Biochem & Blood analyses

A general blood test involves a study that allows you to identify the number of leukocytes , red blood cells , platelets and haematocrit . In addition, the analysis allows to determine haemoglobin and erythrocyte indices (MCV, MCH, MCHC, RDV). The general analysis of blood is carried out, first of all, for an estimation of the general system of a hemopoiesis, inflammatory processes, the maintenance of a haemoglobin and diagnostics of anaemias.

A clinical blood test , part of which is a general blood test, is the most commonly used method in clinical laboratory diagnostics. Specialists distinguish three basic components of the clinical blood test, namely: general analysis, leukocyte formula and calculation of ESR. All these studies make it possible to determine parameters such as erythrocyte sedimentation rate (ESR), haemoglobin content, white blood cell count, colour index, count the number of red blood cells. If necessary, the number of platelets and reticulocytes is determined.

The technological breakthrough made by medical science and modern haematological analysers, capable of determining virtually all blood counts at the same time and providing some information on the morphology of cells, surely indicates that the definition of a clinical blood test requires substantial supplementation. In a hospital or polyclinic, in most cases, a shortened blood test is made, which is usually called a "three". This analysis includes the determination of haemoglobin, the number of leukocytes and ESR.

The clinical analysis of blood is divided into three main groups:

1. A general blood test that allows you to examine from eight or more indicators (up to 30), which include erythrocytes, haemoglobin, total white blood cell count, platelets, and five leukocyte fractions.
2. Ratio of different types of leukocytes, expressed in percent (Leukocyte formula). Using a microscope, specialists calculate the leukocyte fractions.
3. Determination of ESR.

Counting of reticulocytes is carried out using special dyes and a microscope, when exhibiting a specific diagnosis.

As necessary, it is possible to make a complete study of each of these parameters separately (" Leukocyte blood formula ", " Rate of erythrocyte sedimentation (ESR) "). In medical practice, a general blood test is used, but the most complete information about the blood state can be obtained only by determining all its parameters.

Preparation for diagnosis

The purpose of the study should be explained to the patient.

No restrictions in diet and diet are required.

It is necessary to warn the patient that for analysis it will be necessary to take a blood sample, and to inform who and when will do venepuncture.

The patient should be warned about the possibility of unpleasant sensations during the application of the tourniquet to the arm and venepuncture.

Procedures

Blood  is taken from the vein into a test tube with EDTA.

Stir, but do not shake.

After blood is taken, it is transported to the laboratory at a temperature of 4-8 ° C.

It is possible to take blood from the finger (especially in young children and in patients who are impossible to draw blood from the vein).

Samples with haemolysis or formed clot are not subject to analysis.

Reference Values

Index	Men's	Women
Haemoglobin (HGB, Hb)	122 - 168 g / l	112 - 152 g / l
Erythrocytes (RBC)	3.1 - 5.7 x 10 12 / L	3.6 - 5.1 x 10 12 / L
The average volume of erythrocytes (MCV)	78 - 103	80 - 100 Fl
The mean content of Hb in the erythrocyte (MCH)	26.0 - 35.0 pg	27.0 - 34.0 pg
The mean concentration of Hb in the erythrocyte (MCHC)	310-380 g / l	310-380 g / l
The index of distribution of red blood cells by volume	11.0 - 16.0%	11.0 - 16.0%
Haematocrit (HCT)	30.0 - 49.5%	33.0 - 45.0%
Platelets (PLT)	130 - 400 x 10 9 / l	130 - 400 x 10 9 / l
Rate of platelet count by volume	9.0 - 17.0 fl	9.0 - 17.0 fl
Thrombocytes (PCT)	0.12-0.36%	0.12-0.36%
Leukocytes (WBC)	4.0-8.8 x 10 9 / L	4.0-8.8 x 10 9 / L
Neutrophils (NEUT)	40.0 - 74.0%	40.0 - 74.0%
Eosinophils (EO)	0.0 to 5.0%	0.0 to 5.0%
Basophils (BA)	0.0 to 1.5%	0.0 to 1.5%
Monocytes (MON, MO)	1.0 - 12%	1.0 - 12%
Lymphocytes (LYM, LY)	15.0 - 45.0%	15.0 - 45.0%
Neutrophils (absolute indicator) (NEUT)	1.8-8.0 x 10 9 / L	1.8-8.0 x 10 9 / L
Eosinophils (absolute index) (EO)	0.0 - 0.5 x 10 9 / L	0.0 - 0.5 x 10 9 / L
Basophils (absolute index) (BA)	0.0 - 0.2 x 10 9 / l	0.0 - 0.2 x 10 9 / l
Monocytes (absolute value) (MON, MO)	0.0 - 0.8 x 10 9 / l	0.0 - 0.8 x 10 9 / l
Lymphocytes (absolute number) (LYM)	1.0 - 4.5 x 10 9 / L	1.0 - 4.5 x 10 9 / L

In this table, for example, the norms of a certain age group are given. Therefore, the interpretation of the analysis is carried out taking into account the age that fits into the order form when taking blood.

Changes in the morphology of erythrocytes

1. ANISOCYTOSIS - erythrocytes of different sizes. Anisocytosis is an early sign of anemia. Normocytic - erythrocytes with a diameter of 7.1 - 7.9 microns; microcytic - erythrocytes less than 6.9 microns in diameter; Macrocytic - erythrocytes more than 8 μm in diameter; megalocytes (giant) - more than 12 microns in diameter.
2. Poikilocytosis - erythrocytes of different shapes. The forms of erythrocytes are distinguished: spherocytes, ovalocytes, kodocytes (target), acanthocytes, drepanocyte (crescent), echinocyte, stomachite, degmacyte, dacryocyte (teardrop), schistocyte (cacoid, fragmented cell).
3. ANISOCROMIA - red blood cells of different colors. The color of erythrocytes depends on the content of hemoglobin, basophilic substance and the form of erythrocytes. Normochromic erythrocytes - has a normal hemoglobin content. Hypochromic erythrocytes - has low hemoglobin saturation; hyperchromic - has a high content of hemoglobin.

Biochemical blood test (biochemistry of blood.

A biochemical blood test along with a clinical blood test (investigation of the cellular composition of blood, hemoglobin , ESR ) and urine is a widely used method for diagnosing various diseases and pathological conditions.

Usually, the term "biochemical blood test" is understood as a group of studies in which the content of substances formed in various organs and tissues is studied in the course of their vital activity, which subsequently enter the bloodstream. Thus, the determination of the content of these substances makes it possible to evaluate the work of human organs. Defining biochemical indicators, one can judge the current state of organs and systems of the body, identify in advance the disorders in their functioning, adjust treatment, make a prediction for the future.

The main parameters of blood determined by biochemical methods include: substrates or metabolites - substances formed during enzymatic reactions; proteins, hormones and enzymes are protein molecules that promote the course of these reactions.

Biochemical blood analysis can be ordered in the form of a finished panel or each of the parameters separately.

1. The panel "General Biochemistry of Blood" mini - a set of 9 parameters, giving an initial idea of ​​the work of a number of organs and systems of the human body - the liver, kidneys, cardiovascular system, the presence of inflammatory processes (SRB), the metabolism of carbohydrates (blood glucose) and cholesterol.
2. The panel "General biochemistry of blood" is the optimal - a set of 17 biochemical indicators that allows you to first assess the function of the liver, kidneys, cardiovascular system, the presence of inflammatory processes (SRB), the content of basic electrolytes (sodium and potassium), calcium, carbohydrate and cholesterol.
3. The panel "General biochemistry of blood" is an extended set of 25 biochemical indicators, which allows to estimate the liver, pancreas, kidney, cardiovascular system, bone tissue, presence of inflammatory processes (CRP), the content of basic electrolytes (sodium, potassium, chlorine) , calcium, the metabolism of carbohydrates, cholesterol, uric acid, important trace elements (iron, magnesium, phosphorus).

• AST (aspartate aminotransferase, AST, AST) - the index of damage to the cells of the heart muscle and liver cells. The main indications for use: viral and toxic liver damage, suspected myocardial infarction, preventive examinations.
• ALT (alanine aminotransferase, ALAT, ALT) is one of the main indicators of damage to liver cells and cardiac muscle cells. The main indications for use: viral hepatitis, toxic liver damage, cholestasis, suspicions of myocardial infarction, preventive examinations.
• Bilirubin total - an indicator of the formation of pigments in the liver and spleen during the breakdown of heme-containing proteins. The main indications for use: liver disease (viral hepatitis, cirrhosis, liver tumor, etc.), haemolytic anemia, clinical signs of jaundice (jaundice occurs when the content of bilirubin in the blood exceeds 43 μmol / l).
• Bilirubin direct (bound, conjugated) is an indicator of liver pathology. The main indications for use: liver disease, accompanied by cholestasis, differential diagnosis of jaundice.
• GGTP (gamma-glutamyltranspeptidase, γ-GTP or gamma glutamyltransferase, GGT) is a measure of liver and bile duct disease. The main indications for use: acute and chronic hepatitis, obstructive liver damage, obstructive jaundice, cholelithiasis, tumor process, alcoholic liver damage.
• Alkaline phosphatase (AFP) is an enzyme, an indicator of phosphorus-calcium metabolism of bone tissue and liver diseases accompanied by cholestasis. The main indications for use are: liver disease, pathology of bile ducts, an obstruction of bile outflow, gallstone disease, pancreatic head cancer, bone diseases (osteodystrophy, bone tumors), Paget's disease, osteoporosis.
• Alpha-amylase in the blood - an indicator of damage to the pancreas and salivary glands. The main indications for use: diagnosis of acute pancreatitis, mumps, "acute abdomen"
• Alpha-amylase pancreatic in the blood - an enzyme, an indicator of damage to the pancreas. The main indications for use: diagnosis of pancreatitis, "acute abdomen."
• Glucose (sugar) - an indicator of the diagnosis of diseases associated with a violation of carbohydrate and fat metabolism. The main indications for use: diagnosis of diabetes mellitus and evaluation of its treatment, liver disease, obesity, diseases of the endocrine system (pituitary and adrenal glands), screening studies, in people at risk of developing diabetes.
• Blood creatinine is an indicator that reflects kidney function and skeletal muscle damage. The main indications for use: the study of kidney function, skeletal muscle disease.
• Urea of ​​blood (sampling of tests at home) - an indicator of kidney and liver function, reflects the state of protein metabolism. The main indications for use: acute and chronic kidney disease, heart failure, liver disease.
• Uric acid of blood - the decay rate of nucleotides present in the body and coming from food. The main indications for use: gout, assessment of kidney function, cancer (leukemia).
• The total protein of blood is an indicator characterizing the total content of all proteins in the blood. The main indications for use: liver disease, kidney disease, various infections, cancer and many other diseases.
• Calcium is common (Ca-common) in the blood - a microelement that has various functions (building bones of the skeleton and teeth, clotting of blood). The main indications for the appointment: clinical signs of calcium metabolism, osteoporosis, dysfunction of the thyroid and parathyroid glands, bone disease, sarcoidosis, tumors (more often breast and lung cancer) and metastases with bone damage.
• Calcium ionized (Ca ++) in the blood is a non-protein part of the calcium that is in the serum and represents its active form. The main indications for use: violations of the total calcium metabolism in various diseases (renal failure, dysfunction of the thyroid and parathyroid glands, vitamin D deficiency, gastritis, neoplasms of various localizations).
• Iron (Fe) is a vital macroelement involved in the transfer of oxygen and the functioning of many enzymes. The main indications for the appointment: differential diagnosis of anemia, control of iron deficiency anemia, various acute and chronic diseases, violations of the function of the gastrointestinal tract (impaired absorption), liver disease, general weakness.
• Latent (unsaturated) iron-binding capacity of serum (FGSS, NJSS) is an indicator used to detect iron deficiency in the body. The main indications for the appointment: differential diagnosis of anemia, liver disease (acute hepatitis, cirrhosis), nephritis, evaluation of iron therapy, various chronic diseases, gastrointestinal pathology and associated iron absorption impairment.
• Ferritin is an indicator of the state of iron stores in the body and an indicator of inflammation (the "acute phase" protein). The main indications for the appointment: diagnosis of anemia, signs of hemochromatosis (excessive accumulation of iron), inflammatory processes, tumor growth.
• Potassium, sodium, chlorine - The main indications for the appointment: cardiovascular diseases (arrhythmias, hypertension), renal dysfunction, control in the treatment of diuretics, cardiac glycosides, assessment of acid-base balance.
• Magnesium (Mg) in the blood is an intracellular cation and an important trace element. The main indications to the definition: symptoms of exhaustion (weakness, irritability), neurological pathology (convulsions, tremor, hyperexcitability, tetany), tachycardia, impaired renal function.

Other ongoing studies include a general blood test, urine and faeces, hormones in the blood and urine (thyroid and parathyroid glands, genital, adrenal, heart, pancreas, adipose tissue), tumor markers, diagnosis of infectious diseases, HIV infection, hepatitis (A , B, C, E, G, D, TTV), syphilis, PCR diagnostics of infections, research of genetically-mediated diseases (research of predisposition to them), microbiological studies (dysbacteriosis, urine cultures, sputum and others), diagnosis of diabetes mellitus, exchange and cholesterol, diagnosis of heart and vascular diseases, blood coagulation, digestive system, liver and kidney function and other laboratory diagnostic methods. see.