Analize de laborator

si
investigatii

Asist. Univ. Drd. Ruxandra Mihalache

Analize
ANALIZE DE LABORATOR
Hemoleucograma

Eritrocite 4.000.000 – 5.000.000/mcL

Hemoglobina 12 – 14 g/dl

Leucocite 4.000 – 10.000/mcL

Trombocite 150.000 – 400.000/mcL

Biochimie

Profil glucidic
Profil lipidic
Functie renala
Functie hepatica
Profil glucidic
Glucoza este cel mai important monozaharid din sange. Rezulta din
digestia carbohidratilor si din conversia hepatica a glicogenului in
glucoza.

Glicemie (glucoza serica) 70 – 115 mg/dl

Glicemie bazala = glicemie à jeun

Normal – 60-100 mg/dl
Hiperglicemie ≥ 126 mg/dl
Diabet zaharat ≥ 200 mg/dl
 Glicemie à jeun

 Test de toleranta la glucoza (TTGO) – gl la 2 ore dupa administrarea a

75 g glucoza

 Hemoglobina glicozilata /glicata (HbA1c) – valoare medie a glicemiei

in ultimele 2-3 luni
HbA1c = 6% (~126 mg/dl)
HbA1c = 7% (~154 mg/dl)
HbA1c = 8% (~183 mg/dl)
HbA1c = 9% (~212 mg/dl)
HbA1c = 10% (~240mg/dl)
Profil lipidic
Evaluarea riscului de boala coronariana.
COLESTEROL TRIGLICERIDE
 colesterol total  Optim < 150 mg/dl
Optim < 200 mg/dl  Bordeline crescut 150 – 199 mg/dl
Borderline crescut 200 – 239 mg/dl  Crescut 200 – 499 mg/dl
 HDL – colesterol  Foarte crescut ≥ 500 mg/dl
Scazut < 40 mg/dl
Crescut > 60 mg/dl
 LDL – colesterol
Optim < 100 mg/dl
Bordeline crescut 100 – 159 mg/dl
Crescut 160 – 189 mg/dl
Foarte crescut ≥ 190 mg/dl
 Functia renala si acidul uric
 Creatinina
 Perturbarea functiei renale → ↓ excretiei de creatinina → ↑ creatininei serice. Astfel
concentratiile de creatinina ofera o aproximare a ratei filtrarii glomerulare (RFG).
 Principala utilitate este in diagnosticarea insuficientei renale.
 Normal 0.6-1 mg/dl
 Uree
 Normal <50 mg/dl
 Clearence creatinina / Rata filtrarii glomerulare
 Normal 100 – 125 ml/min/1.73m2
 BRC stadiul II 60 – 90 ml/min/1.73m2
 BRC stadiul III 30 – 59 ml/min/1.73m2
 BRC stadiul IV 15 – 29 ml/min/1.73m2
 BRC stadiul V <15 ml/min/1.73m2
 MDRD (Modification of Diet in Renal Disease)
 CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
Concentratie creatinina serica
Varsta
Sex
Rasa
 Acid uric - evaluarea insuficientei renale / monitorizarea tratamentului
gutei / monitorizare tratament citostatic
Normal – ♂ < 7mg/dl
Normal – ♀ < 5.7 mg/dl
 Sumar de urina urobilinogen, corpi cetonici, acid ascorbic, glucoza,
proteine, hematii, pH, nitriti, leucocite, densitate
 Urocultura antibiograma
Functia hepatica

AST 0 – 32 U/L
ALT 0 – 31 U/L

GGT <50 U/L

Fosfataza alcalina <110 U/L
Bilirubina totala <1.2 mg/dl
Bilirubina directa <0.3 mg/dl
Bilirubina indirecta se calculeaza
Ionograma

Sodiu (Na) 135 – 148 mmol/L

Potasiu (K) 3.5 – 5.3 mmol/L

Clor (Cl) 98 – 107 mmol/L

Markeri inflamatori

VSH 0 – 20 mm/ora

Fibrinogen 200 – 400 mg/dl

PCR <0.5 mg/dl

Coagularea

INR (International Normalized Ratio) 1

2-3
aPTT (Timp de Tromboplastina Partiala Activat)
Bacteriologie

Urocultura
Coprocultura
Cultura din sputa / secretii / ulcere de decubit
Examen coproparazitologic
Exudat faringian
 Imunologie
 Functia tiroidiana:
TSH  Hepatita
T3 Ag HBs
fT4 Ac HBC
 Screening oncologic:  BTS
PSA RBW / VDRL
CEA HIV
CA 15-3  Helicobacter pylori
CA 19-9
CA 125
AFP
Investigatii
INVESTIGATII
Explorari functionale

 Electrocardiograma (EKG)
 Holter EKG
 Oscilometrie - Indice glezna brat (IGB)
 Holter TA
Explorari imagistice

 Ultrasonografie
 Radiografie
 Osteoarticulara
 Tranzit baritat
 Urografie
 Computer tomografie
 Rezonanta magnetica nucleara
 DXA
 Endoscopie digestiva superioara / inferioara
Alte proceduri terapeutice

 Consulturi interdisciplinare
 Kinetoterapie
 Fizioterapie
 Ergoterapie
 Logopedie