1

Valori normale ale parametrilor biologici

Hemoleucograma:

Leucocite:
4000-10 000/ mm
3

Polimorfonucleare (PMN):
Neutrofile: 2000 6000/mm
3,
(< 60%)
Eozinofile: 0-700/mm
3
(0-7%)
Bazofile: 0-200/mm
3
(0-2%)
Limfocite: 1000-3000/mm
3
(15-35%)
Monocite: 0-800/mm
3
(0-8%)

Reticulocite: 0.5-1.5 %0

Hematii:
Femei: 4.3 5.5 mil/ mm
3
Barbati: 4.5 5.9mil/ mm
3


Trombocite: 200 000 400 000/ mm
3
Hematocrit:
Femei: 36-47%

Barbati: 40-54%
Hemoglobina eritrocitara medie (MCH): 28-33 pg
Concentratia de Hb eritrocitara (CHEM): 32-36 g/dl
Volumul eritrocitar mediu: 82 92 m
3
Anemia:

Anemia Hb Ht
uoar

8-11 30-39%
medie 6-8 22-30%
sever 2-6 10-22%

Viteza de sedimentare a hematiilor (VSH):
la 1h la 2h
Femei: 3-8
mm
20 mm
Barbati 3-5
mm
15 mm
Fibrinogen: 200-300mg/dl
Proteina C reactiva: < 0,80mg/dl
ASLO: < 200UI/ml
(valori crescute: adulti > 250 UI/ml, copii > 333UI/ml)


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Biochimie:

Electroliti:
Ca: 4.2 5.2 mEq/l (9, 5-10,5 mg/dl)
Mg: 1.5 2.5 mEq/l (1.8 - 2.3 mg/dl)
Na: 135-145 mEq/l
K: 3.5-5.3 mEq/l
Cl: 100-110 mEq/l
Fe: 80-180 g/dl

Pancreas:
Amilazemie:0-100 U/l
Amilazurie: 0-260 U/l

Teste serologice conventionale pentru bolile hepatobiliare:

Sindromul de hepatocitoliza:
ASAT (TGO):
Barbati: < 37 U/l
Femei: < 31 U/l
ALAT (TGP):
Barbati: < 42 U/l
Femei: < 32 U/l
LDH: 110 210 U/l
Sindrom hepatopriv:
Proteine totale: 6.7 8.7 g/dl
Albumine: 3.8 5.5 g/dl
Colinesteraza: 4620-11500 U/l
Timp de protrombina (Quick):13-15 sec, Indice de protrombina: 80-120%
Sindrom de colestaza:
Fosfataza alacalina (FA):
Barbati: 80-306 U/l
Femei: 60-300U/l
Gama GT:
Barbati: 11-50 U/l
Femei: 7-32 U/l
Sindrom icteric:
Bilirubina totala (BT): < 1 mg/dl
Bilirubina directa (BD): < 0.3 mg/dl

Markeri virali:
VHA:
IgM anti VHA
VHB:
Ag HBs: negativ, anti HBc (IgM, IgG), AgHBe/anti HBe
3
ADN VHB: nedetectabil
VHC:
Anti VHC: negativi
ARN VHC: nedetectabili
Proteinograma ( electroforeza proteinelor serice):
Proteine totale: 6.7-8.7 g/dl
Albumine 3.8 5.5 g/dl 58-70%
Alpha 1 0.1-0.25 g/dl 1.5
3%
Alpha 2 0.4-0.8 g/dl 7-11%
Beta 0.5-1.05 g/dl 8-14%
Gama globuline 0.6-1.2 g/dl 8.5-
16%
Glicemie: 70-115 mg/dl

Determinarea glicemiei intamplatoare:


> 200 mg/dl = Diabet zaharat 100 mg/dl


Determinare glicemiei dimineata (preprandial)


> 90 mg/dl >110 mg/dl > 125 mg/dl
Se fac determinari la 3 ani Repetare
TTGO 125 mg/dl = Diabet zaharat

( cu 75 g Glc
cu determinari a jeun si la 2 h)


200mg/dl 140 glicemia <200
= Diabet zaharat Scaderea tolerantei la glucoza
(Toleranta alterata la glucoza)

Glicemia, diabetul zaharat
Se defineste (21):
- glicemia jeun normala o valoare < 100 mg%
- perturbarea homeostaziei glicemiei bazale ( jeun): glicemia cu valori
cuprinse intre 100-125 mg% = Glicemie bazala alterata
4
- diabet zaharat: glicemia a jeun 126 mg% sau glicemia recoltata in orice
moment al zilei 200 mg%
- testul de toleranta la glucoza este recomandabil la glicemie jeun > 100
mg%, dar nu este imperativ
(Genuth S, Alberti KG, Benneh P et al Follow-up report on the diagnostic of diabetes mellitus. Diabetes Care.2003; 26:316s)


American Diabetes Association (Diabetes Care 29.01.2010)

DZ tipII

1. HbA1c > 6,5%;
2. glicemia a jeun 126 mg%;
3. glicemia la 2 ore in cadrul testului de toleranta la glucoza (75g) >200 mg%;
4. glicemia recoltata in orice moment al zilei 200 mg%


Hemoglobina glicozilata (controlul diabetului pe termen lung 4-6 sapt)
Hb A
1c


<4 Valori normale
4-7 Control metabolic bun
7-10 Control metabolic inadecvat
10-14 Control metabolic precar
14-16 Diabet complicat
necontrolat
Profil glicemic:

- preprandial: < 110 mg/dl
- postprandial < 145 mg/dl

Valorile lipidelor serice:
Colesterol:
< 200 Normal
200 239 Crescut la limita ( regim
alimentar)
240 Crescut
Trigliceride:
< 150 Normal
5
150-199 Crescut la limita ( regim
alimentar)
200 Crescut
> 500 Mult crescute
LDL cholesterol:
< 100 optimal
100-130 Normal
130-159 Crescut la limita, risc inalt
160-189 Crescut
190 Foarte crescut

HDL cholesterol:
< 40 Scazut
60 Crescut

Indicele de masa corporeala:

IMC: G/H
2

25-30 Supragreutate
30-35 Obezitate gradul I
35-40 Obezitate gradul II
40-45 Obezitate gradul
III


Enzime de necroza miocardica (Infarct miocardic):

Troponina cardiaca I sau T (CTnI): 0.01 mg/dl
LDH: abandonat, creste de peste 10X VN, persista 10-15 zile.
Creatinkinaza MB (CK-MB): 0-25 U/l
- creste de 2XVN , in primele 24 de ore.
Creatinkinaza totala CK:24-190 U/l

Aparat renal:

Volum urinar:
Barbati: 1000-1800ml/24 h
Femei: 1000-1500ml/24 h

Poliurie: > 2000ml/24h
Oligurie: 400ml
Anurie: < 50 ml/24h

Examen de urina:

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Sediment: celule epiteliale, hematii (< 1-3 H/camp, leucocite < 5 L/camp)
Proteinurie, piurie, glicozurie, cristale( uratice, oxalate de Ca, fosfatice, colesterol)
Cifra Addis (raportarea nr la unitatea de volum sau flux/min):
Hematii: 1-3 H/camp, > 1000H/min
Leucocite: > 5L/ca,p, > 2000 L/min


Proteinurie (din urina/24 h):

albuminurie: 20-200g/min, 30-300 mg/dl
Macroalbuminurie: 300-500 mg/dl
Proteinurie: > 500 mg/dl

Densitate:
- spontana
- in mictiuni separate: trebuie sa existe o valoare > 1024 (pt o functie tubulara
normala)
- < 1024: hipostenurie
- = 1011 izostenurie

Examen bacteriologic:
In mod normal urina este steril.
1. Pe preparate native patologic: sediment piurie
2. Urocultura:
- monocultura: 1 singur germene
- 10 000 -100 000 g/ml se repeta (daca apare acelasi germene = infectie urinara)
- > 100 000 g/ml infectie urinara

Explorarea functie rinichiului:

Ureea: 10-50 mg/dl
Creatinina:
Barbati: 0.5-1.1 mg/dl
Femei: 0.5-0.9 mg/dl
Acid uric:
Barbati: 3.4 - 7 mg/dl
Femei: 2.4 5.4 mg/dl
Hiperuricemei: > 7 mg/dl

Clearence creatinina ( coeficient de epurare plasmatica) = volumul de plasma epurat dintr-o
anumita substanta in unitatea de timp.

Barbati: 100 135ml/min
Femei: 85-125 ml/min