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7/14/2019 Cc xt nghim Bng chuyn ho ton din

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Cc xt nghim Bng chuyn ho ton din - Comprehensive Metabolic Panel

Tn khc : CMP; Chem 12; Chemistry Panel; Chemistry Screen; SMA 12; SMA 20;SMAC

Tn chnh : Comprehensive Metabolic Panel

Xt nghim lin quan :Basic Metabolic Panel

Bng chuyn ha ton din (CMP) l mt bng thng c ch nh gm 14 thnghim cung cp cho ngi cung cp dch v chm sc sc khe thng tin v cc tnhtrng hin ti ca thn, gan, in giiv axit base / cng nh mc glucose v proteintrong mu ca mt ngi . Kt qu bt thng, v c bit l s kt hp ca cc kt qubt thng, c th ch ra mt vn cn c gii quyt.

CMP bao gm cc xt nghim sau y:

* Glucose - ngun nng lng ca c th, mt ngun cung cp n nh phi c sn s dng, v phi c duy tr mt mc tng i n nh trong mu.* Canxi - Mt trong nhng khong cht quan trng nht trong c th, cn thit cho s

hot ng tt ca c bp, dy thn kinh v tim v l cn thit trong qu trnh ng mu vtrong s hnh thnh ca xng

Protein

* Albumin - mt loi protein nh sn xut trong gan, protein chnh trong huyt thanh* Protein ton phn o lng albumin v tt c cc protein khc trong huyt thanh

in gii

* Sodium cn cho qu trnh hot ng bnh thng ca c th, bao gm c chcnng thn kinh v c bp

* Kali cn cho chuyn ha t bo v chc nng c bp* CO2 (carbon dioxide, bicarbonate) - Gip duy tr s cn bng acid-base ca c th

(pH)* Chloride - Gip iu chnh lng cht lng trong c th v duy tr s cn bng acid-
http://labtestsonline.org/understanding/analytes/bmphttp://labtestsonline.org/understanding/analytes/bmp


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base

Th nghim thn

* BUN (Blood Urea Nitrogen) - X l cht thi, l sn phm c sn xut trong

gan lc ra khi mu do thn, nguyn nhn nh hng n thn c kh nng nh hngn lng ur trong mu.* Creatinine - X l cht thi, l sn phm c sn xut trong cc c bp, lc ra khi

mu do thn , nng trong mu l mt du hiu nh gi v thn ang lm vic nh thno.

Gan th nghim

* ALP (alkaline phosphatase) - Enzyme c tm thy trong gan v cc m khc,xng, tng nng ca ALP trong mu ph bin nht l bnh gan hoc ri lon xng.

* ALT (alanine amino transferase, cn gi l SGPT) - Enzyme tm thy ch yu trong

cc t bo ca gan v thn, mt th nghim hu ch cho vic pht hin tn thng gan* AST (aspartate amino transferase, cng c gi l SGOT) - Enzyme cbit c trong cc t bo tim v gan, cng l mt th nghim hu ch cho vic pht hintn thng gan

* Bilirubin - X l cht thi, l sn phm c sn xut bi gan khi n ph v v tich t cc t bo mu

CMP c s dng nh th no?

Panel chuyn ha ton din (CMP) c s dng nh mt cng c sng lc rng nhgi chc nng ni tng v kim tra cc nguyn nhn nh bnh tiu ng, bnh gan, v

bnh thn. CMP cng c th c ch nh gim st nguyn nhn c bit n, nhcao huyt p, v theo di nhng ngi dng bt k loi thuc c th no c tc dngph c lin quan n thn hoc gan. Nu bc s quan tm n hai hoc nhiu thnh phnCMP ca mt ai , bc s c th ch nh CMP ton b bi v n cung cp thm thngtin.

Khi no c ch nh?

CMP l thng c ch nh nh l mt phn ca xt nghim mu cho mt ngi khih kim tra sc kho hng nm . Trong khi cc xt nghim ring r nhy cm, n thngkhng ni vi bc s bit c th nhng g l sai. Kt qu mt xt nghim hoc cc nhm

ca cc kt qu th nghim bt thng, thng c theo di vi cc xt nghim chiu khc xc nhn hoc loi tr chn on nghi ng.

Kt qu xt nghim c ngha l g?

Kt qu ca cc xt nghim l mt phn ca CMP thng c nh gi vi nhau tmkim cc m hnh kt qu. Kt qu ca mt xt nghim bt thng c th c ngha l cnguyn nhn hoc bnh lkhc hn nu c nhiu kt qu xt nghim bt thng. V d,


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kt qu mt xt nghim men gan cao c ngha bnh l khc hn so vi ktqu nhiu xt nghim men gan cao.

Thnh thong,c bit l trong cc bnh nhn nhp vin, mt s b CMPs, thng cthc hin vo nhng ngy khc nhau, kt qu c nh gi hiu r hn cc nguyn

nhn c bn v p ng iu tr.Kt qu ca cc xt nghim ca CMP ngoi gii hn bnh thng c th l do mt lotcc nguyn nhn khc nhau, bao gm, v d, cc bin chng suy thn, kh th, v c linquan n bnh tiu ng. Thng thng, nu bt k kt qu no vt ngoi gii hn,mt hoc nhiu th nghim c thc hin theo di gip xc nh nguyn nhn v /hoc gip thit lp mt chn on.

Xem thng tin chi tit hn trn cc bi vit v mi xt nghim ring r. :

Glucose

CalciumProtein

AlbuminProtein ton phn

in gii

SodiumKaliCO2 (carbon dioxide, bicarbonate)Chloride

Thn th nghim

BUN (Blood Urea Nitrogen)Creatinine

Gan th nghim

ALP (alkaline phosphatase)ALT (alanine amino transferase)AST (aspartate amino transferase)Bilirubin

iu g khc cn bit?

Mt lot cc thuc theo toa v khng k toa c th nh hng n kt qu ca cc thnhphn ca CMP. Hy ni vi bc s hay nh cung cp dch v chm sc sc khe ca qu


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v v bt c loi thuc bn ang dng. Tng t nh vy, iu quan trng l cungcp mt tin s y nh nhiu yu t khc cng c th nh hng n vic gii thchcc kt qu ca bn.

Cu hi thng gp

1.CMP khc vi BMP l g ? v ti sao mt bc s ch nh mt trong hai ?

CMP c thc hin gm 14 th nghim; Panel chuyn ha c bn (BMP) l mt tphp con ca CMP v gm 8 th nghim. BMP khng c cc th nghim v gan (ALP,ALT, AST, v bilirubin) v protein (albumin v protein ton phn). Mt bc s chm scsc khe thng ch nh mt CMP hn l mt BMP nu bc s mun c c mt bctranh y hn v tnh trng chc nng ni tng ca mt ngi hoc kim tra ccnguyn nhn c th, chng hn nh bnh tiu ng hoc gan hoc bnh thn.

2. Mt trong nhng kt qu t CMP ca ti l hi ra khi phm vi tham chiu. iu ny

c ngha l g?

Cc kt qu CMP ca bn c gii thch bi bc s trong bi cnh cc xt nghim khcm bn thc hin cng nh cc yu t khc, chng hn nh lch s sc kho ca bn.Mt kt qu duy nht l hi cao hay thp c th hoc c th khng c ngha bnh l.C nhiu l do ti sao mt kt qu xt nghim c th khc nhau vo nhng ngy khcnhau v l do ti sao n c th nm ngoi phm vi tham chiu.

* Bin i sinh hc (kt qu khc nhau trong cng mt ngi vo cc thi im khcnhau): Nu bc s ch nh cc th nghim cho bn vo nhng dp khc nhau, c mt chi tt cho mt trong nhng kt qu s nm ngoi phm vi tham chiu ngay c khi bn

ang trong tnh trng sc khe tt. i vi l do sinh hc, gi tr ca bn c th thayi t ngy ny sang ngy khc.* Thay i c nhn (s khc bit trong kt qu gia nhng ngi khc nhau): Cc ti

liu tham kho, phm vi thng c thit lp bng cch thu thp kt qu t mt cngng dn s ln v xc nh t cc d liu kt qu trung bnh d kin (trung bnh) v skhc bit d kin so vi trung bnh ( lch chun). C nhng c nhn khe mnh c ktqu kim tra l bnh thng i vi h, nhng khng phi lc no cng nm trong phmvi d kin ca ton b dn s.

Do , mt gi tr th nghim nm ngoi phm vi tham chiu thnh lp c cung cpbi phng th nghim c th c ngha l khng c g ng k. Ni chung, y l trng

hp khi gi tr th nghim ch hi cao hn hoc thp hn phm vi tham kho v y l ldo ti sao bc s c th lp li mt kim tra cho bn v l do ti sao bc s xem li kt qut ln th nghim trc, khi bn thc hin cc xt nghim tng t.

Tuy nhin, mt kt qu bn ngoi phm vi c th ch ra mt vn v phi c tip tciu tra. Bc s s nh gi kt qu th nghim ca bn trong bi cnh ca bnh s, khmlm sng, v cc yu t c lin quan khc xc nh liu mt kt qu nm ngoi phmvi tham chiu, c ngha l bn c mt vn g


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BS NGUYN VN THNH

Ging vin mn Ha sinh B mn xt nghim

KHOA D KT Y HC H Y DC TP HCM

( Ngun ti liu t internet )


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Xt nghim GGT

Tn khc : Gamma-glutamyl Transpeptidase; GGTP; Gamma GT; GTP

Tn chnh: Gamma-glutamyl Transferase

Xt nghim lin quan:AST;ALT;ALP; Bilirubin; Liver panel ; Ethanol

Xt nghim o lng mc gamma-glutamyl transferase (GGT) trong mu. GGT lmt loi enzyme c tm thy nhiu c quan, nh thn, l lch, gan v tuyn ty, tuynhin, gan l ngun gc chnh ca GGT trong mu.

GGT tng hu ht cc bnh gy ra tn thng gan cp tnh hoc ng dn mt,nhng n khng phn bit c gia cc nguyn nhn khc nhau gy ra tn thng gan.V l do ny, vic s dng ca GGT l gy tranh ci,Vin Hn lm Quc gia v Hiphi ha sinh lm sng M cng bo nghin cu bnh gan, v hng dn khuynbn khng nn s dng thng xuyn GGT. Nhng hng dn ny ngh s dngPhosphatase kim (ALP), l mt enzyme gan , ALP cao c th hu ch trong vic xcnh nguyn nhn bnh ca gan.

Mc GGT trong mu rt nhy cm vi nhng thay i ca chc nnggan. Bnh thng, GGT trong mu mc thp, nhng khi gan b tn thng, mc GGT c th tng ln. GGT l men gan tng cao trong mu khi c bt k cc ng dn mtt gan xung rut b tc nghn bi khi u hoc si. iu ny lm cho xt nghim GGTl enzyme gan nhy cm nht trong vic pht hin cc vn v ng mt. Tuy nhin, cc

th nghim GGT khng phi l xt nghim chuyn bit v khng phi l hu ch trongs phn bit gia cc nguyn nhn khc nhau ca tn thng gan bi v n c thc tngln vi nhiu loi bnh gan ( ung th gan v vim gan siu vi ), bnh khcnh bnh mch vnh tim cp tnh.

C hai GGT v ALP tng ln trong cc bnh gan, nhng ALP cng tng cao vi ccbnh ca m xng. V vy, GGT c th c s dng gip xc nh bnh gan hoc bnhxng khi c ALP tng.
http://labtestsonline.org/understanding/analytes/asthttp://labtestsonline.org/understanding/analytes/althttp://labtestsonline.org/understanding/analytes/althttp://labtestsonline.org/understanding/analytes/alphttp://labtestsonline.org/understanding/analytes/bilirubinhttp://labtestsonline.org/understanding/analytes/liver-panelhttp://labtestsonline.org/understanding/analytes/ethanolhttp://labtestsonline.org/understanding/analytes/asthttp://labtestsonline.org/understanding/analytes/althttp://labtestsonline.org/understanding/analytes/alphttp://labtestsonline.org/understanding/analytes/bilirubinhttp://labtestsonline.org/understanding/analytes/liver-panelhttp://labtestsonline.org/understanding/analytes/ethanol


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Khi ung mt lng ru nh cng c th lm tng GGT. Tng cao hn c tm thytrong nghin ru mn tnh, nng hn na nhng ngi tiu th 2-3 ly mi ngy hocnhng ngi ch ung rt nhiu vo nhng dp tic tng(ung say sa). Xt nghim GGTc th c s dng trong vic nh gi mt ngi lm dng ru cp tnh hoc mn

tnh.

Xt nghim c s dng nh th no?

Mc Gamma-glutamyl transferase (GGT) c th c s dng xc nh nguynnhn khi c Phosphatase kim cao (ALP). C hai ALP v GGT cng tng cao bnh cacc ng dn mt v trong mt s bnh gan, nhng ALP cng c tng ln trong bnhxng. Nu mc GGT bnh thng mt ngi c ALP cao, th nguyn nhn c khnng nht l bnh xng.

Th nghim GGT i khi c s dng gip pht hin nguyn nhn bnh ca gan v

ng mt do chn p. N thng c ch nh cng vi xt nghim khc nh ALT, AST,ALP, v bilirubin. Mc tng ca GGT c th cho thy l gan ang b bnh nhngkhng xc nh c th c nguyn nhn . Mc GGT cao c th c gy ra bibnh gan,cng c th c gy ra bi tiu th ru v cc iu kin khc, chng hn nhsuy tim sung huyt.

GGT c th c s dng bit tnh trng lm dng ru mn tnh ca mtngi ( GGT tng trong khong 75% ngi ung ru mn tnh). i khi n c th cs dng gim st vic s dng ru hoc lm dng ru nhng ngi ang ciu tr nghin ru, vim gan do ru.

Khi no c ch nh ?

Xt nghim GGT c th c ch nh khi mt ai c mt mc ALP cao. Thnghim ALP c th xt nghim mt mnh hoc nh mt phn ca mt bng cc xtnghim gan thng xuyn bit sthit hi gan ngay c khi khng c triu chng . Nukt qu ca th nghim ALP l cao nhng cc xt nghim khc ca bng xt nghimchc nng gan bnh thng, chng hn nh AST v ALT u khng tng, th th nghimGGT c th c ch nh gip xc nh cc nguyn nhn gy ALP cao do ri lonxng hoc bnh gan.

GGT c th c ch nh cng vi xt nghim khc theo di, kim tra chc nng

gan khi mt ngi c du hiu hoc triu chng gi bnh gan. Mt s du hiu v triuchng ca tn thng gan bao gm:* Sc khe yu, mt mi

* Mt cm gic ngon ming* Bun nn, nn* Bng sng hoc au* Vng da*Nc tiu m mu, phn c mu nht


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*Nga

GGT tng hu ht cc bnh gy ra thit hi cp tnh vi gan hoc ng dn mt,nhng thng l khng c ch trong vic phn bit gia cc nguyn nhn khc nhau gyra tn thng gan. V l do ny, Vin Hn lm Quc gia v Hip hi ha sinh lm sng

M khuyn bn khng nn s dng thng xuyn xt nghim GGT. N ch hu ch trongvic xc nh nguyn nhn ca ALP cao.

GGT c th c ch nh khi nhng ngi c tin s lm dng ru hon tt iu trru, gim st s tun th vi cc chng trnh iu tr.

Kt qu th nghim c ngha l g?

Mc GGT cao c th cho thy mt nguyn nhn no gy tn hi gan nhng khngc th nguyn nhn g. Hm lng cao c th l do bnh gan, nhng GGT cao cng cth l do cc bnh khc, chng hn nh suy tim sung huyt v tiu th ru. Mc

GGT cao s gip loi tr cc nguyn nhn ALP tng do chng ri lon xng.Nu GGT thp hoc bnh thng, nhng ALP tng, nhiu kh nng l do bnh xng.Mt kt qu thp hoc bnh thng cng khng loi b c ngi khng b bnh ganhoc khng ung ru.

iu g khc nn bit?

Nu bn ung mt lng nh ru, mc GGT ca bn c th gia tng tm thi trongvng 24 gi. Nu iu ny xy ra, bc s ca bn c th cho bn th nghim li.

Mc GGT c th c nng ln trong suy tim. Mt s nghin cu ch ra rngnhng ngi vi mc GGT tng, c nguy c cao t vong do bnh tim, nhng l dokhng c bit r.

Thuc c th lm tng mc GGT bao gm phenytoin, carbamazepine, v an thn nhphenobarbital. S dng nhiu loi thuc theo toa v thuc khng k n khc, bao gmcc thuc chng vim khng steroid (NSAIDs), thuc h lipid mu, khng sinh, thucchn th th histamin (c s dng iu tr chng d tha axit trong d dy), ccthuc khng nm, thuc chng trm cm, v kch thch t nh testosterone c th lmtng nng GGT. Clofibrate v thuc trnh thai c th lm gim nng GGT.

Ht thuc cng c th tng GGT.

Mc GGT tng ph n ln tui, nam gii c mc GGT lun lun cao hn n gii.

Cu hi ph bin

1. Mc GGT c th c tng ln khi ti khng c bt k triu chng no?

C, GGT rt nhy cm v c th c tng ln khi bn khng c triu chng.


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cao ny c th l tm thi, c l do bn ang dng cc loi thuc hoc bnung ru trong vng 24 gi trc khi th nghim. Nu men gan khc bnhthng, bc s ca bn ch c th ch i v sau lm li xtnghim GGT. Nu GGT l rt cao v ( hoc) cc men gan ca bn tng ln, bc s cabn c th ch nhlm nhiu th nghim khc tm kim nguyn nhn.

2. Ti l mt ngi nghin ru, nhng ti b ru. GGT ca ti bao gi tr li bnhthng?

Khi bn ngng ung ru theo thi gian mc GGT ca bn s gim dn n mt trngthi gn bnh thng. Sau khi bn ngng ung phi mt t nht mt thng mc GGT mi tr li bnh thng.King ru s lm gim nguy c tip tc lm tnhi gan ca bn v cho php cc chc nng gan ca bn ci thin tt hn.

BS NGUYN VN THNH

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