Framtagning av normalt referensintervall för RDW och retikulocyter på hematologiinstrumentet ADVIA 2120

Erythropoiesis is a complex and carefully controlled process which is mainly regulated by erythropoietin. Using flow cytometry cells in a blood sample can be analyzed one by one. ADVIA 2120 using flow cytometry for analysis of red blood cells (RBC) and reticulocytes. Red blood cell distribution width (RDW) is a component of the RBC method. RDW indicates size variation on erythrocytes and is measured as a percentage of the mean cell volume (MCV). By measuring the RDW anemia can be divided into makrocytic, microcytic or normocytic. Reticulocytes refract light more strongly than red blood cells because they contain some cellular debris. The number of reticulocytes in the peripheral blood reflects erythropoiesis in the bone marrow. The purpose of this project was that by approved methods to establish reference ranges for the parameters, RDW and reticulocyte counts. The individuals who participated in the study, n=124, were considered healthy and had varying ethnicity. Reference subjects had not donated blood the last six months and participation in the study was voluntary. The statistic evaluation includes examination of distribution, and reference ranges for both men and women were established using the 2.5:t and 97.5:t percentiles. The calculated reference interval for RDW was between 12.0 – 14.3% and the calculated reference interval for reticulocytes was between 38.0 – 112.8 x109 cells/L. The results showed a significant difference between males and females for the parameter reticulocytes was seen. The difference indicates that different reference ranges should be established for men and women (p<0,0001). No significant difference between males and females were seen for RDW (p=0,74) indicating that the same reference ranges can be used for both men and women.