PLASMA SI ELEMENTELE FIGURATE

Plasma
Def.: Parte lichida a sngelui n care se scalda celulele sanguine (DMed 278).
Valori normale: apa: 46-47%
reiduu: 8-!% (su"stante #rganice si an#rganice).
Elemente figurate - Valori normale:
Eritrocite RB
$: 4.2%%.%%%-&.%%%.%%% '(( )
*: 4.&%%.%%%-&.&%%.%%% '(( )
+#pil la nastere: 4.&%%.%%%-6.%%%.%%% '(( )

Leucocite !B &.%%%-8.%%% '(( )
Granulocite
Neutrofile
,eg(entate 2.&%%-&.&%% '(( )
-eseg(entate &%-2&% '(( )
Eu"inofile .%%-2%% '(( )
Ba"ofile 2%-4% '(( )
Limfocite ..2%%-2.4%% '(( )
Monocite )%%-64% '(( )

Trom#ocite .&%.%%%-)%%.%%% '(( )
Elemente figurate - Variatii ale valorilor normale

Leucocite
resteri fi"iologice
normale
/ stari de stres
/ gra0idii
/ dupa e1#rt 1iic intens
/ e(#tii puternice
/ n trata(ent cu d#e
(ari de
c#rtic#ster#ii
/ n in2enctii cu
adrenalina
Sca$eri %atologice
/ 1e"ra ti1#ida si 1e"ra
parati1#ida
/ unele 0ir#e
: gripa3 ru2e#la3
ru"e#la3 hepatita
acuta
/ "#li ale #rganel#r
he(at#p#etice
/ septice(ii
/ "#ala de iradiatie
resteri %atologice
/ "#li in1ecti#ase
(icr#"iene (ai
putin n 1e"ra ti1#ida
si 1e"ra parati1#ida
/ dupa necr#a tisulara
/ in1arct
/ tu(#ri
/ dupa inter0entii
chirurgicale
/ dupa he(#ragii (ari
/ he(#lia
/ ure(ie crescuta
/ c#(a dia"etica
/ n ti(pul accesel#r de
guta
/ n leuce(ie (.&.%%%-
.&%.%%%)
Limfocite
Sca$eri %atologice
/ su" in1luenta h#r(#nil#r gluc#c#rtic#ii
/ sindr#( +ushing
/ ure(ia crescuta
/ #oala &o$g'ing
resteri %atologice
/ unele #oli cronice( TB3
si1ilis
/ unele in1ectii 0irale
/ unele in1ectii "acteriene (tuse
c#n0ulsi0a)
/ leuce(ie li(1atica
cr#nica
/ li(1#a(e (aligne
Neutrofile
Sca$eri %atologice
/ in1ectii "acteriene (1e"ra ti1#ida s4 1e"ra
parati1#ida)
/ in1ectii 0irale
/ in1ectii 1ungice sau paraitare
/ int#5icatii (edica(ent#ase
resteri %atologice
/ in1ectii generale si l#cale
/ tu(#ri (aligne
/ leuce(ie granul#citara
cr#nica
/ int#5icatii
Eo"inofile
Sca$eri %atologice
/ stari de stres
/ dupa un trata(ent cu c#rtic#ster#ii
/ n pri(a 1aa a in1ectiei acute
resteri %atologice
/ # crestere 6&% indica
parait#e
/ #oli alergice
/ leiuni (aligne ale tesutului
he(at#p#etic
/ leiuni der(at#l#gice
distructi0e.
Ba"ofile
resteri %atologice
/ #oli alergice
/ leiuni in1ecti#ase (ru2e#la3
ru"e#la3 sinuite cr#nice)
/ "#li (iel#pr#li1erati0e cr#nice
/ leuce(ie granul#citara
cr#nica
/ policitemie )era*
Monocite
resteri %atologice
/ #oli alergice
/ leiuni in1ecti#ase (ru2e#la3
ru"e#la3 sinuite cr#nice)
/ "#li (iel#pr#li1erati0e cr#nice
/ leuce(ie granul#citara
cr#nica
/ %olicitemie )era*
Trom#ocite
PLT
Sca$eri %atologice
/ genea de1icitara sau lia crescuta n
splina cu distrugeri e5agerate cu
1act#ri in1ecti#si
+ soc anafilactic
/ stari de de1i"rilare intra0asculara
/ di1erite leiuni (edulare
/ (etastae (edulare
+ anemie %ernicioasa ,emolitica
+ %ur%ura trombocitopenica -sca$eri
su# ./*/// trom#ocite '(( ) )
resteri %atologice
/ dupa he(#ragii acute
/ dupa splenect#c(ie
/ dupa inter0entii chirurgicale
/ cancere 0iscerale
/ hiperadrenalis(
/ atr#1ie splenica
E0AMENE &EMAT1L1GIE
&ematocrit &T
Def.: Mari(e a 0#lu(ului #cupat de gl#"ulele r#sii ntr-# pr#"a de snge n rap#rt cu
0#lu(ul pr#"ei3 e5pri(ata n pr#cente
Valori normale *: 42-48%
$: 4%-4)%

&emoglo#ina &GB
Valori normale
*: .)-.7 g'.%% (7
$: ..-.& g'.%% (7


VS& -VSE2
Def.: 8itea de sedi(entare a he(atiil#r (0itea de sedi(entare a eritr#citel#r) 9 8itea
cu care gl#"ulele r#sii se separa de plas(a sanguina si se depun la 1undul tu"ului
aseat n p#itie 0erticala
Valori normale la # #ra
*: .-.% ((
la d#ua
#re
7-.& ((
$: 2-.2 (( .2-2% ((
resteri %atologice
/ "#li in1ecti#ase
/ "#li in1la(at#rii (e5. tu"ercul#a acti0a3
reu(atis( p#liarticular acut)
/ septice(ii
/ leuc#e
/ (iel#(
/ #oala &o$g'in - neo%lasm al ganglionilor
limfatici
/ ne1r#e
/ "#li de c#lagen
Sca$eri %atologice
/ "#li alergice
/ hepatita epide(ica
resteri fi"iologice normale
/ (enstruatie
/ ulti(ele luni de sarcina
/ la c#pii.

Tim% $e s3ngerare -TS2 8al#ri n#r(ale: 2-4 (inute

Durata necesara pentru ca # inciie de di(ensiuni standardiate3 practicata n sc#p se(i-
diagn#stic3 sa ncetee sa (ai sngeree .

Tim% $e
coagulare
-T2
8al#ri n#r(ale:
2-4 (inute
+resteri
/ he(#1ilie
/ a1i"rin#genie.

Fi#rinogen
Def.: Pr#teina plas(atica sintetiata n 1icat si inter0enind n c#agulare

+resteri pat#l#gice
/ stari reu(atice
/ c#lagen#e (sin.: c#necti0ita)
/ in1ectii pul(#nare acute
/ cancere pul(#nare
/ dupa inter0entii chirurgicale
,caderi pat#l#gice
/ afectiuni ,e%atice gra)e -ficatul nu
sinteti"ea"a2
/ a1i"rin#genie c#ngenitala - "#ala 1#arte
rara.

Tim%ul &o4ell 8al#ri n#r(ale: .-2 (inute
+resteri pat#l#gice - :se(anat#r cu ti(pul de c#agulare (;+)

Tim%ul 5uic' -tim% $e %rotrom#ina2 8al#ri n#r(ale: 67-6. secun$e
Def.: ;i(p de c#agulare a plas(ei sanguine n preenta unui e5tract de tesut de #rigine
u(ana3 ani(ala sau sintetica3 tr#("#plastina

resteri %atologice
/ ,i%o- si afi#rinogenie
/ n preenta antic#agulantel#r
circulante
/ hip#pr#tr#("ine(ie
/ n preenta antitr#("inel#r.


PRINIPALII 1NSTITUIENTI AN1RGANII AI SANGELUI
ATI1NI
So$iu
8al#ri n#r(ale:
76/-78.
mg96//
mL
,caderi pat#l#gice
/ ap#rt salin insu1icient
+ $es,i$ratari glo#ale
/ ingestii scaute de
lichide
/ %oliurii -:n $ia#et
"a,arat2
/ insu1icienta renala
cronica
/ insu1icienta
c#rtic#suprarenala
+resteri pat#l#gice
/ pierderi de lichide la ni0el
e5trarenal
(e5.: transpiratii e5cesi0e3
$iaree; )oma2
/ pierderi de lichide la ni0el
renal
(e5*( $ia#et insi%i$;
insuficienta renala2
/ insu1icienta cardiaca
/ trau(atis(e cere"rale
/ ,i%eral$osteronism
alciu
8al#ri n#r(ale:
83&-.%3& (g'.%%
(7
,caderi pat#l#gice
/ tetanii
/ insu1icienta renala
/ rahitis(
/ #ste#(alacie
/ hip#0ita(in#a D
/ hip#paratir#idis(
+resteri pat#l#gice
/ hiper0ita(in#a D
/ hiperparatir#idis(
/ ne1r#patii cr#nice
/ (iel#( (ultiplu
Magne"iu
8al#ri n#r(ale:
23& (g'.%% (7.
+reste #data cu calciul
Fier
8al#ri n#r(ale:
(sidere(ie 9
c#ncentratia
$e in sg)

*( </-6=/
>g'.%% (7
$( ?/-67/ >g'.%%
(7
,caderi pat#l#gice
/ ane(ii 1eripri0e
/ he(#ragii
/ trata(ente cu 0ita(ina
*.2
/ stari infectioase
cronice
/ ne1r#patii cr#nice
+ %oliartrita
reumatoi$a
/ pr#cese neo%la"ice
+resteri pat#l#gice
/ hepatite (se degradeaa
he(#gl#"ina)
/ cnd capacitatea de a
prelua $e 2< n (adu0a
este depasita de
capacitatea de pr#ducere
prin degradarea
eritr#citel#r
/ he(#sider#a
/ he(#cr#(at#a
u%ru
Valori normale(
?/-67/ >g96//
mL
,caderi pat#l#gice
/ "#ala Men=es
/ sindr#( ne1r#tic
+resteri pat#l#gice
/ in1ectii acute sau cr#nice
/ in1arct (i#cardic
/ leuce(ii acute
/ ne#plas(e
/ "#ala >ils#n
@inc
8al#ri n#r(ale:
/;?-6;8 mg97
,caderi pat#l#gice
/ sarcina
/ "#li in1ecti#ase cr#nice
(;*+)
/ pierderi renale
/ in1la(atii
+resteri pat#l#gice
/ reu(atis( acut
/ stari de he(#lia
Potasiu
)3&-43& (?@'7

( 4%-4%% (?@'7
intracelular3
cit#plas(a
celulel#r3
(usculatura
striata3
(i#card3
he(atii)
,caderi pat#l#gice
/ pierderi digesti0e
(diaree3 0#(a)
/ disgra0idii
/ sten#a pil#rica
/ diaree
/ 1istule digesti0e
/ pierderi urinare
+resteri pat#l#gice
+ insuficienta
corticosu%rarenala
/ distrugeri celulare cu alterari
ale 1unctiei renale
+ insuficienta renala acuta
sau cronica
AIABET
Nic,el
8al#ri n#r(ale:
.32-436 Ag'7

,caderi pat#l#gice
/ cir#a hepatica
/ ure(ie crescuta

+resteri pat#l#gice
/ infarct miocar$ic
o#alt
8al#ri n#r(ale:
.32-)36 Ag'7

ANI1NI
lor
8al#ri n#r(ale:
)4&-)!& (g'.%%
(7
,caderi pat#l#gice
/ pierderi digesti0e
/ insuficienta renala
acuta sau cronica
/ ad(inistrari de
diuretice de tipul
1ur#se(idului
/ alcalo"e meta#olice
+resteri pat#l#gice
/ ap#rt salin crescut
/ deshidratari si hiperhidratari
hipert#ne
/ ne1r#patii intestinale
/ int#5icatie cu aceta#la(id
Fosfor
8al#ri n#r(ale:
:dulti: )-43&
(g'.%% (7
+#pii: 4-6 (g'.%%
(7
,caderi pat#l#gice
/ rahitis(
/ hip#0ita(in#a D
/ ,i%er%aratiroi$ism
-in)ers ca la a
BC 2
/ utiliare e5cesi0a de
antiacide cu :l(BC)
) sau Mg(BC) 2
+resteri pat#l#gice
+ insuficienta renala acuta
sau cronica
/ $ia#et "a,arat
/ hip#paratir#idis(
/ hiper0ita(in#a D
Sulf
8al#ri n#r(ale:
.2%-.7% (g'.%%
(7

Bicar#onat
8al#ri n#r(ale:
:dulti: 6% 0#lu(e +B 2 '.%% (7
+#pii: 46-6) 0#lu(e +B 2 '.%% (7


Io$
-ecesar:
.%%-2%% Ag'24 h
,caderi pat#l#gice
/ hip#tir#idis( (gusa
+resteri pat#l#gice
/ hipertir#idis( ("#ala
din care
#rganis(ul
retine d#ar
.% Ag
ende(ica) *ased#D)

PRINIPALII 1NSTITUIENTI 1RGANII AI SANGELUI
1MPUSII NEA@1TATI
Gluco"a
8al#ri
n#r(
ale:
D/-6B/
(g'.
%%
(7
,caderi pat#l#gice
/ hiperinsulinis(
/ hipertir#idis(
/ atr#1ia gal"ena a 1icatului
+resteri pat#l#gice
/ dia"et aharat
/ hipersecretie de adrenalina
+ tumori ,i%ofi"are sau
su%rarenale
7a .8% (g gluc#a '.%% (7 snge3
rinichiul nu (ai 1ace 1ata
rea"s#r"tiei si gluc#a trece n
urina 9 gluc#urie (sin#ni(:
(eliturie)
Aci$ lactic
8al#ri
n#r(
ale:
!-.&
(g'.
%%
(7

+resteri pat#l#gice
/ hepat#patii
+ insuficienta car$iaca
+ $u%a eforturi fi"ice mari*
Aci$
%iru)
ic
8al#ri
n#r(
ale:
%3!-.32
(g'.
%%
(7

+resteri pat#l#gice
/ de1icienta de 0ita(ina * .
/ alc##lis(
/ n cursul e5ercitiil#r 1iice
grele
Li%i$e
total
e
8al#ri
n#r(
ale:
=//-?//
(g'.
%%
(7
,caderi pat#l#gice
/ n#u-nascuti
/ hipertit#idie (arderile sunt
(ai inense)
+resteri pat#l#gice
+resteri pri(are ((#stenite3
1a(iliale)E
+resteri secundare
/ guta
/ dia"et
/ alc##lis(
/ ad(inistrare de
antic#ncepti#nale #rale
/ hip#tir#idie
olesterol
8al#ri
n#r(
ale:
6B/-B//
(g'.
%%
(7
,caderi pat#l#gice
/ sarcina
/ hipertit#idie (arderile sunt
(ai inense)
+resteri pat#l#gice
/ ater#scler#a
/ dia"et
/ guta
1MPUSI A@1TATI NEPR1TEII
+resteri pat#l#gice
Aci$ uric
8al#ri n#r(ale:
$: 236-6 (g'.%% (7
*: )3&-7
(g'.%% (7
,caderi pat#l#gice
+ afectiuni
,e%atice
me$icamente
+resteri pat#l#gice
/ guta
insuficienta renala cronica;
$iuretice -tia"i$e2;
alcoolism
/ leuce(ie
/ "#li de iradiatie
$es,i$ratare
reatina si
creati
nina
8al#ri n#r(ale:
+reatina:
/;B-/;= mg'.%%
(7
+reatinina:
/;=-6;6 mg'.%%
(7
,caderi pat#l#gice
/ functiuni
,e%atice
$efectuase
+resteri pat#l#gice
/ $istrofie musculara
+ miastenia gra)is
+ %oliomielita
Biliru#ina
Valori normale:

Bilirubina directa
(c#n2ugata):
%3.-%32 (g'.%% (7
Bilirubina indirecta
(li"era3
nec#n2ugata):
%3.-%36 (g'.%% (7
Bilirubina totala
(directa <
indirecta):
%32-%38
(g'.%% (7
resteri %atologice ( icter (c#l#rare n gal"en a pielii3
scler#ticii (al"ul #chiului) si a (uc#asel#r3 din
caua acu(ularii n snge a "iliru"inei)
Icter mecanic -o#structi)2* Dat#rat calculil#r "iliari
sau di0ersel#r tu(#ri. $icatul 1uncti#neaa
n#r(al3 dar nu poate elimina bilirubina.
+aracteristici: #iliru#ina $irecta crescutaE
ur#"ilin#gen n#r(alE
he(#lia n#r(ala.
Icter ,emolitic* Dat#rat degradarii crscute a
eritr#citel#r. Ficatul nu poate conjuga t#ata
"iliru"ina indirecta.
+aracteristici: #iliru#ina in$irecta crescutaE
sterc#"ilin#gen crescutE
ur#"ilin#gen crescutE
he(#lia ridicata.
Icter ,e%atocelular* Dat#rat (icr#"il#r (0irusul
hepatic). +elulele hepatice sunt a1ectate.
+aracteristici: "iliru"ina directa crescutaE
"iliru"ina indirecta crescutaE
ur#"ilin#gen crescutE
he(#lia ridicata.
Icterul nou-nascutului* .
. 1ii#l#gic - 1rec0ent la pre(aturiE
. la laptele (atern - cauat de preenta n lapte a unei
su"stante ce (piedica c#n2ugarea "iliru"inei.
1MPUSI A@1TATI PR1TEII
Proteine
8al#ri n#r(ale:
6-8 g'.%% (7
,caderi pat#l#gice
/ afectiuni ale
ficatului
/ ingestii scaute
de pr#teine
/ eli(inari (ari
de pr#teine
n arsuri
gra0e
+resteri pat#l#gice
/ n p#ligl#"ulii ("#ala rara)
/ aparitia de pr#teine an#r(ale
Dispr#teine(ie 9 #rice a1ectiune
caracteriata printr-#
hiperpr#ductie de
i(un#gl#"uline
(disgl#"uline(ie 9 an#(alie
cantitati0a sau calitati0a a
/ n pierderi prin
urina
gl#"ulinel#r)
Reactia cu
timolu
l
%-& unitati Mac 7agan F reactie negati0a
&-7 unitati Mac 7agan F reactie sla" p#iti0a
6 7 unitati Mac 7agan F reactie intens p#iti0a.

Fosfata"a Alcalina :
8al#are -#r(ala : B. - 66. UI
rescuta : *#li de $icat - +ai "iliare (#"structie canale "iliare Gcalculi3 cancerH3
c#lestaa Gnutritie t#tala parenterala3 sepsis3 anti"i#tice3 (edica(ente.H3 c#lecistita
acuta3 (etastae hepatice3 hepatita3 +M83 M#n#nucle#a 4n1ecti#asa3 +ir#a G"iliara
pri(ara3 alc##lica.H)3 *#li Bs#ase ((etastae #s#ase #ste#"lastice3 cancer pri(iti0
#s#s Paget3 hiperparatir#idis( Gpri(ar sau secundarH3 1racturi n curs de 0indecare3
#ste#(alacie3 ric=etsi3 p#liartrita reu(at#ida)3 pancreatita acuta3 insu1icienta
cardiaca c#ngesti0a3 sarcina ' nastere3 +ancer ((etastae #s#ase ' hepatice3
(iel#( (ultiplu3 leuce(ie)3 Medica(ente ((edica(ente c#lestatice3 anti"i#tice3
1en#tiaide3 estr#geni3 c#ntracepti0e #rale3 ind#(etacin3 4-C3 Metr#tre5at)3
hipertir#idis(3 per1#ratie ' in1arct intestinal3 sarc#id#a3 sepsis.
Sca"ut : hip#1#s1ate(ie3 hip#tir#idis(3 malnutritie*

GGTP; GGT (ga((a gluta(il transpeptidaa ' trans1eraaE speci1ica pentru pat#l#gia
hepatica3 nu se gaseste n #s3 se c#releaa cu 1#s1ataa alcalina)
8al#are -#r(ala : 6/ - ./ UI
rescuta : #oli ,e%atice; colesta"a; ancer ((etastae hepatice3 hepat#(3
pancreatic)3 Cepatita3 icter #"structi03 trau(atis( hepatic3 pancreatita acuta3
hepatita alc##lica3 Medica(ente (Dilatin3 $en#"ar"ital)3 insu1icienta cardiaca
c#ngesti0a3 sepsis3 ,indr#( ne1r#tic3 M#n#nucle#a 4n1ecti#asa.

TG1; G1T; AST (transamina"a glutamil oEaloacetica serica3 as%artat
aminotransfera"a)
8al#are -#r(ala : / - 8/ UI
rescuta ( IMA; Boli ,e%atice (hepatita3 staa3 necr#a3 3 c#lestaa3 cir#a3
#"structie "iliara)3 (i#cardita3 insu1icienta cardiaca c#ngesti0a3 e("#lis( ' in1arct
pul(#nar3 trau(atis(e3 pancreatita acuta3 "#li (usculatura scheletica3 arsuri3
ane(ie he(#litica3 (edica(ente (anti"i#tice3 Me0ac#r3 antihipertensi0e3
c#ntracepti0e #rale3 ;e#1ilina3 4-C)3 M#n#nucle#a 4n1ecti#asa.

TGP; GPT; ALT (transamina"a glutamil %iru)ica3 alanin aminotransfera"a)
8al#are -#r(ala : / - 8/ UI
rescuta ( Boli ,e%atice (hepatita3 cir#a3 1icat de s#c3 insu1icienta hepatica n
stadii ter(inale3 necr#a3 staa3 c#lestaa3 cancer3 #"structie "iliara2; %ancreatita
acuta3 Medica(ente (:l#purin#l3 4-C3 Met#tre5at3 c#ntracepti0e #rale3 $enit#ina3
:spirina3 :ld#(et3 4nd#cin3 Ceparina3 :nti"i#tice)3 insu1icienta cardiaca c#ngesti0a3
#oli ale musculaturii sc,eletice3 M#n#nucle#a 4n1ecti#asa3 s#c3 IMA;
miocar$ita.

LA& (lactic dehidr#genaa)
8al#are -#r(ala : ./ - B8/ UI
rescuta ( IMA -)3rf 7-8 "ile %ostinfarct3 7DC-. este (ai sensi"ila3 7DC-
.67DC-2)3 (i#cardita3 insu1icienta cardiaca c#ngesti0a3 :ne(ie Ce(#litica3
he(#lia3 in1arct (pul(#nar3 renal3 intestinal)3 "#li hepatice (hepatita3 necr#a.)3
cancer; leucemie acuta3 li(1#(3 "#li ale (usculaturii s=eletice3 :8+3 s#c cal#ric3
necr#a tisulara3 trans1uii3 M#n#nucle#a 4n1ecti#asa.

Biliru#ina Totala (icter 0ii"il 6 2.&-).% (g'dl)
8al#are -#r(ala : /*B - 6*. mg9$l sau 7 - B. umol9l (,4)
*iliru"ina ;#tala crescuta : "#li de 1icat - cai "iliare (hepatita3 #"structie "iliara
Gcalculi c#led#cieni3 calculi 0eiculari3 stricturi3 atreie3 cancer (pri(ar sau
(etastae)3 trau(atis( chirurgical3 pancreatita)3c#lestaa3 cir#a3 1icat de staa3
sepsis3 nutritie t#tala parenterala3 Medica(ente (Cal#tan3 c#ntracepti0e #rale3
:l#purin#l3 anti"i#tice3 ster#ii3 4-C3 4nd#(etacin3 Metild#pa3 sul1#na(ide3
;#l"uta(ida3 +l#ra(1enic#l3 +l#rpr#(ain)3 M#n#nucle#a 4n1ecti#asa3 insu1icienta
hepatica3 ictere ereditare (eg. Iil"ert).
*iliru"ina directa (c#n2ugata3 hidr#s#lu"ila3 apare si n urina):
8al#are -#r(ala : /*7 mg9$l sau 8 umol9l
rescuta : #"structie "iliara (calculi 0eiculari3 calculi c#led#cieni3 stricturi3 cancer
((etastae3 hepat#(3 pancreatic3 a(pul#(3 c#langi#carcin#()3 pancreatita3
hepatita (0irala3 t#5ica3 (edica(ent#asa)3 sepsis3 nutritie parenterala t#tala3 cir#a
("iliara pri(iti0a3 alc##lica.)3 Du"in Jh#ns#n3 K#t#r3 "#ala >ils#n .
*iliru"ina indirecta (nec#n2ugata)3
8al#are -#r(ala : 6*/ mg9$l sau 6? umol9l
rescuta : he(#lia3 transuii3 ,ic=le +ell :ne(ia3 he(at#( n res#r"tie3 hepatita3
cir#a3 sepsis3 insu1icienta hepatica c#ngesti0a3 cancer3 insu1icienta hepatica3
Iil"ert3 +rigler - -a22ar.

Al#umina (#rigine hepatica3 && - 6& % pr#teine t#tale3 t L .&-.8 ile)
8al#are -#r(ala : 7;8 - .*= g9$l
rescuta : he(#c#ncentratie3 deshidratare.
Sca"uta : Ciperhidratare3 (alnutritie3 "#li hepatice (hepatita3 cir#a3 insu1icienta
hepatica)3 ,indr#( -e1r#tic3 gl#(erul#ne1rita cr#nica3 enter#patii cu pierdere de
pr#teine (+r#hn3 c#lita ulcerati0a3 "#ala >hipple.)3 sarcina3 cancer3 arsuri se0ere3
(ala"s#r"tie3 i(#"iliare prelungita.

Proteine Totale (al"u(ina < gl#"uline)3
8al#are -#r(ala : .*= - ?*8 g9$l
rescute ( $es,i$ratare3 (iel#( (ultiplu3 sarc#id#a3 in1la(atii cr#nice3
c#lagen#e (7?D3 P:3 scler#der(ie.)3 (acr#gl#"uline(ie
,caute : 0ei :l"u(ina ,cauta

Aci$ Uric 3
8al#are -#r(ala : B*8 - D*. mg9$l sau 68/ - 88/ umol9l
rescuta ( guta; $es,i$ratare; insuficienta renala cronica; $iuretice
-tia"i$e2; alcoolism3 leuce(ie3 li(1#(3 (iel#( (ultiplu3 "#li (iel#pr#li1erati0e3
radi#terapie3 anemie ,emolitica3 dieta "#gata n nucle#pr#teine3 (alnutritie3
P#licite(ia 8era3 t#5e(ia gra0idica3 (edica(ente (chi(i#terapice)3 dia"et insipid.
,caut ( Me$icamente (:l#purin#l3 Pr#"enecid3 ,alicilati3 c#rtic#ster#ii3 >ar1arin)3
,4:DC3 Ce(#cr#(at#a3 "s#li hepatice3 "#ala >ils#n 3 ,indr#( $anc#ni.

1smolalitatea ((Bs(#l ' =g 9 ((#l ' =g3 esti(are 9 2 G-aH < :#t ureic ' 2.8 < glc '
.8)
8al#are -#r(ala : BD8 - B<= m1smol 9 'g
rescuta : $es,i$ratare; ,i%erglicemie -$ia#et "a,arat3 c#(a
hiper#s(#lara n#ncet#tica)3 hipernatre(ie3 ure(ie3 dia"et insipid (central sau
ne1r#gen)3 t#5ine (etan#l3 (etan#l3 etilen glic#l)3 Medica(ente (diuretice3 (anit#l)3
hipercalce(ie.
Sca"uta : hip#natre(ie3 ,4:DC3 int#5icatie cu apa3 hiperhidratare

olesterol Total : Prefera#il M 2%% (g'dl sau &..8 ((#l'l3 #or$erline - risc mo$erat
2%% - 2)! (g'dl3 risc crescut 6 24% (g'dl sau 6 6.2% ((#l'l
$act#ri de risc pentru "#ala c#r#nariana : 0rsta ("ar"ati 6 443 1e(ei 6 &4)3 1u(at3
C;:3 CD7 M )& (g'dl3 dia"et3 antecedente 1a(iliale3 +#lest ' CD7 6 4.&
rescuta : Ciperc#lester#le(ie3 Dia"et aharat3 hip#tir#idis(3 4M:3 tri(estrul ) al
sarcinii3 a1ectiuni "iliare3 c#lestaa3 #"structie "iliara3 ,indr#( -e1r#tic3 dieta "#gata
n c#lester#l3 sedentaris(3 #"eitate3 Ciperc#lester#le(ie 1a(iliala3
Ciperlip#pr#teine(ii 3 Medica(ente (ster#ii3 c#ntracepti0e #rale3 1en#tiaide3
$enit#ina)
Sca"ut : (alnutritie3 hipertir#idis(3 "#li hepatice3 insu1icienta hepatica3 (iel#(
(ultiplu3 (ala"s#r"tie3 ane(ie he(#litica3 Medica(ente (-iacina3 :l#purin#l3
+#lchicina3 4-C3 Me0ac#r3 Pra0ach#l3 +h#lestira(ina3 N#c#r3 7esc#l3 1i"re)

Trigliceri$e 3
8al#ri -#r(ale : 7/ -67. mg9$l sau /*78 - 6*.B mmol9l
rescute : Ciperlip#pr#teine(ii pri(are (4-8)3 dia"et aharat3 hip#tir#idis(3 4M:3
pancreatita acuta3 alc##lis( (acut sau cr#nic)3 ,indr#( -e1r#tic3 "#li hepatice3 dieta
"#gata n lipide'glucide3 guta3 sarcina3 Medica(ente (ster#rii3 estr#gen3
c#ntracepti0e #rale3 lipide ad(inistrate intra0en#s)3 glic#gen#e.
Sca"ute : (alnutritie3 (ala"s#r"tie3 hipertir#idis(3 (edica(ente ce scad
trigliceride(ia

LAL colesterol : Prefera#il M .)% (g'dl3 #or$erline - risc mo$erat .)% - .&! (g'dl3
risc crescut 6 .6% (g'dlE G7D7 9 c#lester#l t#tal - ;I'& - CD7H

&AL colesterol : risc car$iac sca"ut 6 4& (g'dl sau ...6 ((#l'l3 risc car$iac
crescut M )& (g'dl sau %.!% ((#l'l
rescut ( s%ort regulat; a%ort mo$erat $e alcool; -iacina
Sca"ut : fumat; se$entarism; o#e"itate; insuficienta renala; $ia#et; "eta
"l#cante.

Amila"e 3
8al#ri -#r(ale : B/ - 68/ UIE pr#0in din pancreas3 gl. sali0are3 1icat.
rescute : %ancreatita acuta; ulcer %e%tic %erforat (p#steri#r)3 c#lecistita
acuta3 #"structie canal cistic3 cancer pancreatic3 pseud#chist pancreatic3 ascita
pancreatica3 #cluie intestinala3 per1#ratie intestinala3 in1arct intestinal3 perit#nita3
apendicita acuta3 sarcina3 sarcina e5trauterina3 ruptura de chist #0arian3
c#led#c#litiaa3 par#tidita3 #rei#n3 trau(atis( de gl. sali0are sau pancreas3 in1arct
pul(#nar3 arsuri3 cet#acid#a dia"etica3 insu1icienta renala3 alc##lis( acut3
c#langi#pancreat#gra1ie retr#grada end#sc#pica3 (acr#a(ilae(ia3 Medica(ente
(M#r1ina3 :spirina3 diuretice tiaidice3 c#rtic#ster#ii3 :arti#prina3 c#ntracepti0e
#rale)3 cir#a.
Sca"ute : pancreatita cr#nica n stadiu ter(inal3 insu1icienta hepatica3 hepatita
se0era.

Li%a"a 3
8al#ri -#r(ale : B/ - 68/ UI3 n diagn#sticul tardi0 al pancreatitei acute3 creste la
2 sapta(ni3 dupa un epis#d acut de pancreatitaE speci1ica pancreasului.
rescuta : %ancreatita acuta; cancer %ancreatic3 c#lecistita acuta3
#"structie canal pancreatic3 #cluie intestinala3 in1arct intestinal3 ulcer peptic
per1#rat3 narc#tice.

PF; F (creatin 1#s1#=inaa)3
8al#ri -#r(ale : . - B// UI (i#eni(e M*3 MM3 **)
+restere PF totala ( IMA; chirurgie cardiaca3 p#st in2ectii 4M3 trau(atis(e3
sindr#( de stri0ire3 p#litrau(atis(e3 resuscitare cardi# pul(#nara3 de1i"rilare3
electr#cutare3 (i#ita3 ra"d#(i#lia3 :8+3 e1#rturi intense3 s#c.
+restere PF - MB : 4M:3 angina insta"ila3 chirurgie cardiaca3 ische(ie cardiaca3
(i#cardita acuta3 pericardita3 cardi#(i#patie3 de1i"rilare3 ra"d#(i#lia3 distr#1ii
(usculare.
+restere PF - BB : :8+3 he(#ragie su"arahn#idiana3 tu(#ri cere"rale3 c#n0ulsii3
s#c3 trau(atis(e craniene3 neur#chirurgie3 e("#lis( ' in1arct pul(#nar3 cancer
(digesti03 sn3 #0ar3 pla(n).
+restere PF - MM : trau(atis(e3 sindr#( de stri0ire3 p#st #perat#r3 in2ectii 4M3
?MI3 ra"d#(i#lia3 (i#ita (p#li-3 der(at#-)3 distr#1ie (usculara3 e1#rt 1iic intens3
hiperter(ie (aligna3 c#n0ulsii