrected, otherwise the processes occurring in the body undergo changes. With a decrease in the number of blood cells, immunity is significantly reduced and a secondary infection occurs.

First of all, it is necessary to determine the reason for the deviation from the norm in neutrophil indicators. In most cases, after eliminating this cause, blood cell levels normalize.

If the number of neutrophils has changed due to the use of any medications, then it is necessary to change the medication. In extreme cases, it is necessary to completely discontinue this group of drugs. This issue can only be resolved by a specialist.

If the reason for the change in indicators is physical or mental stress, the doctor gives the patient general recommendations. It is necessary to normalize sleep and stop playing sports for a while. To avoid stress and its consequences, it is necessary to perform breathing exercises.

If there is a lack of nutrients (anemia, anorexia), correction of indicators is carried out using therapeutic diet and, if necessary, medications are prescribed.

If infection is present, appropriate treatment is prescribed. Upon completion of the course of therapy, the indicators, as a rule, normalize.

Neutrophil test and result

A laboratory test aimed at determining the number of neutrophils is a general or clinical blood test. In addition to these cells, the level of hemoglobin, red blood cells, platelets, lymphocytes, and all leukocytes is determined in the blood (signed leukocyte formula) and erythrocyte sedimentation rate (ESR).

Special preparation for this study not required. There are several tips that will help you get reliable results:

Blood sampling is usually carried out in the morning (except in emergency situations);

It is not recommended to eat before the procedure; the last meal should be 10–12 hours before blood sampling;

A few days before the study, it is necessary to stop playing sports and avoid stressful situations;

You cannot donate blood directly after physiotherapeutic procedures and x-ray examinations;

You need to give up in a couple of days alcoholic drinks and fatty foods, you should not smoke before taking blood;

Women are advised to postpone this type of laboratory test during menstruation, with the exception of serious illness or emergency situation.