Muaj ob hom kev kuaj ntshav tseem ceeb - kho mob (nws tseem hu ua dav dav) thiab biochemical. Ob hom kev tshuaj ntsuam yuav suav nrog ntau qhov kev tshawb fawb sib txawv. Yog li ntawd, lawv tham txog kev kuaj ntshav dav dav thiab txuas ntxiv. Qhov no siv rau thawj hom kev tshawb fawb. Hauv qhov thib ob, peb tab tom tham txog kev kuaj ntshav biochemical thiab biochemical txuas ntxiv.
UAC
Nyob rau hauv rooj plaub ntawm kev tshuaj xyuas tiv thaiv, cov neeg mob tau muab tshuaj ntsuam xyuas cov ntshav niaj hnub. Hauv lwm txoj kev, nws yog hu ua "kev kuaj ntshav dav dav (CBC)". Nrog nws cov kev pab, cov ntsiab lus ntawm hemoglobin, tus naj npawb ntawm cov khoom tsim - platelets, erythrocytes, leukocytes raug soj ntsuam, cov mis leukocyte, xim Performance index thiab erythrocyte sedimentation tus nqi yog txiav txim. Muab cov ntsuas no, tus kws kho mob tuaj yeem txheeb xyuas cov txheej txheem inflammatory thiab tsim kom muaj nws theem, anemia, thiab ntsuas qhov mob ntawm cov hlab ntsha. Qhov no yog ib qho kev soj ntsuam tsis tshwj xeeb, uas yog, piv txwv li, nce tus lej ntawm leukocytes hauv cov ntshav.yuav tsis qhia txog cov kab mob tshwj xeeb, tab sis yuav qhia txog nws lub xub ntiag thiab ntawm lub cev dav dav.
Thaum ncua UAC tau sau npe
Yog tias pom muaj qhov txawv txav lossis thaum kuaj ntshav ntawm cov neeg mob uas twb muaj kab mob lawm, cov kev tshawb fawb tshwj xeeb raug sau tseg. Cov no suav nrog kev kuaj ntshav txuas ntxiv mus. Cov tom kawg suav nrog kev kawm ntxaws ntxiv ntawm cov cellular muaj pes tsawg leeg ntawm cov ntshav. Cov txiaj ntsig yuav suav nrog erythrocyte, leukocyte, thiab platelet indices.
Piv txwv li, yog tias xav tias muaj myocardial infarction, tus kws kho mob yuav tsum paub ESR, tus lej ntawm leukocytes, vim lawv qhov kev hloov pauv qhia tus kab mob no, thiab lub sijhawm ntawm tus kab mob tuaj yeem txiav txim siab los ntawm qhov sib txawv. los ntawm cov qauv ntawm cov ntsuas no. Cov ntsuas no suav nrog hauv cov npe niaj hnub ntawm kev kuaj ntshav kom tiav.
Yog tias cov ntaub ntawv CBC qhia txog cov kab mob xws li ntshav qab zib, tom qab ntawd txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau nws yuav tsum tau kuaj ntshav ntxiv, suav nrog cov ntsuas erythrocyte.
UAC txuas ntxiv li cas suav nrog
Kev kuaj ntshav siab dav dav yuav suav nrog cov pab pawg hauv qab no:
1. Cov ntsuas tsis tu ncua:
- hemoglobin concentration,
- RBC suav,
- leukocytes,
- platelets,
- xim ntsuas,
- hematocrit.
2. RBC Indices:
- nruab nrab erythrocyte ntim,
- mean erythrocyte hemoglobin (Hb),
- qhov nruab nrab ntawm hemoglobin (Hb) hauverythrocyte,
- normoblasts,
- Ydelta hemoglobin.
3. Platelet Indices:
- mean platelet suav,
- platelet faib dav los ntawm ntim,
- thrombocrit,
- tsis paub granulocytes.
4. Leukoformula:
- lymphocytes,
- neutrophils,
- basophils,
- eosinophils,
- monocytes.
5. Kev ntsuam xyuas Reticulocyte:
- reticulocytes,
- hemoglobin cov ntsiab lus hauv reticulocytes,
- feem ntawm cov tsis paub qab hau reticulocytes,
- kho cov reticulocyte suav,
- reticulocyte ntau lawm index.
Qhov nyuaj ntawm cov txiaj ntsig tau los ntawm kev tshawb fawb ntawm cov ntsuas ntawm CBC yog hu ua hemogram. Nws yog ib lub rooj nyob rau hauv uas cov ntsuas tau qhia, lawv cov qauv, units ntawm kev ntsuas thiab qhov tshwm sim ntawm txoj kev tshawb no.
Rau cov kab mob dab tsi yog qhov txuas ntxiv OAC tau sau tseg
Kev kuaj ntshav txuas ntxiv tus kws kho mob yuav sau rau hauv cov xwm txheej hauv qab no:
- kuaj kab mob ntawm cov ntshav thiab hematopoiesis,
- Ntseev cov kab mob inflammatory,
- kev soj ntsuam kev kho mob.
Nws kuj tau qhia rau lwm yam pathologies. Cov pab pawg tseem ceeb ntawm cov kab mob uas txuas ntxiv cov ntshav suav tuaj yeem raug sau tseg yog:
- ntshav ntshav,
- hemorrhagic diathesis - los ntshav mob,
- hemoblastoses - kab mob oncological ntawm cov ntshav.
Qee yam kab mob no yog tus yam ntxwv ntawmKev hloov pauv ntawm cov khoom tsim (piv txwv li, nrog ntshav ntshav, cov qe ntshav liab txo qis), qee qhov kev hloov pauv hauv cov qauv (piv txwv li, nrog mob qog noj ntshav), qee qhov tau nrog kev hloov pauv ntawm tus lej. cov qe ntshav thiab lawv cov khoom. Cov kab mob kawg yog hu ua ntshav qog noj ntshav. Yog li ntawd, lub hemogram suav nrog cov ntsuas ntawm cov qe ntshav (piv txwv li, tus naj npawb ntawm cov platelets) thiab cov ntsuas kev hloov pauv ntawm qhov loj thiab lwm yam khoom ntawm cov hlwb (piv txwv li, qhov dav ntawm kev faib cov platelets los ntawm ntim).
Normal UAC values
Lub rooj qhia cov txiaj ntsig ib txwm muaj ntawm KLA. Cov qauv ntawm kev kuaj ntshav txuas ntxiv yog ib lub tswv yim tsis txaus ntseeg. Txawm hais tias muaj pes tsawg leeg ntawm tus neeg cov ntshav yog qhov ncaj ncees, ntau yam tuaj yeem cuam tshuam qhov tshwm sim. Tsis tas li ntawd, nyob rau hauv ntau pawg neeg - cov menyuam yaus, cov poj niam cev xeeb tub, cov neeg ncaws pob - cov qauv sib txawv me ntsis. Yog li ntawd, kev txiav txim siab yuav tsum tau ua los ntawm kws kho mob.
| Indicator | ntsuas ntsuas |
Norma ผู้หญิง |
Norma men |
| ESR | mm/h |
under 30:8-15 tom qab 30: tsis tshaj 25 |
under 30: 2-10 tom qab 30: tsis tshaj 15 |
| Hemoglobin | g/l | 115-140 | 140-160 |
| x109 /l |
under 30:4, 2-9 after 30: 3-7, 9 |
under 30:4, 2-9 tom qab 30xyoo: 3-8, 5 |
|
| Erythrocytes | x1012 /l | 3, 5-4, 7 | 3, 9-5, 5 |
| YHematocrit | % |
under 30: 35-45 after 30: 35-47 |
under 30: 39-49 after 30: 40-50 |
| YReticulocytes | % | 2-12 | |
| Mean erythrocyte ntim | fl | 80-100 | |
| Mean erythrocyte Hb | pg | 27-31 | |
| RBC ntim faib dav | % | 11, 5-14, 5 | |
| ntsuas xim | 0, 85-1 | ||
| Platelets | g/l | 150-380 | 180-320 |
| Mean platelet ntim | fl | 7, 4-10, 4 | |
Extended UAC decryption
Kev txiav txim siab kuaj ntshav siab yog ib txoj haujlwm nyuaj txawm tias tus kws kho mob. Nws yuav tsum tau ua nrog tsuas yog tus kws kho mob nqaim uas coj tus neeg mob mus rau txoj kev tshawb no. Tom qab tag nrho, qhov kev kuaj mob tsis tuaj yeem ua los ntawm ib lossis ob qhov ntsuas, nws yog ib qho tsim nyog yuav tsum coj mus rau hauv tus account tag nrho cov txheej txheem ntawm cov ntsuas nrog rau cov tsos mob thiab cov kev tshawb fawb ntxiv.
Piv txwv li, xav txog qhov ntsuas li qhov dav ntawm kev faib cov platelets los ntawm ntim. Ib lub npe tsis to taub tag nrho rau ib tus neeg zoo tib yam, txawm tias nws paub tias platelets muab cov ntshav txhaws. Qhia qhov heterogeneity ntawm platelets hauv lawv ntim. Platelets muaj qhov loj me:
- normal,
- giant - pathological,
- loj - hluas,
- small - qub.
Nws muaj peev xwm tsim kom muaj cov platelet zoo li cas - cov hluas lossis laus, uas yog, tsis ua nws txoj haujlwm ntxiv - tsuas yog los ntawm lawv qhov loj - ntim. Qhov taw qhia qhia tias qhov feem pua ntawm tag nrho yog nyob hauv cov hlwb me thiab loj dhau. Feem ntau, lawv yuav tsum tsis pub ntau tshaj 15-17%. Ib qho kev hloov pauv hauv qhov ntsuas qhia tau hais tias muaj cov kab mob hauv cov pob txha uas ua rau cov platelets ntau dhau, piv txwv li, polycythemia vera, myeloid leukemia, myelofibrosis, qhov tseem ceeb thrombocythemia. Txawm li cas los xij, qhov kev hloov pauv hauv qhov ntsuas no kuj tuaj yeem pom hauv lwm cov kab mob, suav nrog helminthic invasions thiab Alzheimer's disease. Yog li ntawd, tsuas yog ib qho kev hloov pauv hauv qhov ntsuas no tsis tuaj yeem qhia txog qee yam kab mob, tab sis tuaj yeem ua tiav tag nrho cov kev tshawb fawb.
ntshav chemistry
Kev ua haujlwm ntawm txhua lub cev yog nrog los ntawm kev tso tawm qee yam tshuaj rau hauv cov ntshav - enzymes, cov tshuaj hormones, cov khoom lag luam metabolic ntawm cov hlwb. Thaum lub cev muaj kab mob, tus nqi lossis cov ntsiab lus ntawm cov tshuaj no hauv cov ntshav yuav hloov. Yog li, biochemical tsom xam yuav tso cai rau peb los soj ntsuam cov kev ua haujlwm ntawm ntau lub cev thiab lub cev thiab lub xeev ntawm cov metabolism hauv feem ntau.
Thaum txuas ntxiv biochemical AK raug tshuaj
Kev kuaj ntshav biochemical txuas ntxiv tuaj yeem suav nrog kwv yees li 40 qhov ntsuas. Txawm li cas los xij, tsis tas yuav kuaj ntshav rau tag nrho cov ntsuas no. Los ntawm tag nrho cov npe, tus kws kho mob yuav xaiv cov kev tshawb fawb nouas yuav tso cai rau koj los qhia meej txog lub xeev ntawm ib lub cev lossis lub cev. Piv txwv li, thaum lub sij hawm myocardial infarction, ntau cov enzymes thiab myoglobin protein nkag mus rau hauv cov hlab ntsha. Yog li ntawd, kev tsim cov enzymes AST, ALT, LDH, CP thiab lawv cov isoenzymes yuav qhia tus kws kho mob txog qhov muaj lub plawv nres thiab qhia nws lub sijhawm. Cov ntsuas no suav nrog hauv cov npe niaj hnub ntawm kev tshawb fawb biochemical. Txawm li cas los xij, qhov qhia tshwj xeeb tshaj plaws ntawm myocardial infarction yog qib ntawm troponins hauv cov ntshav. Qhov kev sim no tsis tau ua rau txhua tus neeg mob, nws suav nrog hauv cov npe ntawm cov kev kuaj ntshav biochemistry siab heev thiab tsuas yog raug tshuaj yog tias xav tias mob plawv nres.
Qhov piv txwv thib ob ntawm kev teem sijhawm ntawm kev tshawb fawb biochemical ntxiv yog txhawm rau nrhiav qhov ua rau muaj ntshav liab. Yog tias xav tias muaj ntshav liab, tus neeg mob yuav raug kuaj ntshav rau cov ntsiab lus hlau, uas yog ib feem ntawm kev kuaj ntshav siab.
Dab tsi yog Advanced Biochemical AK suav nrog
Daim ntawv ib txwm ntawm "kev kuaj ntshav rau biochemistry" suav nrog txog 20-30 qhov ntsuas. Thaum kawm thawj zaug, tus kws kho mob zuam tawm tsuas yog qee qhov ntsuas uas yuav tsum tau tshawb xyuas. Feem ntau cov no yog: tag nrho cov protein, tag nrho bilirubin, qabzib, urea, enzyme kev ua - AST, ALT, alkaline phosphatase.
Yog tias xav tias muaj tus kab mob no, kev kuaj ntshav txuas ntxiv yog tsim los kuaj xyuas qhov tseeb, uas qhia txog qhov xwm txheej ntawm lub cev. Piv txwv li, yog tias xav tias atherosclerosis, daim ntawv teev cov kev ntsuam xyuas yuav suav nrog, ntxiv rau tag nrho cov roj (cholesterol) tag nrho: triglycerides, lipoproteins. High density (HDL), tsawg ntom (LDL) thiab tsawg ntom (VLDL). Cov npe tuaj yeem nthuav dav ntxiv los ntawm kev kawm cov ntsiab lus ntawm lipoprotein a, apolipoprotein A1, apolipoprotein B.
Kev kuaj ntshav biochemical
Yog tias tsim nyog, cov kev tshawb fawb biochemical hauv qab no tuaj yeem suav nrog hauv cov npe ntawm kev kuaj ntshav biochemical siab:
| YBiochemical indicator | Meaning |
| Glucose (los yog ntshav qab zib) | Qhov taw qhia ntawm carbohydrate metabolism, tus cim ntawm cov teeb meem hauv endocrine system lossis daim siab. Qhov taw qhia muab kev tswj ntshav qab zib hauv ntshav qab zib. Cov neeg mob hnyav yuav tsum tau saib xyuas qhov ntsuas no thiab kuaj ntau zaus. |
| Bilirubin | Qib ncaj qha bilirubin qhia lub peev xwm tso kua tsib los ntawm lub gallbladder, qib ntawm indirect bilirubin qhia txog lub siab. |
| Urea (los yog cov nitrogen seem) | Cov khoom ntawm kev ua cov protein. Nws raug tso tawm los ntawm ob lub raum, yog li qib qhia lawv tus mob. |
| Qib qhia txog kev ua haujlwm ntawm lub raum thiab lub zog metabolism hauv lub cev. suav nrog ua ke nrog urea. | |
| YCov roj (cholesterol) | Qhov taw qhia ntawm cov roj metabolism. Cov neeg mob uas muaj kab mob plawv yuav tsum saib xyuas qhov ntsuas no. |
| ACT | Intracellular enzyme, yog li feem ntau nws cov haujlwm hauv cov ntshav yog tsawg. Nkag mus rau hauv cov ntshav (kev ua haujlwm nce ntxiv yog kuaj pomnyob rau hauv kev tsom xam) nyob rau hauv cov ntaub ntawv ntawm kev puas tsuaj rau ib yam kabmob, feem ntau yog lub plawv, siab, txiav. |
| ALT | Intracellular enzyme, yog li feem ntau nws cov haujlwm hauv cov ntshav yog tsawg. Nws nkag mus rau hauv cov ntshav (cov haujlwm nce ntxiv yog kuaj pom hauv kev tshuaj ntsuam) yog tias muaj kev puas tsuaj rau daim siab. |
| Amylase | Enzyme, kev hloov pauv hauv kev ua ub no qhia txog pathology ntawm lub plab lossis pancreas. |
| GTF | Enzyme, kev hloov pauv hauv kev ua ub no qhia tias ua txhaum ntawm daim siab, kab mob biliary. |
| LDG | Enzyme, nws cov isoforms sib txawv yog nyob hauv cov kabmob sib txawv. Yog li, qhov kev hloov pauv ntawm qee yam isoforms qhia txog kev puas tsuaj rau lub cev, piv txwv li, LDH4 - lub siab. |
| Alkaline Phosphatase | Enzyme, kev ua ub no qhia txog lub xeev ntawm cov kua tsib, pob txha, plab hnyuv, raum, placenta. |
| tag nrho protein | Qib qhia qhov kev siv ntawm cov metabolism hauv feem ntau, muaj cov as-ham. |
| Albumin | Cov ntshav protein ntau, qib qis qhia tias lub cev qhuav dej, qib siab tsis tshua muaj. |
| Triglycerides | Zog substrates. Fat metabolism qhia. |
| ntshav hlau | Nws yog ib feem ntawm hemoglobin ntawm cov qe ntshav liab. Qhov txo qis hauv qhov ntsuas tau lees paub qhov kev kuaj mob ntawm hlau deficiency anemia. |
txheej txheem sau ntshav
Feem ntau, rau kev tshuaj ntsuam dav dav, ntshav yog muab los ntawm tus ntiv tes, thiab raubiochemical thiab lwm yam - los ntawm cov hlab ntsha. Txawm li cas los xij, yog tias xav tau kev tshuaj xyuas dav dav, ces yuav tsum muaj cov khoom siv ntxiv, thiab nws yog qhov nyuaj rau kev noj ntshav ntau los ntawm tus ntiv tes. Leej twg tau pub ntshav los ntawm tus ntiv tes tsawg kawg ib zaug nco ntsoov tias nws nyuaj npaum li cas rau tus neeg ua haujlwm noj qab haus huv los nyem ob peb tee xwb.
Rau qhov kev soj ntsuam txuas ntxiv, cov ntshav yuav raug coj los ntawm cov hlab ntsha, feem ntau yog los ntawm cubital fossa lossis los ntawm cov leeg ntawm lub hauv pliaj lossis tes. Tes yog tso tawm ntawm cov khaub ncaws. Muab ib daim ntaub oilcloth rau hauv qab lub luj tshib. Lub tes yog qis qis. Ib tug tourniquet (venous cuff) yog siv me ntsis saum lub luj tshib ntawm daim ntaub so ntswg los yog ris tsho hauv qab. Tus neeg ua haujlwm noj qab haus huv hnov lub plawv dhia thiab pom cov hlab ntsha uas muaj ntau tshaj plaws. Ces koj yuav tsum tuav koj lub nrig ob peb zaug, ces clamp nws.
Ntshav yog siv los ntawm lub tshuab nqus tsev. Nws yog sau nyob rau hauv ob peb lub xeem raj, externally txawv nyob rau hauv cov xim ntawm lub kaus mom. Txhua lub raj yog tsim los rau nws tus kheej - ib qho los yog ntau dua kev soj ntsuam. Piv txwv li, kev tshawb fawb hematological tsuas yog ua tiav nkaus xwb - tsis yog cov ntshav coagulated. Txhawm rau tiv thaiv cov ntshav los ntawm txhaws, cov tshuaj reagents tshwj xeeb tau ntxiv rau hauv lub raj kuaj. Cov hlab no muaj ntshav (EDTA) lossis ntsuab (heparin) lub kaus mom. Hloov pauv, txhua qhov kev tshuaj ntsuam biochemical yog ua nrog cov ntshav. Nws settles thaum cov ntshav txhaws. Silicon dioxide yog siv rau qhov no. Silica raj muaj cov kaus mom liab.
Tom qab noj cov ntshav, cov tourniquet thawj zaug yuav raug tshem tawm, tsuas yog tom qab ntawd rab koob yuav raug tshem tawm ntawm cov leeg. Ib qho cawv paj rwb pob yog siv rau qhov chaw puncture. Koj yuav tsum tuav koj txhais tes ntawm lub luj tshib thiab tuav nws li 3-5 feeb. Yog tias txhais tes tsis yog clamped kom zoo, hematoma yuav tsim. Yog li ntawd, nws tsis yog yuav tsum tau xyuas seb cov ntshav yog los ntawm qhov puncture los yog tsis. Tuav koj txhais tes tsawg kawg 3 feeb!
