ghid de interpretare a unor analize de sange
DESCRIPTION
Valori normale pentru analizele sanguine, cauzele care pot determina valori anormale.TRANSCRIPT
Capitolul 13
GHID DE INTERPRETAREA UNOR ANALIZE
DE SÂNGE
13.•. DETERMINARI HEMATOLOGICE
Analiza ValoriCresteScade
din sânge
normale
Leucocite
4.500-1O-eXX)fmm3Formulaleucocit
raNeutrofile
3-5%Infectii, tumori,Infectii virale si bac-nesegmentate
intoxicatii,teriene, parazitoze,Neutrofile
54-62%leucemiicolagenoze, into-segmentate
xicatiiEozinofile
1-3%Stari alergice, para-Debutul bolilor
zitoze, b. Hodgkin,infectioase,
pneumopatii,intoxicatii,
dupa radiatiipostcorticoterapie
Bazofile0-0,75%Carenta de pro-
teine, unele formede leucemie si detumori, mal arieLimfocite25-33%TBC la debut, scar-Infectii grave,
latina, tuse convul-bo~la Hodgkin,
siva, leucemiedupa cortico-
limfatica cronicaterapie
288 E bine sa stii!
Analiza ValoriCresteScadedin sânge
normaleMonocite
3-7% Mononucleoza
infectioasa, endocardita, bmcelm:n.leucemii, paludi~1I1Eritrocite4,6-6,2 mil/mm3PoliglobuliiAnemii
Barbati4,2- 5,2millmm3
Femei4,5-5,lmillmm3
Copii Reticulocite0,2-2%Anemii hemolitice,Anemii apla~l jCl'
posthemoragice, faza de regenerarea unei anemiiTrombocite150-350 mii!mm3 Coagulare intraV/lN
cui ara disemilllllll,ec.I.D.) purplll'litrombocitopclllrllFibrinogen250-450 mg%Reumatism arti-Insuficienti.l hepll
cular acut,tica grava, lellcellIII,
pneumonll
cancer de prostII/il,
de pancreasVSHInfectii, disglobu-Hepatita epidl'1I1i
Barbati3-10 mrn/l oralinemii, cancer evo-ca, policitemic,
5-18 mrn/2 oreIutiv, TBC, infarct,stari alergicc,
Femei6-12 mrn/l orasepticemie, leptospi-talasemie,
6- 20 mrn/2 oreroza, lupus, sarcina,insuficienl.i1
menstruatie
cardiacaHematocrit
HemoconcentratiiHemodilulii,-
Barbati
42-52% anumite fOrnll\ lil'Femei
37-48% anemllNou-nascuti
49-54%
Copii
35-49%
Hemoglobina
AnemiiBarbati
13-18 g/dlFemei
12-16 g/dlNou-nascuti
16,5-19,5 g/dlCopii
11,2-16,5 g/dl
Ghid de interpretare 289
Analiza ValoriCresteScade
din sânge
normale
Timp de
5-15 min.Hemofilie,
coagulare
hipofibrinogenemie,C.I.D.Timp de
12-14 sec.Medicatie antico-Aport, absorbtieprotrombina
agulanta, deficientesau utilizare cres-de sinteza sau de
cuta de vitamina
functionare a facto-K, icter mecanic,
rilor coagulariiafectare hepatica
Timp Howell
50 sec.-1min. 20Hemofilie, hipofibri-sec.
nogenemie, C.I.D.,tratamentul cuanticoagulanteFier
50-150 f.lg/dlAnemii posthemo-Anemia Biermer,ragice, feriprive,avi-
anemii si icteretaminoze, tumori
hemolitice,maligne, tulburari
hepatite,de absorbtie
hemosideroza
13.2. DETERMINARI BIOCHIMICE DIN SÂNGE
Analiza ValoriCresteScade
din sânge
normaleAlanin
5-35 D/IHepatite virale,aminotransferaza
infarct miocardic,(ALAT)SGPT
ciroze, infarctepulmonare si renale,necroze musculare,litiaza de coledoc,carcinom de pancreasAspartat
7-40 D/IInfarct miocardic,aminotransferaza
hepatite virale,(ASAT)SGOT
ciroze, infarcte pul-monare si renale,necroze musculare,litiaza de coledoc,carcinom de pan-creas
290 E bine sa stii!
Analiza ValoriCresteScadedin sânge
normaleAlbumina
3,5-5,5 g/dl Hepatite acute ~icronice, malnut:ritiu,boli infectioase,sindrom nefrotic,gastro-enteropal il,alcoolism, cirozilAlfa-
sub 10 VI/mlCancer hepatic,fetoproteina
tumori testiculareAmoniac
11-35 J..ImolJlAcidoza metaboli-Alcaloza respira-ca, respiratorie
torie, metabolicl\,acidoza renalaAmilaza serica
25-125 VIIPancreatita acuta,Coma diabeticlioreIOnAcid lactic
4,5-19,8 mg/dlGlicogenoze,Insuficienta renlllKepilepsie, infarct, tumori, intoxicatiimedicamentoaseAcid uric
2,3-8;5 mg/dlGuta, nemte, leucemii
Acizi grasi totali
190-420 mg/dlDiabet zaharat, hiper-tiroidie, feocromoci-Acizi grasi
8-25 mg/dltom, obezitate, glico-neesterificati
genoze, alcoolism,stres, sarcinaBicarbonat
22-26 mEq/1Alcaloze dinAcidoze din dilllwl
(HC03)
varsaturi le intensezaharat dezech iIlbrat, insuficienlllll'nala uremica, dillll'l\fistule pancrca IirI'Bilirubina totala
0,3-1,1 mg/dldirecta
0,1-0,4 mg/dlIcter mecanic princalculi sau tumoriindirecta
0,2-0,7 mg/dlIcter prin hemoliza:hepatite, cirozaCalciu
4,5-5,5 mEq/lHipervitaminoza D,Hipoparatiroidic, III
(9-11 mg/dl)
mielom multiplu, tu-hitism grav, hi[loylmori sauinfectiiosoase
taminoza D, tellllll(\
Ghid de interpretare 291
Analiza ValoriCresteScade
din sânge
normale
Clor96-106 mEq/1Boli renaleInsolatie, varsaturi,
diaree, insuficientasuprarenalianacronicaColesterol total150-200 mg/dlDiabet, obezi tate,Ciroze, boli infecti-
esterificat68-76% din totalalcoolism, mixe-oase grave, pneu-
dem, sindroamemonie, endocardita
nefrotice, icteremaligna, hipertiroidie
Colinesteraza2,25-7,0 UliINefroza, cancer deForme de leucemie,
pancreas,
hepatite sub acute,
obezi tate, diabetciroza, metastaze
hepatice, lipsaproteinelor dinalimentatieCupru70-155 I1g/mlDegenerescenta
hepato-lenticulara(boala Wilson),infectii acute saucromceCreatinfosfo-30-170 U/iInfarct miocardic,
kinaza (CPK)distrofii si trauma-
tisme musculare,polimiozite, derma-tomiozite, hemo-ragii cerebrale, into-xicatii cu somnifereCreatinina0,6-1,2 mg/dlBoli renale, guta,
boli hepatice,mioziteFosfataza acida0,11-0,60 U/iCancerul de
prostataFosfataza20-90 U/IBoala Paget,
alcalinahiperparatiroidism,
colestaza, rahitism,osteomalacie,tumori osoase,tumori hepatice
292 E bine sa stii!
Analiza ValoriCresteScadedin sânge
normale
Fosfolipide6-12 mg/dlCiroza biliara, icter
mecanic, sindromnefrotic, diabet za-harat, hiperlipemie,hipercolesterolemieFosfor anorganic2,6-4,5 mg/dlAcromegalie, gigan-Hiperparatiroidii,
tism, insuficiente
tulburari de
renale, hipervita-crestere
minoze D2, hipoparatiroidiiGama-1-60 VIIHepatite acute,
Glutamil-hepatite toxice,
transpeptidazatratament cu anti-
(GGT)depresive, tumori,
ciroza biliaraGlicemia70-115 mg/dlDiferite forme deInsuficienta
diabet, infectii,cortico-suprare-
intoxicatii cu oxidnaliana, tiroidian~,
de carbon, tumori,hipofizara,
accidentehepatica grava,
vasculare cerebraledupa doze mari
de antidiabeticcHDL30-80 mg/dl Ateroscleroza,
infarct miocardicLactat100-190 VIIHepatita cronica,
dehidrogenazaciroza, pancreatita,
(LDH)infarct pulmonar,
unele anemii,tumori maligneLipide totale450-850 mg/dlSindrom nefrotic,
ciroza hepatica,icter mecanic,diabet, pancreatitaacuta, mixedem,hipercorticism,arterita
Ghid de interpretare 293
Analiza ValoriCresteScadedin sânge
normaleLDL
60-180 mg/dlA terosc1 eroza,
infarct miocardic,inflamatiiMagneziu1,5-2,5 mEq/Hipertiroidie,Rahitism,
11,8-3,0 mg/dl
insuficientemixedem, nefroza,renale, ciroze
tetaniePotasiu
3,5-5,0 mEq/1Stari de soc, arsuri,Diaree, varsaturi,hemoragii, infarct,
boala Cushing,boli maligne,
tumori suprarenale,hemolize, nefrita
tratament cucortizonProteine tot ale
6-8 g/dlHemoconcentratii,Hemodilutii,insuficienta de
denutritie, boliaport lichidian,
renale, ciroza,diaree, varsaturi,
stari de soc, hemo-holera, diabet dez-
ragii, intoxicatiiechilibrat, mielom
cromceAlbumina
3,5-5 g/dl Nefroza lipoidica,52-68%
ClrozeAlfa 1
0,2-0,4 g/dlInfarct miocardic
globulina
2-5%Alfa 2
0,5-0,9 g/dlNefroza lipoidica,
globulina
7-14%reumatism articular
acut, TBC, hepa-tite infectioaseBeta0,6-1,1 g/dlCiroze
globulina
9-15%Gama
0,7-1,7 g/dlColagenoze,
globulina
11-21%hepatite, ciroze,infectii, ictereRaport albu-
1,2-1,5mina/globulina Sodiu
136-145 mEq/lDeshidratare, insu-Varsaturi, diaree,
ficienta cardiaca,
insuficienta cor-
hiperfunctie cor-
tico-suprarenala
tico-suprarenala
294 E bine sa stii!
Analiza ValoriCresteScade
din sânge
normale
Trigliceride
40-150 mg/dlSarcina, hiper-Infectii cronice,
lipemie esentiala,hipertiroidie,
ateroscleroza,
unele forme de
hipotiroidie,
cancersindrom nefroticUree
21-43 mg/dlBoIi renale acuteAfectiunisau cromce,
hepatice
diabet, febra
13.3. DETERMINARI HORMONALE DIN SÂNGE
Analiza ValoriCresteScadedin sânge
normale
AldosteronSindrom Conn,Boala Addisson,
ortostatism5-30 ng/dlinsuficientaviriIism
cIinostatism3-10 ng/dlcardiaca, ciroza,
tratament cudiuretice laxativeCalcitoninaCancer medular,
femeie0-20 pg/mlfeocromocitom,
barbat0-28 pg/mltumori carcinoide,
bronsiceCatecolamineFeocromocitom,
adrenaIina0-140 pg/mlneuroblastom
noradrenaIina70-1700 pg/ml
dopamina0-30 pg/ml
Corticotrofina6-76 pg/mlBoala Cushing,Tumori corticosu-
(ACTH)tumori bronsice,prarenaIiene, insu
pancreatice, timice,ficiente hipotala-
hipercorticism,
mo-hipofizare,stres
corticoterapie
CortizolBoala Cushing,Boala Addison,
ora 86-23 Jlg/dlboli hepatice, stresinsuficienta
ora 163-15 Jlg/dl hipofizara
ora 220-10 Jlg/dl
Ghid de interpretare 295
Analiza ValoriCresteScade
din sânge
normale
FSH (Hormonul
Menopauza,Insuficienta hipo-foliculostimulant)
insuficientatalamo-hipofizara,barbat
4-25 VI/lovariana primaracicluri anovula-femeie
4-30 UI/l torii, administrare
postmenopauza
40-250 UliI de estrogeniGH (Hormonul
0-10 nglmlAdenom hipofizar:Insuficienta hipo-de crestere)
acromegalie, gi-fizara: nanism
gantismGonadotrofinesub 15-20 UliIHiperfunctie hipo-Pubertate întâr-
fizara, tumori si le-
ziata, infantilismziuni ale sistemu-
hipofizar, ameno-lui nervos central,
ree, anoreXleinsuficienta gonadi-
mintala
ca, tumori seminale17-Hidroxicor-8-18 !lg/dlHiperplazie corti-Insuficienta
ticosteroizicosuprarenaliana,corticosuprarenaiiana
sindrom Cushing,si hipofizara
tumori supra-
anterioararenaliene17-Hidroxipro-
Sarcina, tumoriCicluri
gesteron
lutealeanovulatorii
barbat0,2-1,8 !lg/l
femeie-folicular0,02-0,8 !lg/l
femeie-luteal0,9-3,04 !lg/l
postmenopauza
sub 0,45 !lg/lInsulina
5-25 !lU/mlInsulinomDiabet zaharatdezechilibratLH (Hormonul
Menopauza, insu-Insuficienta gona-luteinizant)
ficienta ovariana,dica hipotalamo-barbat
6-18 UI/linsuficientahipofizara, ovarpremenopauza
5-22 VI/ltesticularapolichistic
mijlocul ciclului
de 3 ori bazal
postmenopauzapeste 30 VI/l
Parathormonul10-60 pg/mlAdenom paratiro-Tetanie
idian, carcinom pul- monar, nefropatii
296 E bine sa stii!
Analiza ValoriCresteScade
din sânge
normale
Prolactina
Adenom hipofizar,Dupa administrarefemeie
1-25 ng/mlamenoree,de bromergocrip-
barbat1-20 ng/mlgalactoree, uneletina, hormoni
anticonceptionaletiroidieni, B6
Testosteron
Cancer testicular,Cancer prostatic,barbat
275-875 ng/dlvirilism, pubertatesindrom Turner
femeie23-75 ng/dlprecoce
sarcina38-190 ng/dl
TSH (Hormonul
0-7 mU/IInsuficientaHipertiroidism,tireostimulant)
tiroidiana primara,insuficientatiroidite, gusi prin
hipotalamo-defecte enzimatice
hipofizaraTiroxina libera
1,0-2,1 ng/dlHipertiroidism,Hipotiroidism,
Tiroxina T4
4,4-9,9 J..lg/dlsupraalimentatiealcoolism,
Triiodotironina T3
150-250 ng/dl intoxicatii
13.4. DETERMINARIIMUNOLOGICE DIN SÂNGE
Antigenul sub 5 ng/mlcarcinoembrionar Complement
Infectii acute, boliBoli autoimune:
C383-177 mg/dl neoplazice,lupus eritematos
C4
15-45 mg/dl hepatita acutadiseminat, glomc-rulonefrita, anemii
~
hemolitice,
hepatite croniceIgA60-333 mg/dlCuma alcoolica,glo-Sindroame
merulonefrita,necro-nefrotice, aplazii
ze hepatice, mielom
medul areIgG
550-1.900 mg/dlCiroza hepatica,pielonefrita, lupus,mielom, glomeru-lo-nefrita autoimunaIgM
45-145 mg/dlHepatita acuta,ciroza biliara,pielonefrite, boli
Iparazitare, lupus
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