4. Calculation of the color index.
The color index is the ratio between the amount of hemoglobin in the blood and the number of red blood cells is called. The color indicator allows you to determine the degree of saturation of red blood cells with hemoglobin.
1 μl of blood normally contains 166 * 10 -6 g of hemoglobin and 5.00 * 10 6 erythrocytes, therefore, the hemoglobin content in 1 erythrocyte is normally equal to:
The value of 33 pg, which is the norm of hemoglobin content in 1 erythrocyte, is taken as 1 (unit) and is designated as the Color Index.
In practice, the calculation of the Color Index (CPI) is performed by dividing the amount of hemoglobin (Hb) in 1 μl (in g / l) by a number consisting of the first 3 digits of the number of red blood cells, followed by multiplying the result by a factor of 3.
For example, Hb \u003d 167 g / l, The number of red blood cells is 4.8 10 12 (or 4.80 10 12). The first three digits of the red blood cell count are 480.
CPU \u003d 167 / 480 3 \u003d 1.04
Normally, the color index is in the range of 0.86-1.05 (Menshikov V.V., 1987); 0.82-1.05 (Vorobiev A.I., 1985); 0.86-1.1 (Kozlovskaya L.V., 1975).
In practical work, it is convenient to use conversion tables and nomograms to calculate the color index. According to the value of the color index, it is customary to divide anemia into hypochromic (below 0.8); normochromic (0.8-1.1) and hyperchromic (above 1.1).
clinical significance. Hypochromic anemia is more often iron deficiency anemia due to prolonged chronic blood loss. In this case, erythrocyte hypochromia is due to iron deficiency. Hypochromia of erythrocytes occurs with anemia of pregnant women, infections, tumors. With thalassemia and lead poisoning, hypochromic anemia is not caused by iron deficiency, but by a violation of hemoglobin synthesis.
The most common cause of hyperchromic anemia is a deficiency of vitamin B 12, folic acid.
Normochromic anemia is observed more often in hemolytic anemia, acute blood loss, aplastic anemia.
However, the color index depends not only on the saturation of erythrocytes with hemoglobin, but also on the size of the erythrocytes. Therefore, the morphological concepts of hypo-, normo- and hyperchromic coloration of erythrocytes do not always coincide with the data of the color index. Macrocytic anemia with normo- and hypochromic erythrocytes may have a color index higher than one, and vice versa, normochromic microcytic anemia always gives a color index lower.
Therefore, with various anemias, it is important to know, on the one hand, how the total hemoglobin content in erythrocytes has changed, and on the other hand, their volume and saturation with hemoglobin.
1 Transfer of excitation to the autonomic ganglion. Mediators of postsynaptic.
In vertebrates, there are three types of synaptic transmission in the autonomic nervous system: electrical, chemical, and mixed. An organ with typical electrical synapses is the ciliary ganglion of birds, which lies deep in the orbit at the base of the eyeball. The transfer of excitation here is carried out practically without delay in both directions. Transmission through mixed synapses, in which the structures of electrical and chemical synapses simultaneously adjoin, can also be classified as rare. This species is also characteristic of the ciliary ganglion of birds. The main method of transmission of excitation in the autonomic nervous system is chemical. It is carried out according to certain laws, among which two principles are distinguished. The first (Dale's principle) is that a neuron with all processes releases one mediator. As it has now become known, along with the main one, other transmitters and substances involved in their synthesis can also be present in this neuron. According to the second principle, the action of each mediator on a neuron or effector depends on the nature of the postsynaptic membrane receptor.
In the autonomic nervous system, there are more than ten types of nerve cells that produce various mediators as the main ones: acetylcholine, norepinephrine, serotonin and other biogenic amines, amino acids, ATP. Depending on which main mediator is released by the axon endings of autonomic neurons, these cells are usually called cholinergic, adrenergic, serotonergic, purinergic, etc. neurons.
Each of the mediators performs a transfer function, as a rule, in certain links of the arc of an autonomous reflex. So, acetylcholine is released in the endings of all preganglionic sympathetic and parasympathetic neurons, as well as most postganglionic parasympathetic endings. In addition, part of the postganglionic sympathetic fibers that innervate the sweat glands and, apparently, skeletal muscle vasodilators, also transmit via acetylcholine. In turn, norepinephrine is a mediator in postganglionic sympathetic endings (with the exception of the nerves of the sweat glands and sympathetic vasodilators) - the vessels of the heart, liver, and spleen.
The mediator released in the presynaptic terminals under the influence of incoming nerve impulses interacts with a specific receptor protein of the postsynaptic membrane and forms a complex compound with it. The protein with which acetylcholine interacts is called the cholinergic receptor, adrenaline or norepinephrine - the adrenoreceptor, etc. The place of localization of the receptors of various mediators is not only the postsynaptic membrane. The existence of special presynaptic receptors, which are involved in the feedback mechanism of regulation of the mediator process in the synapse, was also found.
In addition to cholino-, adreno-, purinoreceptors, in the peripheral part of the autonomic nervous system there are receptors for peptides, dopamine, prostaglandins. All types of receptors, initially found in the peripheral part of the autonomic nervous system, were then found in the pre- and postsynaptic membranes of the nuclear structures of the CNS.
A characteristic reaction of the autonomic nervous system is a sharp increase in its sensitivity to mediators after organ denervation. For example, after vagotomy, the organ has an increased sensitivity to acetylcholine, respectively, after sympathectomy - to norepinephrine. It is believed that this phenomenon is based on a sharp increase in the number of corresponding receptors on the postsynaptic membrane, as well as a decrease in the content or activity of enzymes that break down the mediator (acetylcholine esterase, monoamine oxidase, etc.).
In the autonomic nervous system, in addition to the usual effector neurons, there are also special cells that correspond to postganglionic structures and perform their function. The transfer of excitation to them is carried out in the usual chemical way, and they respond in an endocrine way. These cells are called transducers. Their axons do not form synaptic contacts with effector organs, but freely terminate around the vessels, with which they form the so-called hemal organs. The transducers include the following cells: 1) chromaffin cells of the adrenal medulla, which respond to the cholinergic transmitter of the preganglionic sympathetic ending with the release of adrenaline and norepinephrine; 2) juxta-glomerular cells of the kidney, which respond to the adrenergic transmitter of the postganglionic sympathetic fiber by releasing renin into the bloodstream; 3) neurons of the hypothalamic supraoptic and paraventricular nuclei that respond to synaptic inflow of various nature by releasing vasopressin and oxytocin; 4) neurons of the nuclei of the hypothalamus.
The action of the main classical mediators can be reproduced using pharmacological preparations. For example, nicotine produces an effect similar to that of acetylcholine when acting on the postsynaptic membrane of the postganglionic neuron, while choline esters and the fly agaric toxin muscarine act on the postsynaptic membrane of the effector cell of the visceral organ. Consequently, nicotine interferes with interneuronal transmission in the autonomic ganglion, muscarine - with neuro-effector transmission in the executive organ. On this basis, it is believed that there are respectively two types of cholinergic receptors: nicotinic (N-cholinergic receptors) and muscarinic (M-cholinergic receptors). Depending on the sensitivity to various catecholamines, adrenoreceptors are divided into α-adrenergic receptors and β-adrenergic receptors. Their existence has been established by means of pharmacological preparations that selectively act on a certain type of adrenoreceptors.
In a number of visceral organs that respond to catecholamines, there are both types of adrenoreceptors, but the results of their excitation are, as a rule, opposite. For example, in the blood vessels of skeletal muscles there are α- and β-adrenergic receptors. Excitation of α-adrenergic receptors leads to narrowing, and β-adrenergic receptors - to the expansion of arterioles. Both types of adrenergic receptors were also found in the intestinal wall, however, the reaction of the organ upon excitation of each of the types will be unambiguously characterized by inhibition of the activity of smooth muscle cells. There are no α-adrenergic receptors in the heart and bronchi, and the mediator interacts only with β-adrenergic receptors, which is accompanied by an increase in heart contractions and bronchial dilatation. Due to the fact that norepinephrine causes the greatest excitation of β-adrenergic receptors of the heart muscle and a weak reaction of the bronchi, trachea, and blood vessels, the former began to be called β1-adrenergic receptors, the latter - β2-adrenergic receptors.
When acting on the membrane of a smooth muscle cell, adrenaline and norepinephrine activate adenylate cyclase located in the cell membrane. In the presence of Mg2+ ions, this enzyme catalyses the formation of cAMP (cyclic 3 ", 5" -adenosine monophosphate) from ATP in the cell. The latter product, in turn, causes a number of physiological effects, activating energy metabolism, stimulating cardiac activity.
A feature of the adrenergic neuron is that it has extremely long thin axons that branch out in organs and form dense plexuses. The total length of such axon terminals can reach 30 cm. Along the course of the terminals there are numerous extensions - varicose veins, in which the neurotransmitter is synthesized, stored and released. With the advent of the impulse, norepinephrine is simultaneously released from numerous extensions, acting immediately on a large area of smooth muscle tissue. Thus, the depolarization of muscle cells is accompanied by a simultaneous contraction of the entire organ.
Various drugs that have an effect on the effector organ similar to the action of the postganglionic fiber (sympathetic, parasympathetic, etc.) are called mimetics (adrenergic, cholinomimetics). Along with this, there are also substances that selectively block the function of the postsynaptic membrane receptors. They are called ganglion blockers. For example, ammonium compounds selectively turn off H-cholinergic receptors, and atropine and scopolamine selectively turn off M-cholinergic receptors.
Classical mediators perform not only the function of transmitters of excitation, but also have a general biological effect. The cardiovascular system is most sensitive to acetylcholine, it also causes increased motility of the digestive tract, simultaneously activating the activity of the digestive glands, reduces the muscles of the bronchi and lowers bronchial secretion. Under the influence of norepinephrine, there is an increase in systolic and diastolic pressure without a change in heart rate, heart contractions increase, secretion of the stomach and intestines decreases, smooth muscles of the intestine relax, etc. Adrenaline is characterized by a more diverse range of actions. Through the simultaneous stimulation of ino-, chrono- and dromotropic functions, adrenaline increases cardiac output. Adrenaline has an expanding and antispasmodic effect on the muscles of the bronchi, inhibits the motility of the digestive tract, relaxes the walls of organs, but inhibits the activity of sphincters, the secretion of the glands of the digestive tract.
Serotonin (5-hydroxytryptamine) has been found in the tissues of all animal species. In the brain, it is contained mainly in structures related to the regulation of visceral functions; on the periphery, it is produced by enterochromaffin cells of the intestine. Serotonin is one of the main mediators of the metasympathetic part of the autonomic nervous system, which is mainly involved in neuroeffector transmission, and also performs a mediator function in the central formations. Three types of serotonergic receptors are known - D, M, T. D-type receptors are localized mainly in smooth muscles and are blocked by lysergic acid diethylamide. The interaction of serotonin with these receptors is accompanied by muscle contraction. M-type receptors are characteristic of most autonomic ganglia; blocked by morphine. By binding to these receptors, the transmitter causes a ganglion-stimulating effect. T-type receptors found in the cardiac and pulmonary reflexogenic zones are blocked by thiopendol. Acting on these receptors, serotonin is involved in the implementation of coronary and pulmonary chemoreflexes. Serotonin is able to have a direct effect on smooth muscles. In the vascular system, it manifests itself in the form of constrictor or dilator reactions. With direct action, the muscles of the bronchi are reduced, with reflex action, the respiratory rhythm and pulmonary ventilation change. The digestive system is especially sensitive to serotonin. It reacts to the introduction of serotonin with an initial spastic reaction, which turns into rhythmic contractions with increased tone and ends with inhibition of activity.
For many visceral organs, purinergic transmission is characteristic, so named due to the fact that during stimulation of presynaptic terminals, adenosine and inosine, purine decay products, are released. In this case, the mediator is ATP. Its location is the presynaptic terminals of the effector neurons of the metasympathetic part of the autonomic nervous system.
ATP released into the synaptic cleft interacts with two types of purine receptors in the postsynaptic membrane. Purinoreceptors of the first type are more sensitive to adenosine, the second - to ATP. The action of the mediator is directed mainly to smooth muscles and manifests itself in the form of its relaxation. In the mechanism of intestinal propulsion, purinergic neurons are the main antagonistic inhibitory system in relation to the excitatory cholinergic system. Purinergic neurons are involved in the implementation of downward inhibition, in the mechanism of receptive gastric relaxation, relaxation of the esophageal and anal sphincters. Intestinal contractions following purinergically induced relaxation provide the appropriate mechanism for the passage of the food bolus.
Histamine may be one of the mediators. It is widely distributed in various organs and tissues, especially in the digestive tract, lungs, and skin. Among the structures of the autonomic nervous system, the largest amount of histamine is found in postganglionic sympathetic fibers. Based on the responses, specific histamine (H-receptors) receptors were also found in some tissues: H1- and H2-receptors. The classical action of histamine is to increase capillary permeability and contraction of smooth muscle. In its free state, histamine lowers blood pressure, reduces heart rate, and stimulates sympathetic ganglia.
GABA has an inhibitory effect on the interneuronal transmission of excitation in the ganglia of the autonomic nervous system. As a mediator, it can take part in the occurrence of presynaptic inhibition.
Large concentrations of various peptides, especially substance P, in the tissues of the digestive tract, hypothalamus, dorsal roots of the spinal cord, as well as the effects of stimulation of the latter and other indicators, served as the basis for considering substance P as a mediator of sensitive nerve cells.
In addition to classical mediators and "candidates" for mediators, a large number of biologically active substances - local hormones - are also involved in the regulation of the activity of the executive organs. They regulate tone, have a corrective effect on the activity of the autonomic nervous system, they play a significant role in the coordination of neurohumoral transmission, in the mechanisms of release and action of mediators.
In the complex of active factors, a prominent place is occupied by prostaglandins, which are abundant in the fibers of the vagus nerve. From here they are released spontaneously or under the influence of stimulation. There are several classes of prostaglandins: E, G, A, B. Their main action is the excitation of smooth muscles, inhibition of gastric secretion, and relaxation of the muscles of the bronchi. They have a multidirectional effect on the cardiovascular system: class A and E prostaglandins cause vasodilation and hypotension, class G - vasoconstriction and hypertension.
Synapses of the ANS have, in general, the same structure as the central ones. However, there is a significant diversity of chemoreceptors in postsynaptic membranes. The transmission of nerve impulses from preganglionic fibers to the neurons of all autonomic ganglia is carried out by H-cholinergic synapses, i.e. synapses on the postsynaptic membrane of which nicotine-sensitive cholinergic receptors are located. Postganglionic cholinergic fibers form on the cells of the executive organs (glands, SMCs of the digestive organs, blood vessels, etc.) M-cholinergic synapses. Their postsynaptic membrane contains muscarinic-sensitive receptors (atropine blocker). And in those and other synapses, the transmission of excitation is carried out by acetylcholine. M-cholinergic synapses have a stimulating effect on the smooth muscles of the digestive canal, urinary system (except sphincters), and gastrointestinal glands. However, they reduce the excitability, conductivity and contractility of the heart muscle and cause relaxation of some vessels of the head and pelvis.
Postganglionic sympathetic fibers form 2 types of adrenergic synapses on effectors - a-adrenergic and b-adrenergic. The postsynaptic membrane of the first contains a1-and a2 - adrenoreceptors. When exposed to NA on a1-adrenergic receptors, narrowing of the arteries and arterioles of internal organs and skin, contraction of the muscles of the uterus, gastrointestinal sphincters, but at the same time relaxation of other smooth muscles of the digestive canal occurs. Postsynaptic b-adrenergic receptors are also divided into b1 - and b2 - types. b1-adrenergic receptors are located in the cells of the heart muscle. Under the action of NA on them, the excitability, conductivity and contractility of cardiomyocytes increase. Activation of b2-adrenergic receptors leads to vasodilation of the lungs, heart and skeletal muscles, relaxation of the smooth muscles of the bronchi, bladder, and inhibition of the motility of the digestive organs.
In addition, postganglionic fibers were found that form histaminergic, serotonergic, purinergic (ATP) synapses on the cells of internal organs.
The color indicator of blood is a clinical analysis, during which the degree of hemoglobin concentration in one cell is determined in a calculated and conditional manner. It is the number of RBCs (erythrocytes) that is taken into account, since these cells give the red color of the biological fluid, contain iron and hemoglobin, which is vital for humans.
The blood color index is calculated using a special formula if the analysis is carried out manually, or using a hematological analyzer by calculating a similar erythrocyte index.
If the color index of the blood is lowered or increased, this will indicate the development of certain pathological processes in the body of a child or an adult. Quite often it is iron deficiency anemia.
The determination of the color index of blood is carried out by conducting laboratory tests. Only a general blood test is used, but without an analytical system. Only a doctor can correctly decipher the tests, after which a decision will be made on further diagnostic and therapeutic measures.
The prognosis for a reduced or increased indicator will be purely individual in nature, since everything depends on the severity of the violation and the underlying factor.
Norms
The blood color index has the same standards for both children and adults. However, babies under three years of age are excluded, since their number of red blood cells will in any case be higher. The optimal next color indicator of blood:
- the color index of blood is the norm for men and women - 0.86–1.05 units;
- in newborns and up to five days - 0.9–1.3 units;
- from five days to 15 years - 0.85–1.0 units.
Such an index is relatively stable and does not differ dramatically in terms of age. It should be noted that the parameter may be slightly increased or decreased, which may be a symptomatic sign and not indicate the development of any pathological process.
Analysis and calculations
To determine whether the index is elevated or a low color index is present, a blood sample is taken for a general clinical examination. The procedure is very simple, but for the correct results, you should follow some rules:
- testing is carried out on an empty stomach;
- a day before blood sampling, alcohol, taking medications (if possible) should be excluded;
- if the patient is taking any drugs, the referral doctor or laboratory assistant must be notified.
Blood sampling is carried out by puncturing the thumb and taking the required amount of blood.
The following can influence the distortion of test results:
- violation of the technique of blood sampling;
- non-compliance with the rules of preparation on the part of the patient.
If during the study the indicator is critically lowered or too high, a second study may be prescribed to eliminate the error.
Calculating the color index is quite simple - you need to know the amount of hemoglobin and the total content of red blood cells. The formula for calculation is as follows: the mass of hemoglobin in terms of g / l must be multiplied by 3 and the resulting amount divided by the first three digits of the number of red blood cells in the blood.
For example: 125 g / l of hemoglobin and 4.10 million / μl of erythrocytes are determined. Therefore, 125*3/410=0.91. Knowing the parameters, you can calculate the color index of the blood yourself.
Decryption
Depending on the amount of CCT and hemoglobin in the blood test, the result may be as follows:
- hyperchromic - 1.05;
- normochromic - 0.85–1.05;
- hypochromic - less than 0.85 units.
You can set the type of anemia by color index and the presence of other pathological processes.
Causes of deviation from the norm
Deviation from the norm may have the following reasons:
- oncological processes or benign formations;
- pernicious anemia;
- Iron-deficiency anemia;
- lack of folic acid and other trace elements, vitamins and minerals in the body;
- acute or chronic blood loss;
- poisoning with toxic substances;
- anemia, which is common during pregnancy;
- diseases of the cardiovascular system;
- effect of penetrating radiation.
To establish the exact reasons for what led to the deviation from the norm of the indicator, only a doctor can by carrying out all the necessary diagnostic procedures.
It should be noted that the analysis in determining the diagnosis is never considered as a separate unit. Together with other laboratory and instrumental diagnostic measures, the test makes it possible to determine the type and severity of the pathological process.
As for the clinical picture, the nature of the course of the disease will depend entirely on the underlying factor. If you feel unwell, you need to consult a doctor, and not carry out self-diagnosis and start treatment based on a pseudo-diagnosis. Timely treatment to the doctor significantly increases the chances of a full recovery.
It is impossible to overestimate the importance of blood in our body. It transports oxygen to all organs, cells and tissues, taking carbon dioxide from them. That is why it is important to monitor all indicators in order to avoid any serious diseases. The color index of blood in an adult, child, (CP) displays the relative one that transports oxygen in one red blood cell.
In order to calculate this value, it is necessary to know the amount of hemoglobin and red blood cells in the blood. These color indicators in the blood are indicated during the delivery of a routine blood test, so it is not difficult to recognize them. A simple medical will allow you to find out, consider the color indicator of blood (CP), and also determine if there are any deviations from the norm and identify diseases in the early stages of development. Therefore, it is necessary, at least once a year, to take a general blood test and be examined by specialists.
Norm
The main symptom of the disease is a sharp decrease in the formation of bloody rings, which include an increase in the level of hemoglobin in the blood. The cause of the disease is a deficiency of vitamin B12, the formation of malignant tumors or autoimmune diseases.
Iron deficiency anemia mostly affects women, children and the elderly. Due to the lack of oxygen, organs and cells begin to "suffocate", as a result of which their functionality and vital activity are disturbed. In the mild stages of the disease, slight fatigue may occur.
With the complication of microcytic anemia, the following may appear:
- speeded up;
- Paleness of the palms;
- Increased breathing;
- conjunctivitis, etc.
Treatment
It is worth noting that changes in the color index in children can be associated not only with anemia, but also with renal failure. Therefore, after passing the analysis, you must immediately consult a doctor. In the early stages of the disease, the child can be cured quickly and painlessly with the use of one or two drugs that will raise the level of iron in the blood. In advanced and complicated cases, an immediate blood transfusion may be necessary.
Treatment of anemia in adults also depends on the form and degree of development of the disease. Sometimes it is enough to undergo only one medical course of treatment. Having passed the analysis in time, you can avoid serous complications. Therefore, if you have any suspicions related to health, you should immediately consult a doctor.
The use of medications that promote elevation can cause hemochromatosis. As a rule, this is a rare genetic disease, which is as dangerous as anemia. In most cases, this ailment manifests itself in men. This is primarily due to the fact that the male body uses much less iron than the female.
Strict adherence to the required amount of iron, protein, vitamins and minerals will help restore CPU levels quickly and easily. Physical activity will also help a lot. The main thing is not to overdo it!
The color indicator of blood, the designations of which can be easily determined by passing a general blood test, is of great importance in the prevention of the development of various diseases. It is necessary to undergo an examination by a doctor and pass all the tests, adhere to a healthy lifestyle.
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The calculation of the color index (or color, which is a synonym) is an old but important method for studying peripheral blood.
The color indicator carries information about the degree of saturation of red blood cells () with a pigment that contains and carries oxygen -. It is calculated by a formula if the total analysis is done manually or replaced by a similar erythrocyte index (MCH) that is calculated by an automatic analytical system (hematology analyzer).
Color or color indicator - norm and deviations
The color indicator is a characteristic that signals significant changes regarding the ratio of the main components of red blood (erythrocytes and hemoglobin).
The norm of the color index in both adults and children, excluding babies under 3 years old, according to various sources, ranges from 0.8 to 1.1, although some authors argue that 0.8 is already small, and 1.1 is already beyond the permissible limits. borders.
The norm of the CPU in a child under 3 years old is slightly lower and amounts to 0.75 - 0.96.
The color indicator is determined within the framework carried out without the participation of an analytical system. In the presence of an automatic hematological analyzer, the calculation of the CPU becomes impractical, it gradually becomes a thing of the past, being replaced by erythrocyte indices.
The most common situation is when the CPU is lowered (hypochromia), which gives reason to suspect the development(IDA, anemia accompanying neoplastic processes or chronic diseases of internal organs). It happens that a person does not feel the lowered values of the indicator, he is in no hurry to take a blood test, therefore he remains in the dark. However, often the patient complains of, drowsiness, decreased performance (symptoms of anemia) and for this reason consults a doctor or immediately to the laboratory. That's when one decimal fraction tells you what diagnosis will soon be made.
Calculation in two steps
The color index is calculated by the formula: CPU = hemoglobin x 3: number of red blood cells.
For example, with a red blood cell count of 4.2 x 10 12 / l and a hemoglobin level of 128 g / l, the color index will be 0.9 (128 x 3 and divided by 420), which corresponds to the norm (normochromia). Meanwhile, it should be noted that normochromia - does not always mean the norm. A proportionally reduced number of red blood cells and hemoglobin will also have a similar designation - normochromia, but in this case we will talk about normochromic anemia. In addition, there are other situations:
- There may be a lot of erythrocytes or their number is at the upper limit of the norm, for example, 4.7 x 10 12 / l with hemoglobin 120 g / l. When calculating the color index (120 x 3: 470 = 0.76), it is found that it does not fit into normal values, that is, erythrocytes circulate "empty", there are many of them, but they do not contain enough hemoglobin (hypochromia). This phenomenon indicates the development of anemia, the type and cause of which should be clarified by further hematological studies.
- The content of erythrocytes in the blood is normal (for example, for women 4.0 x 10 12 / l) or close to the lower limit of the norm, and hemoglobin is high (160 g / l), and after calculating the CPU it turns out that it exceeds 1.0 (160 x 3: 400 = 1.2). This means that the erythrocytes are excessively saturated with hemoglobin and in such a case they speak of hyperchromia - the blood of such people is thick and “heavy”.
Thus, a reduced or low color index, first of all, indicates the presence of anemia, and its high value indicates the cause of which is also to be found out.
Lower values suggest serious examination
The criterion for saturation of red blood cells with hemoglobin is the average content of blood pigment (Hb) in one erythrocyte, which is calculated by the formula: SGE = hemoglobin: per number of red blood cells in one liter of blood. The indicator is measured in picograms (pg) and normally ranges from 27 to 31 pg. An automatic analyzer measures the average hemoglobin content in an erythrocyte (MHC) in the same units, calculating it using the formula: MHC = ten times the hemoglobin level divided by the number of red blood cells in a microliter (10 6). By measuring the average content of hemoglobin in the erythrocyte, as in the case of cirrhosis, anemia is divided into hypochromic, normochromic and hyperchromic.
Of course, each of these indices separately cannot represent the only reliable indicator of pathology, therefore, in case of their decrease, one should look for the cause of the violations. Most often it is iron deficiency anemia, then it becomes necessary to find a problem with the absorption or synthesis of iron, and this is still a lot of all sorts of examinations, including not only blood tests, but also not always pleasant procedures, such as fibrogastroduodenoscopy (FGDS).
This is what a fractional number means that is not included in the normal values \u200b\u200bof the color index.
Video: Dr. Komarovsky about low hemoglobin
Color indicator - a parameter included in the general blood test. It serves as a starting point for the diagnosis of diseases of the red germ of hematopoiesis with serious consequences. Let's figure out what a color indicator is, to identify what pathology it is needed and how it is determined.
The red color of erythrocytes is due to hemoglobin, a protein compound (globin) with iron ions.
This complex performs the function of a carrier of dissolved gases: it delivers oxygen to the tissues and takes carbon dioxide out of them back into the blood.
The color indicator reflects the level of hemoglobin in the blood cell and the degree of its saturation with iron. The more the blood cell contains hemoglobin and carrier metal ions, the higher the color of the erythrocyte and the more efficient the delivery of oxygen to the tissues.
What else can you get from the indicator?
The digital value of the color index of blood indirectly allows you to judge the indices.
Calculated by analytical instruments:
- MCH (mean hemoglobin content in the blood), the normal value of which is 27-33.3 pg;
- The average concentration in the blood cell of the oxygen carrier (the norm is 30-38%).
Thus, a color parameter of 0.86 corresponds to the lower limit of the normal MCH and an average hemoglobin concentration of 30%.
Result of automatic analyzers
With automatic calculation, the color indicator can be replaced by the MCH index (mean corpuscular hemoglobin), from English the abbreviation translates as "the average hemoglobin content in one erythrocyte."
The MCH index is more informative: it displays the level of hemoglobin that has combined with oxygen and transferred to the tissues. 
The doctor matters both parameters:
- Calculated manually;
- determined by the device.
How to calculate?
The formula by which the parameter is calculated:
Hemoglobin level * 3 / first 3 digits of the red blood cell level, substituted into the formula without a comma.
If the analyzes contain two numbers separated by a comma, you need to remove the comma and add 0. The number 3 in the formula is unchanged. Calculation example for a hemoglobin level of 160 g/l and RBC=4.5 g/l:
160*3/450=1.06. The resulting figure corresponds to the color indicator (not measured in arbitrary units).
Norms
The color indicator in a healthy person is within the following values:
| Gender, age | Norm |
|---|---|
| Men | 0,86-1,05 |
| Women are not pregnant | 0,86-1,05 |
| pregnant | 0,85-1,0 |
| newborn babies | 0,9-1,3 |
| 1-3 years | 0,85-0,96 |
| 3-12 years old | 0,85-1,05 |
| Over 12 | 0,86-1,05 |
The condition in which the red blood cell contains the optimal amount of hemoglobin and iron and has a normal red color is called normochromia (normo + chromos - color). The deviation of the color parameter may be in the direction of hypo- (decrease, decrease) or hyperchromia (increase).
The result is evaluated as follows:
- Hypochromia (CP 0.85 or less);
- Normochromia (0.86-1.05);
- Hyperchromia (over 1.06).
The norm of the color indicator is the same for men and women of all ages. Pregnancy is the only non-disease condition in which the color index is low in the adult. The low rate is due to physiological anemia, characteristic of the 3rd trimester.
Interesting. A higher rate is typical for a child of the first year of life. It is explained by the presence in infants of fetal erythrocytes with a high concentration of hemoglobin. By adolescence, the rate becomes the same as in adults.
An altered (higher or lower than normal) color index goes hand in hand with low red blood cells and indicates anemia.
The relationship of the color index with the size of erythrocytes
Cells filled with hemoglobin are enlarged and are called megalocytes. Their diameter exceeds 8 microns. The higher the color index, the larger the size of the blood cell. The diameter of erythrocytes with a normal color value is in the range of 7-8 microns.
If, during maturation, an erythrocyte is not saturated with a sufficient amount of red pigment, its diameter remains reduced - 6.9 microns or less.
Such a cell is called a "microcyte", and anemia, for which a microcyte is characteristic, is called microcytic.
What does the low level mean?
On the violation of hemoglobin synthesis.
A low score indicates hypochromic microcytic anemia (with reduced hemoglobin and red blood cell count).
Anemia of blood cells This type of anemia includes:
- Iron deficiency;
- Chronic posthemorrhagic;
- Sideroachrestic;
- Hypoplastic.
All of them are the result of low hemoglobin, they are united by a violation of the inclusion of iron ions in the erythrocyte.
Iron-deficiency anemia
Iron deficiency is the most common cause of hypochromic anemia.
The disease occurs due to: 
- Insufficient consumption of animal products;
- Inflammatory process of the small intestine, leading to a decrease in the absorption of the microelement through the mucous membrane;
- Pregnancy, lactation, intensive growth in children.
Anemia in pregnant women not only worsens the condition of the woman, but also negatively affects the hematopoiesis of the fetus. She responds well to iron therapy, which is safe for the unborn child.
To make a diagnosis, you need to know the level of iron in the plasma and the total iron-binding capacity of the serum (TIBC).
Chronic posthemorrhagic anemia
The reason is constant bleeding, in which the loss of iron exceeds its intake with food.
Anemia develops in the following diseases:
- Erosive gastritis;
- peptic ulcer;
- hemorrhoids;
- Abundant prolonged menstruation, intermenstrual bleeding with hormonal failures.
Sideroachrestic
The disease is caused by a hereditary disorder of hemoglobin synthesis in the bone marrow. The body does not lack iron, it simply is not able to include it in hemoglobin.
hypoplastic
You can determine it with a puncture of the bone marrow. In the analysis of punctate, there are damaged stem cells that are not able to absorb a sufficient amount of hemoglobin.
What does increased value mean?
Lack of vitamin B12 or folic acid. As a result, red blood cells with large sizes and a high concentration of hemoglobin are formed. Blood cells with such parameters die ahead of time.
Hyperchromic anemia (with a high color index) is caused by the following reasons:
Important! Anemia does not always occur with a change in color parameter. In some conditions, there is normochromia (a reduced number of red blood cells, but a normal level of hemoglobin). It is characteristic of kidney disease, acute blood loss.
Whom should I contact to check the color indicator?
To the therapist. The reasons for going to the doctor are usually pale skin, drowsiness, lethargy.
What tests are needed?
General blood analysis. It will give a complete picture of the state of the hematopoietic system.
Prevention
Elevated hemoglobin
High hemoglobin is a sign: 
- Hypoxia (lack of oxygen);
- dehydration;
- chronic infection.
It indicates the work of the body in stress mode and is a harbinger of the depletion of health resources.
In addition to a general blood test, a biochemical one is also informative, which is also prescribed by a therapist.
He will indicate what is needed to prevent high hemoglobin:
- Rationalization of physical activity;
- Rejection of bad habits;
- Sanitation of foci of chronic infection;
- Healthy diet.
Products that lower hemoglobin: 
- Identify and treat diseases of the digestive organs (gastritis, enteritis), dysbacteriosis, hormonal disorders;
- Include in the diet foods high in iron, folic acid, vitamin B12;
- To refuse from bad habits;
- Take prophylactic courses of multivitamins.
Anemia of mild to moderate severity is treated by a general practitioner. It is undesirable to take any drugs without his consent.
The doctor will prescribe a course of an iron-containing drug for hypochromic anemia, cyanocobalamin or folic acid for hyperchromic anemia.
Nutrition for anemia includes:
- Pork, beef liver, kidneys;
- Nuts, dried fruits;
- Spinach;
- Buckwheat;
- Legumes.
With compensated chronic diseases and a rational lifestyle, the iron consumed by the body is completely replenished through food.
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