Routine blood test is the most basic blood test. Blood consists of liquid and tangible cells, and the routine examination of blood is the cellular part of blood. Blood has three different functions: red blood cells (commonly known as erythrocytes), white blood cells (commonly known as leukocytes) and platelets. By observing the quantitative changes and morphological distribution, diseases can be judged. It is one of the auxiliary examination methods commonly used by doctors to diagnose the disease.
Erythrocyte examination
Normal value: male (4.0 ~ 5.5)? 10 * 12/L； Female (3.5 ~ 5.0)? 10 * 12/L； Newborns (6.0 ~ 7.0)? 10 * 12/ l
Clinical significance: Erythropenia in routine blood examination is common in anemia caused by various anemia and diseases. Polycythemia is common in blood concentration, polycythemia vera, hypoxia and so on. 2
Leukocyte examination
Normal value: adult (4.0 ~ 10.0)? 10*9/L newborn (15.0 ~ 20.0)? 10 * 9/ l
Clinical significance: During routine blood examination, most patients have elevated white blood cells, so diseases usually occur when white blood cells are abnormal. Such as various inflammations, burns, malaria, typhoid fever and virus infection.
hemoglobin
Normal value: male 120 ~ 160 g/L female1/kloc-0 ~150 g/l newborn170 ~ 200 g/l.
The clinical significance of hemoglobin increase or decrease is basically similar to that of red blood cell count, but hemoglobin can better reflect the degree of anemia.
Platelet number
Normal value: (100 ~ 300)? Reticulocyte count 10*9/L: 0.5%- 1.5%.
Clinical significance: The main function of platelets is to stop bleeding. According to the number of platelets, diseases can be judged, such as thrombocytosis, acute infection, hemolysis, fracture, thrombocytopenic purpura, hypersplenism, uremia and so on.
Bleeding time measurement (BT)
Normal value: paper method (1-5min)
Clinical significance: According to the length of bleeding time in routine blood examination, diseases such as thrombocytopenia, platelet dysfunction, acute leukemia and scurvy can be judged.
Second, blood lipid examination
(1) Blood lipid detection is a method for quantitative determination of lipids in blood (plasma). Blood lipid is the general name of neutral fats (triglycerides and cholesterol) and lipids (phospholipids, glycolipids, sterols and steroids) in plasma, which widely exists in human body. They are essential substances for the basic metabolism of living cells.
(2) Normal value
1) total cholesterol (TC): the normal range is 5.23-5.69 mmol/L. ..
2) Triglyceride (TG): The normal range varies greatly, from 0.56 to1.7 mmol/L. ..
3) High density lipoprotein cholesterol (HDL-C): the normal range is greater than1.00 mmol/L. ..
4) Low density lipoprotein cholesterol (LDL-C): the range is less than 3.1.2 mmol/L. ..
(2) Clinical significance
1) total cholesterol
If it exceeds 5.72 mmol/L, it can be regarded as an increase in blood lipid. The level of total cholesterol mainly depends on diet, physical labor, environment, gender and age. Women will increase significantly after menopause; The neonatal concentration is very low, and it will soon approach the adult level after breastfeeding; It will also increase with age.
2) Triglycerides
If it exceeds 1.7 mmol/L, it is the increase of triglycerides, which is a risk factor for atherosclerosis and coronary heart disease. If it is lower than 0.56 mmol/L, it is called hypotteganemia. It can be seen in some hereditary diseases with lipoprotein deficiency or secondary abnormal lipid metabolism, such as digestive tract diseases, endocrine diseases (hyperthyroidism, chronic adrenal insufficiency), advanced tumors, cachexia and the application of drugs such as heparin.
3) High density lipoprotein cholesterol (HDL-C): It is influenced by many factors, such as age, sex, race, diet, obesity, drinking and smoking, exercise, drugs, etc.
4) Low density lipoprotein cholesterol (LDL-C): The therapeutic target of LDL-C in patients with hyperlipidemia is below 2.6 mmol/L, and the increase is common in familial hypercholesterolemia and type Ⅱ A hyperlipoproteinemia.
(3) People who need to be examined: patients with coronary heart disease, coronary atherosclerosis, heart disease and obesity.
(4) Possible diseases with high results:
Hypertriglyceridemia, hyperlipoproteinemia, diabetes and hypertension, three highs, hyperlipidemia, acquired hyperlipoproteinemia, generalized verruca plana, obesity.
(5) Taboos before inspection:
1) Fasting: fasting begins on 10 the night before blood collection, and venous blood is taken at 9:00- 10 the next morning, that is, blood collection on an empty stomach exceeds 12 hours in the morning.
2) Avoid high-fat food in the last meal before blood test; Don't drink alcohol, because drinking alcohol can obviously increase the concentration of triglyceride-rich lipoprotein and high-density lipoprotein (HDL) in plasma, leading to errors in the test results.
3) The experiment was carried out under relatively stable physiological and pathological conditions. The blood lipid level will change with some physiological and pathological conditions. Such as trauma, acute infection, fever, myocardial infarction, menstruation and pregnancy.
3. Blood glucose fasting whole blood glucose 3.9 ~ 6.1mmol/L (70 ~110 mg/dl), plasma glucose 3.9 ~ 6.9 mmol/L (70 ~125mg/dl). 65438+ 0 hour after meal: blood sugar is 6.7-9.4 mmol/L, and the maximum is not more than11.1mmol/L (200 mg/dl). After meal, it returns to normal 3 hours, and urine sugar is negative every time.
If the fasting blood glucose exceeds11.1mmol/L (200 mg/dl), it means that there is little or no insulin secretion. Therefore, when fasting blood glucose is significantly increased, diabetes can be diagnosed without other tests.
Tip: Fasting blood glucose test is generally done. Please don't eat before the test. Carbohydrates in food can be converted into glucose after digestion, which will seriously affect your blood sugar index.
Hypoglycemia standard: the fasting blood glucose concentration of adults below 2.8mmol/L is called hypoglycemia.
Fourth, uric acid.
Normal reference value
Phosphotungstic acid reduction method:
Male: 149 ~ 4 16 umol/L female: 89 ~ 357 umo1/l.
Uricase? Peroxidase coupling method:
Adults: 90 ~ 420 umo1/l.
Elevated uric acid often causes gout.
Five, liver function examination
Liver function examination is to detect various indexes related to liver function metabolism through various biochemical examination methods to reflect the basic situation of liver function. Protein examination related to liver function includes serum total protein, albumin to globulin ratio, blood turbidity and flocculation test, and alpha-fetoprotein examination. Serum enzymes related to liver diseases include alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and lactate dehydrogenase. Tests related to biotransformation and excretion include sodium sulfobromophthalein retention test; Experiments related to bile pigment metabolism, such as bilirubin quantification and urine three bile test.
Normal value (subject to the inspection result sheet of the inspected hospital)
Clinical significance
Abnormal result
1, alanine aminotransferase increased: acute and chronic viral hepatitis, liver injury caused by drinking, liver injury caused by drugs, ALT abnormality caused by other factors (fatty liver, liver cancer, etc.). ).
2, aspartate aminotransferase: aspartate aminotransferase (AST) increased >; 60u/L: acute myocardial infarction, acute hepatitis, drug-induced hepatocyte necrosis, active chronic hepatitis, active liver cirrhosis, liver cancer, myocarditis, nephritis and myositis.
3. Analysis of the ratio of alanine aminotransferase to aspartate aminotransferase: A large increase in aspartate aminotransferase means that liver cells are seriously damaged. Therefore, ALT/AST ratio is often used as a diagnostic index and a disease monitoring index in clinic.
4、? Analysis of transglutaminase (GGT) results: GGT mainly comes from the hepatobiliary system, so it is mainly a monitoring item of hepatobiliary diseases.
(1) GGT of liver inflammation increased slightly and moderately.
(2) Other hepatobiliary diseases, such as liver cancer, obstructive jaundice, biliary cirrhosis, cholangitis, gallbladder polyps, gallstones, pancreatitis, pancreatic head cancer, biliary tract cancer, etc. And GGT increased significantly.
5. Analysis of bilirubin results
(1) When liver cells are damaged, such as hepatitis, direct and indirect bilirubin will increase significantly.
(2) Biliary diseases, especially gallstones, gallbladder polyps, cholecystitis, etc. However, the direct bilirubin in the blood increased significantly.
(3) Hemolytic diseases increase the source of bilirubin in blood, and the liver treatment is not timely, which leads to a significant increase in indirect bilirubin.
6. Analysis of the results of total protein, albumin and globulin.
The content of protein in blood can reflect the liver function. If protein decreases, it means that the synthetic function of the liver is impaired, which is a serious manifestation of diseases, such as chronic active hepatitis, liver cirrhosis, liver failure and so on. Some non-liver diseases can also change protein in blood, so we should pay attention to some physiological factors when analyzing the results.
It is necessary to examine patients with impaired liver function or in health examination.
7. Preventive measures
Taboos before inspection:
(1) Be careful not to take drugs before the examination, because some drugs will increase the burden on the liver and cause temporary damage to the liver function, thus causing the accuracy of the liver function test results.
(2) Pay attention to ensuring adequate sleep before the examination, and do not do strenuous exercise, which may lead to an increase in transaminase, thus affecting the examination results.
(3) Never drink alcohol the day before. Drinking alcohol will lead to the increase of transaminase, which will affect the test results.
Taboos during inspection:
1, you can't eat before examination, and you need to be on an empty stomach for blood test. The fasting time is usually 8 ~ 12 hours.
2. The venous blood should be fresh and tested immediately.
6. Renal function examination is an experimental method to study renal function. The commonly used measurement items include blood urea nitrogen, blood creatinine, blood urea and endogenous creatinine clearance rate. Many environmental pollutants, such as lead, mercury, cadmium, chromium, arsenic, hydrocarbon solvents and petroleum products, can cause kidney damage, and renal function examination is an important index.
1, blood urea nitrogen
Reference value: normal situation: diacetyl-oxime chromogenic method 1.8 ~ 6.8 mmol/L urease-Nessler chromogenic method 3.2 ~ 6.1mmol/l.
Clinical significance: acute and chronic nephritis, severe pyelonephritis, acute and chronic renal insufficiency caused by various reasons, heart failure, shock, massive internal bleeding, burns, dehydration, adrenal cortex hypofunction, prostatic hypertrophy, chronic urinary tract obstruction, etc.
2. Serum creatinine
Reference value: normal condition: adult male 79.6 ~ 132.6? Mol/L female 70.7 ~ 106. 1? Mol/L children 26.5 ~ 62.0? Mol/L whole blood 88.4 ~ 159. 1? Molar/liter.
Clinical significance: supplements: renal failure, uremia, heart failure, gigantism, acromegaly, salicylate treatment, etc. Decrease: progressive muscular atrophy, leukemia, anemia, etc.
3. Blood urea
Reference value: normal situation: 3.2 ~ 7.0 mmol/L.
Clinical significance: Elevated levels indicate acute and chronic nephritis, severe pyelonephritis, acute and chronic renal insufficiency caused by various reasons, heart failure, shock, burns, dehydration, massive internal bleeding, adrenal cortical hypofunction, prostatic hypertrophy, chronic urinary tract obstruction, etc.
4. Endogenous creatinine clearance rate in blood
Reference value: Normal condition: 0.80 ~ 1.20ml for adults? S- 1/ m2
Clinical significance: endogenous creatinine clearance rate decreased to 0.5 ~ 0.6 ml? When s-l/m2, glomerular filtration function decreases, such as