Ghid De Interpretare A Unor Analize De Sange [607361]

Capitolul 13
GHIDDEINTERPRETARE
AUNORANALIZE
DESÂNGE
13.•.DETERMINARI HEMATOLOGICE
Analiza ValoriCresteScade
dinsângenormale
Leucocite4.500-1O-eXX)fmm3
Formulaleucocitra
Neutrofile3-5%Infectii, tumori,Infectiiviralesibac-
nesegmentateintoxicatii, teriene,parazitoze,
Neutrofile54-62%leucemiicolagenoze, into-
segmentatexicatii
Eozinofile1-3%Starialergice, para- Debutul bolilor
zitoze,b.Hodgkin,infectioase,
pneumopatii,intoxicatii,
duparadiatiipostcorticoterapie
Bazofile0-0,75%Carenta depro-
teine,uneleforme deleucemie side tumori,malarie Limfocite25-33%TBCladebut,scar- Infectiigrave,
latina,tuseconvul-bo~laHodgkin,
siva,leucemiedupacortico-
limfatica cronicaterapie

288 Ebinesastii!
Analiza ValoriCresteScade
dinsângenormale
Monocite3-7% Mononucleoza
infectioasa, endo cardita,bmcelm:n.leucemii, paludi~1I1Eritrocite4,6-6,2 mil/mm3PoliglobuliiAnemii
Barbati4,2-5,2millmm3
Femei4,5-5,lmillmm3
Copii Reticulocite0,2-2%Anemiihemolitice,Anemiiapla~ljCl'
posthemoragice, fazaderegenerareauneianemii Trombocite150-350mii!mm3Coagulare intraV/lN
cuiaradisemilllllll,ec.I.D.)purplll'litrombocitopclllrll Fibrinogen250-450 mg%Reumatism arti- Insuficienti.l hepll
cularacut,ticagrava,lellcellIII,
pneumonllcancerdeprostII/il,
depancreasVSHInfectii, disglobu- Hepatita epidl'1I1i
Barbati3-10mrn/loralinemii,cancerevo- ca,policitemic,
5-18mrn/2oreIutiv,TBC,infarct, starialergicc,
Femei6-12mrn/lorasepticemie, leptospi- talasemie,
6-20mrn/2oreroza,lupus,sarcina, insuficienl.i1
menstruatiecardiaca
HematocritHemoconcentratii Hemodilulii,-
Barbati42-52% anumite fOrnll\lil'
Femei37-48% anemll
Nou-nascuti49-54%
Copii35-49%
HemoglobinaAnemii
Barbati13-18g/dl
Femei12-16g/dl
Nou-nascuti16,5-19,5 g/dl
Copii11,2-16,5 g/dl

Ghiddeinterpretare 289
Analiza ValoriCresteScade
dinsângenormale
Timpde5-15min.Hemofilie,
coagularehipofibrinogenemie,
C.I.D. Timpde12-14sec.Medicatie antico- Aport,absorbtie
protrombinaagulanta, deficiente sauutilizare cres-
desintezasaudecutadevitamina
functionare afacto-K,ictermecanic,
rilorcoagulariiafectare hepatica
TimpHowell50sec.-1min. 20 Hemofilie, hipofibri-
sec.nogenemie, C.I.D.,
tratamentul cu anticoagulante Fier50-150f.lg/dlAnemiiposthemo-Anemia Biermer,
ragice,feriprive,avi-anemiisiictere
taminoze, tumorihemolitice,
maligne, tulburarihepatite,
deabsorbtiehemosideroza
13.2.DETERMINARI BIOCHIMICE DINSÂNGE
Analiza ValoriCresteScade
dinsângenormale
Alanin5-35D/IHepatite virale,
aminotransferazainfarctmiocardic,
(ALAT)SGPTciroze,infarcte
pulmonare sirenale, necroze musculare,litiazadecoledoc, carcinom depancreas Aspartat7-40D/IInfarctmiocardic,
aminotransferazahepatite virale,
(ASAT)SGOTciroze,infarctepul-
monaresirenale, necroze musculare, litiazadecoledoc, carcinom depan- creas

290 Ebinesastii!
Analiza ValoriCresteScade
dinsângenormale
Albumina3,5-5,5g/dl Hepatite acute~i
cronice,malnut:ritiu,boliinfectioase,sindrom nefrotic, gastro-enteropal il, alcoolism, cirozil Alfa-sub10VI/mlCancerhepatic,
fetoproteinatumoritesticulare
Amoniac11-35J..ImolJlAcidoza metaboli-Alcaloza respira-
ca,respiratorietorie,metabolicl\,
acidoza renala Amilaza serica25-125VIIPancreatita acuta, Comadiabeticli
oreIOn Acidlactic4,5-19,8 mg/dlGlicogenoze,Insuficienta renlllK
epilepsie, infarct, tumori,intoxicatiimedicamentoase Aciduric2,3-8;5mg/dlGuta,nemte,leucemii
Acizigrasitotali190-420 mg/dl Diabetzaharat,hiper-
tiroidie,feocromoci- Acizigrasi8-25mg/dltom,obezitate, glico-
neesterificatigenoze, alcoolism,
stres,sarcina Bicarbonat22-26mEq/1Alcaloze dinAcidoze dindilllwl
(HC03)varsaturi leintense zaharatdezechiIl
brat,insuficienlllll'nalauremica,dillll'l\ fistulepancrcaIirI' Bilirubina totala0,3-1,1mg/dl
directa0,1-0,4mg/dlIctermecanic prin
calculisautumori indirecta0,2-0,7mg/dlIcterprinhemoliza:
hepatite, ciroza Calciu4,5-5,5mEq/lHipervitaminoza D, Hipoparatiroidic, III
(9-11mg/dl)mielommultiplu, tu- hitismgrav,hi[loyl
morisauinfectiiosoasetaminoza D,tellllll(\

Ghiddeinterpretare291
Analiza ValoriCresteScade
dinsângenormale
Clor96-106mEq/1BolirenaleInsolatie, varsaturi,
diaree,insuficientasuprarenalianacronica Colesterol total150-200 mg/dlDiabet, obezitate, Ciroze,boliinfecti-
esterificat68-76% dintotalalcoolism, mixe- oasegrave,pneu-
dem,sindroamemonie,endocardita
nefrotice, icteremaligna,hipertiroidie
Colinesteraza2,25-7,0 UliINefroza, cancerde Formedeleucemie,
pancreas,hepatite subacute,
obezitate,diabetciroza,metastaze
hepatice, lipsa proteinelor din alimentatie Cupru70-155I1g/mlDegenerescenta
hepato-lenticulara(boalaWilson),infectiiacutesau cromce Creatinfosfo-30-170U/iInfarctmiocardic,
kinaza(CPK)distrofii sitrauma-
tismemusculare,polimiozite, derma- tomiozite, hemo- ragiicerebrale, into- xicatiicusomnifere Creatinina0,6-1,2mg/dlBolirenale,guta,
bolihepatice,miozite Fosfataza acida0,11-0,60 U/i Cancerul de
prostataFosfataza20-90U/IBoalaPaget,
alcalinahiperparatiroidism,
colestaza, rahitism, osteomalacie,tumoriosoase,tumorihepatice

292 Ebinesastii!
Analiza ValoriCresteScade
dinsângenormale
Fosfolipide6-12mg/dlCirozabiliara,icter
mecanic, sindrom nefrotic, diabetza- harat,hiperlipemie,hipercolesterolemie Fosforanorganic2,6-4,5mg/dlAcromegalie, gigan- Hiperparatiroidii,
tism,insuficientetulburari de
renale,hipervita-crestere
minozeD2, hipoparatiroidii Gama-1-60VIIHepatite acute,
Glutamil-hepatite toxice,
transpeptidazatratament cuanti-
(GGT)depresive, tumori,
cirozabiliara Glicemia70-115mg/dlDiferiteformede Insuficienta
diabet,infectii,cortico-suprare-
intoxicatii cuoxidnaliana,tiroidian~,
decarbon,tumori,hipofizara,
accidentehepatica grava,
vasculare cerebraledupadozemari
deantidiabeticc HDL30-80mg/dl Ateroscleroza,
infarctmiocardic Lactat100-190 VIIHepatita cronica,
dehidrogenazaciroza,pancreatita,
(LDH)infarctpulmonar,
uneleanemii,tumorimaligne Lipidetotale450-850 mg/dlSindrom nefrotic,
cirozahepatica,ictermecanic,diabet,pancreatitaacuta,mixedem,hipercorticism,arterita

Ghiddeinterpretare 293
AnalizaValoriCresteScade
dinsângenormale
LDL60-180mg/dlAterosc1eroza,
infarctmiocardic,inflamatii Magneziu1,5-2,5mEq/Hipertiroidie,Rahitism,
11,8-3,0 mg/dlinsuficientemixedem, nefroza,
renale,cirozetetanie
Potasiu3,5-5,0mEq/1Staridesoc,arsuri, Diaree,varsaturi,
hemoragii, infarct,boalaCushing,
bolimaligne,tumorisuprarenale,
hemolize, nefritatratament cu
cortizon Proteine totale6-8g/dlHemoconcentratii,Hemodilutii,
insuficienta dedenutritie, boli
aportlichidian,renale,ciroza,
diaree,varsaturi,staridesoc,hemo-
holera,diabetdez-ragii,intoxicatii
echilibrat, mielomcromce
Albumina3,5-5g/dl Nefroza lipoidica,
52-68%Clroze
Alfa10,2-0,4g/dlInfarctmiocardic
globulina2-5%
Alfa20,5-0,9g/dlNefroza lipoidica,
globulina7-14%reumatism articular
acut,TBC,hepa- titeinfectioase Beta0,6-1,1g/dlCiroze
globulina9-15%
Gama0,7-1,7g/dlColagenoze,
globulina11-21%hepatite, ciroze,
infectii, ictere Raportalbu-1,2-1,5mina/globulina Sodiu136-145 mEq/lDeshidratare, insu- Varsaturi, diaree,
ficienta cardiaca,insuficienta cor-
hiperfunctie cor-tico-suprarenala
tico-suprarenala

294 Ebinesastii!
Analiza ValoriCresteScade
dinsângenormale
Trigliceride40-150mg/dlSarcina, hiper-Infectiicronice,
lipemieesentiala,hipertiroidie,
ateroscleroza,uneleformede
hipotiroidie,cancer
sindrom nefrotic Uree21-43mg/dlBoIirenaleacute Afectiuni
saucromce,hepatice
diabet,febra
13.3.DETERMINARI HORMONALE DINSÂNGE
Analiza ValoriCresteScade
dinsângenormale
AldosteronSindrom Conn, BoalaAddisson,
ortostatism5-30ng/dlinsuficientaviriIism
cIinostatism3-10ng/dlcardiaca, ciroza,
tratament cu diuretice laxative CalcitoninaCancermedular,
femeie0-20pg/mlfeocromocitom,
barbat0-28pg/mltumoricarcinoide,
bronsice CatecolamineFeocromocitom,
adrenaIina0-140pg/mlneuroblastom
noradrenaIina70-1700 pg/ml
dopamina0-30pg/ml
Corticotrofina6-76pg/mlBoalaCushing,Tumoricorticosu-
(ACTH)tumoribronsice, prarenaIiene, insu
pancreatice, timice,ficientehipotala-
hipercorticism,mo-hipofizare,
strescorticoterapie
CortizolBoalaCushing, BoalaAddison,
ora86-23Jlg/dlbolihepatice, stres insuficienta
ora163-15Jlg/dl hipofizara
ora220-10Jlg/dl

Ghiddeinterpretare 295
Analiza ValoriCresteScade
dinsângenormale
FSH(HormonulMenopauza, Insuficienta hipo-
foliculostimulant)insuficienta talamo-hipofizara,
barbat4-25VI/lovariana primaraciclurianovula-
femeie4-30UI/l torii,administrare
postmenopauza40-250UliI deestrogeni
GH(Hormonul0-10nglmlAdenom hipofizar:Insuficienta hipo-
decrestere)acromegalie, gi- fizara:nanism
gantism Gonadotrofinesub15-20UliI Hiperfunctie hipo- Pubertate întâr-
fizara,tumorisile-ziata,infantilism
ziunialesistemu-hipofizar, ameno-
luinervoscentral,ree,anoreXle
insuficienta gonadi-mintala
ca,tumoriseminale 17-Hidroxicor-8-18!lg/dlHiperplazie corti- Insuficienta
ticosteroizicosuprarenaliana, corticosuprarenaiiana
sindrom Cushing,sihipofizara
tumorisupra-anterioara
renaliene 17-Hidroxipro-Sarcina, tumori Cicluri
gesteronluteale anovulatorii
barbat0,2-1,8!lg/l
femeie-folicular0,02-0,8 !lg/l
femeie-luteal0,9-3,04 !lg/l
postmenopauzasub0,45!lg/l
Insulina5-25!lU/mlInsulinomDiabetzaharat
dezechilibrat LH(HormonulMenopauza, insu- Insuficienta gona-
luteinizant)ficienta ovariana, dicahipotalamo-
barbat6-18UI/linsuficientahipofizara, ovar
premenopauza5-22VI/ltesticularapolichistic
mijloculcicluluide3oribazal
postmenopauzapeste30VI/l
Parathormonul10-60pg/mlAdenom paratiro-Tetanie
idian,carcinom pul-monar,nefropatii

296 Ebinesastii!
Analiza ValoriCresteScade
dinsângenormale
ProlactinaAdenom hipofizar, Dupaadministrare
femeie1-25ng/mlamenoree,debromergocrip-
barbat1-20ng/mlgalactoree, unele tina,hormoni
anticonceptionaletiroidieni, B6
TestosteronCancertesticular, Cancerprostatic,
barbat275-875 ng/dlvirilism, pubertate sindrom Turner
femeie23-75ng/dlprecoce
sarcina38-190ng/dl
TSH(Hormonul0-7mU/IInsuficientaHipertiroidism,
tireostimulant)tiroidiana primara, insuficienta
tiroidite, gusiprinhipotalamo-
defecteenzimaticehipofizara
Tiroxina libera1,0-2,1ng/dlHipertiroidism,Hipotiroidism,
Tiroxina T44,4-9,9J..lg/dlsupraalimentatiealcoolism,
Triiodotironina T3150-250 ng/dl intoxicatii
13.4.DETERMINARIIMUNOLOGICE DINSÂNGE
Antigenulsub5ng/ml
carcinoembrionarComplementInfectiiacute,boli Boliautoimune:
C383-177mg/dlneoplazice,lupuseritematos
C415-45mg/dlhepatita acutadiseminat, glomc-
rulonefrita, anemii~hemolitice,
hepatite cronice IgA60-333mg/dlCumaalcoolica, glo- Sindroame
merulonefrita, necro-nefrotice, aplazii
zehepatice, mielommedulare
IgG550-1.900 mg/dl Cirozahepatica,
pielonefrita, lupus, mielom,glomeru-lo-nefrita autoimuna IgM45-145mg/dlHepatita acuta,
cirozabiliara,pielonefrite, boliI parazitare, lupus

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