Normal value indicators for routine physical examination

The essence of what everyone often calls “normal values” for routine physical examinations is Covers the physiological index reference intervals for 95% of healthy people of the same age and gender. , there is no absolutely universal unified standard, nor does it mean that "exceeding it means you are sick." The specific value will be affected by the testing equipment, reagents, diet before testing, and the individual's basic conditions. It is only used as a reference for health screening and cannot be directly used as a basis for diagnosing a disease.

I have been doing health management consultation in a physical examination center for almost 6 years. The most common scene I have seen is that clients rush over as soon as they get the report, point to a certain indicator with an arrow and ask, "Is there something big wrong with me?" Last month, there was a young girl who had just graduated. The lymphocyte count in the blood routine was 0.1×10^9/L higher than the reference value. She became red-eyed on the spot and said that she had checked Baidu to be afraid that it was leukemia. After asking for a long time, she found out that she had just caught a viral cold three days ago and had a fever that had just subsided in two days. This high indicator is completely a normal sign that the immune system is still working. After a week of rest and a review, everything was normal.

Let’s talk about the blood pressure that everyone is most concerned about. There are indeed two parallel sets of reference values ​​for this indicator: the current domestic hypertension prevention and treatment guidelines still set 140/90mmHg as the critical value, while the American College of Cardiology (ACC) standard is lowered to 130/80mmHg. In fact, both sides are supported by clinical data. The domestic standards are more suitable for the epidemiological characteristics of the domestic population and will not cause overdiagnosis, while the American standards are more biased towards early intervention and reducing long-term cardiovascular risks. If you don’t have underlying diseases such as diabetes or coronary heart disease, as long as your blood pressure measured at home is stable within 135/85mmHg, you don’t need to be too anxious. Just stay up less late and drink less salty soup.

The most common arrows you see in blood tests are white blood cells, red blood cells, and platelets. The white blood cell reference value for healthy adults is generally (3.5-9.5) × 10^9/L. If it is higher, it is more likely to be bacterial infection. If it is lower, it may be viral infection or the recent immunity is too low.； The red blood cell count is generally 4.3-5.8×10^12/L for men and 3.8-5.1×10^12/L for women. If it is lower than this range, it is likely to be anemia. If it is only slightly lower for women, it is probably related to blood loss during the menstrual period. You can get better by eating more red meat and taking some iron supplements, so don’t panic.

Blood sugar and blood lipids in blood biochemistry are the most commonly asked questions. The reference range of fasting blood sugar is generally 3.9-6.1mmol/L. If it is between 6.1-7.0, the fasting blood sugar is impaired and it is pre-diabetes. Control your diet and move quickly. It will most likely be reversed. There is no need to rush to take medicine. Blood lipids are even more interesting. Many people are startled when they stare at the arrow of triglycerides. In fact, this indicator is greatly affected by the diet of the previous day. I saw an elder brother eating roasted whole lamb and drinking two kilograms of white wine with his friends the night before. The next day, the triglycerides soared to 8mmol/L, which is 5 times higher than the normal value. After going back to a light diet for two weeks and checking again, it returned to 1.5, which is completely normal. On the contrary, low-density lipoprotein, which is easily ignored by everyone, is the "bad cholesterol" in blood lipids. The reference value for healthy people is <3.4mmol/L. However, if you have a history of coronary heart disease, cerebral infarction or diabetes, it is safe to control it to 1.8 or even below 1.4. This needs to be customized by a doctor. Don't rely on the reference value for ordinary people.

There is also blood uric acid that everyone is concerned about recently. The conventional reference values ​​are <420 μmol/L for men and <360 μmol/L for women. There are indeed two voices in the academic circles: one group believes that as long as it exceeds the reference value, it is considered hyperuricemia, and intervention must be performed regardless of symptoms to avoid the risk of long-term gout and kidney damage.； The other group believes that if there is no history of gout attacks, no kidney stones, or abnormal kidney function, there is no need to rush to take medicine even if the level reaches 480 μmol/L. First, control the intake of seafood, beer, and high-fructose foods, drink more water and exercise more. Excessive medication will increase the burden on the liver and kidneys. Both views are supported by large-scale clinical data. The specific choice must be based on the individual's physical condition.

When I consult with clients, I never just focus on a single indicator. What is more important is the trend of your physical examination for several consecutive years. For example, if your blood pressure has been between 130-135/80-85 for three consecutive years, even if it is a little higher than the "ideal value" mentioned by others, it is still 110/70 than last year. It is safer to suddenly rise to 130/80 this year. The latter requires extra vigilance to see if there is something wrong with your recent living habits.

To put it bluntly, these so-called "normal values" are just a reference for ordinary people, not a black and white health verdict. If there are really abnormal indicators, first recall whether you stayed up late, drank alcohol, or exercised strenuously before the physical examination, and take the report to the doctor to make a comprehensive judgment based on your medical history and symptoms. It is much more useful than worrying about terminal illness entries found on Baidu.