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VOLUMUL PLASMATIC

90% ap
- 9% s. organice

10% reziduu
-1% s. minerale

PROTEINELE plasmatice-roluri
Creterea i diferenierea celular
Fondul proteic
P.oncotic, vscozitate, densitate, pH, VSH
Imunitate
Hemostaz
Eritropoiez
Tensiunea arterial
Transport i depozitare
Enzime

3 tipuri de proteine
albumine
globuline
fibrinogen

Sinteza proteinelor
Ficat

-globuline, -globuline

Limfocitele B activate

-globuline

Structura
primar, secundar, teriar, cuaternar

PROTEINEMIA
Creteri
-postprandial
-inflamaii cronice
-mielom multiplu

6,7 8,4 g/dl


Scderi
copii
vegetarieni
inaniie
tulburri de digestie / absorbie
insuficien hepatic
afeciuni renale

ALBUMINELE
GLOBULINELE

-1 -antitripsina,
1
glicoproteina 1-acid, eritropoietina
1-fetoproteina, 1-lipoproteinele (HDL)

-2 ceruloplasmina, angiotensinogenul, bradikininogenul,


2-antiplasmina, haptoglobina

-1 C3, transferina, 1-microglobulina


-2 properdina
-
Ac (imunoglobulinele)
Proteina C reactiv
<1 mg/dl

ALBUMINE

GLOBULINE

PLASMA

FRACIUNILE PROTEICE SEPARATE PRIN ELECTROFOREZ

IMUNOGLOBULINELE SERICE
copil
De origine matern

adult
Vrst (luni)

Disproteinemii
- modificarea raportului albumine/globuline
insuficiena hepatic:
afeciuni renale:

albuminele i globulinele

albuminele

infecii, inflamaii: globulinele

boli autoimune: autoanticorpi

FIBRINOGENUL
- CRETE

-inflamaii, cancere

- SCADE

- b. hepatice severe, CID

PROTEINE CONJUGATE
grup proteic

grup prostetic

Metaloproteine apotransferina, ceruloplasmina, anhidraza carbonic


Glicoproteine Lipoproteine Cromoproteine hemoglobina....

PROTEINO-ENZIME
FP ai coagulrii, CERULOPLASMINA, LIPOPROTEINLIPAZA
ENZIME DE CITOLIZ

- TGO transaminaza glutamo-oxaloacetic = ASAT aspartat-amino-transferaza


- TGP transaminaza glutamo-piruvic = ALAT alanin-amino-transferaza
- LDH lactic-dehidrogenaza
- CPK creatin-fosfo-kinaza
ENZIME DE COLESTAZ
- fosfataza alcalin
- -glutamil-transpeptidaza GTP
ENZIME DE EXCREIE
-fosfataza acid
-amilaza
-pepsinogenul

S. azotate
proteice
6,7 8,4 g/dl

Proteino-enzime

Albumine
Globuline

3,5 -4,5 g/dl (55-60%)


2,5 -3,5 g/dl (38-40%)

-Fibrinogen

0,2 -0,4 g/dl

Aminoacizi

20-40 mg/dl

-TGO (ASAT)
-TGP (ALAT)
-LDH
-CPK
-Fosfataza alcalin
-Amilaza

F: < 31 U/l
F: < 31 U/l
< 480 U/l
< 240 U/l
< 110 U/l
8-32 UW

a1
a2
b1+b2
g

4%
9-16%
8%
8-12%
14-16%

B: < 37 U/l
B: < 41 U/l

Substane azotate neproteice


= azot rezidual

S. azotate neproteice Amoniac


Uree
30 50 mg/dl

Acid uric
Creatin
Creatinin

urme 50 mg/dl
25-40 mg/dl
4 (2-6) mg/dl
0,6 mg/dl
0,5 1,1 mg/dl

Substane neazotate
lipide
glucide
sruri minerale
oligoelemente
altele

S. neazotate
(~ 1 g/dl)

Lipide
-Fosfolipide
-Colesterol
liber
esterificat
-trigliceride
-AGL
Lipoproteine
-HDL
-LDL
-VLDL
-IDL

500-800 mg/dl
180-350 mg/dl
< 200-250*mg/dl
45-75 mg/dl
105-170 mg/dl
< 130 mg/dl
4-14 mg/dl
200-300 mg/dl
F: >55 mg/dl B: > 45 mg/dl
<130 mg/dl

Corpi cetonici

5-20 mg/l

Lipoproteinele
HDL

25-30%

LDL

70-75%

IDL
VLDL

colesterol bun
colesterol ru

esterificat
liber

HIPERCOLESTEROLEMIE
ATEROSCLEROZ
BOLI CARDIO-VASCULARE

Enzime plasmatice cu rol n


degradarea lipidelor plasmatice
Lipoprotein-lipaza
Triglicerid-lipaza
Lecitin-colesterol-acil-transferaza LCAT

CORPII CETONICI
acidul acetoacetic (ficat, din acetil-CoA)
decarboxilare

acetona
reducere

acidul hidroxibutiric

Glucide
-Glucoza

70-120 mg/dl

Acid lactic
Acid citric

6-22 mg/dl
1,7-3 mg/dl

Acid piruvic
Alcool etilic

GLUCOZA
Hipoglicemie
Hiperglicemie
Hemoglobina glicozilat 5-8%

Substane minerale plasmatice


Cationi
(155 mEq/l)

Na+
K+
Ca++
Ca total
Mg++

135 - 145 mEq/l


3,5 - 5,1 mEq/l
3 - 5 mEq/l
10 mEq/l
2-3 mEq/l

Anioni
(155 mEq/)

ClHCO3PO43Ali anioni

98 -111 mEq/l
24 - 27 mEq/l
3-5 mEq/l
12 mEq/l

oligoelemente

Fier (sideremie)
Cupru
Fluor
Iod

50-130 mg/dl
110 mg/dl
110 mg/dl
8-11 mg/dl