PRINCIPALII CONSTITUIENTI ORGANICI AI SANGELUI

Roxana_zaha@yahoo.com, gr.5 AS mg
COMPUSII NEAZOTATI
Glucoza
Valori normale:
70-120 mg/100 mL

Scaderi patologice
hiperinsulinism
hipertiroidism
atrofia galbena a ficatului

Cresteri patologice
diabet zaharat
hipersecretie de adrenalina
tumori hipofizare sau suprarenale

La 180 mg glucoza /100 mL sânge, rinichiul nu mai face fata reabsorbtiei si

glucoza trece în urina = glucozurie (sinonim: meliturie)

Acid lactic

Valori normale:

9-15 mg/100 mL

Cresteri patologice
hepatopatii
insuficienta cardiaca
dupa eforturi fizice mari.

Acid piruvic

Valori normale:
0,9-1,2 mg/100 mL

Cresteri patologice
deficienta de vitamina B 1
alcoolism
în cursul exercitiilor fizice grele
Lipide totale

Valori normale:
600-800 mg/100 mL

Scaderi patologice
nou-nascuti
hipertitoidie (arderile sunt mai inense)
Cresteri patologice
Cresteri primare (mostenite, familiale);
Cresteri secundare
guta
diabet
alcoolism
administrare de anticonceptionale orale
hipotiroidie

Colesterol

Valori normale:
120-200 mg/100 mL

Scaderi patologice
sarcina
hipertitoidie (arderile sunt mai inense)
Cresteri patologice
ateroscleroza
diabet
guta

COMPUSI AZOTATI NEPROTEICI

Uree

Valori normale:
20-40 mg/100 mL
Scaderi patologice
insuficienta renala
degradare excesiva de proteine
tumori
iradieri
aport excesiv de proteine alimentare
Cresteri patologice
atofia galbena
necroza hepatica (nu se sintetizeaza uree)
Acid uric

Valori normale:
F: 2,6-6 mg/100 mL
B: 3,5-7 mg/100 mL

Scaderi patologice
afectiuni hepatice
Cresteri patologice
guta
leucemie
boli de iradiatie
Creatina si creatinina

Valori normale: Creatina:

0,2-0,6 mg/100 mL
Creatinina:
0,6-1,1 mg/100 mL
Scaderi patologice
functiuni hepatice defectuase
Cresteri patologice
distrofie musculara
miastenia gravis
poliomielita

Bilirubina

Valori normale:
Bilirubina directa (conjugata):
0,1-0,2 mg/100 mL
Bilirubina indirecta (libera, neconjugata):
0,1-0,6 mg/100 mL
Bilirubina totala (directa + indirecta): 0,2-0,8 mg/100 mL
Cresteri patologice : icter (colorare în galben a pielii, scleroticii (albul
ochiului) si a mucoaselor, din cauza acumularii în sânge a bilirubinei)
Icter mecanic (obstructiv). Datorat calculilor biliari sau diverselor tumori.
Ficatul functioneaza normal, dar nu poate elimina bilirubina.
Caracteristici: bilirubina directa crescuta;
urobilinogen normal;
hemoliza normala.
Icter hemolitic. Datorat degradarii crscute a eritrocitelor. Ficatul nu poate
conjuga toata bilirubina indirecta.
Caracteristici: bilirubina indirecta crescuta;
stercobilinogen crescut;
urobilinogen crescut;
hemoliza ridicata.
Icter hepatocelular. Datorat microbilor (virusul hepatic). Celulele hepatice
sunt afectate.
Caracteristici: bilirubina directa crescuta;
bilirubina indirecta crescuta;
urobilinogen crescut;
hemoliza ridicata.
Icterul nou-nascutului. .
fiziologic - frecvent la prematuri;
la laptele matern - cauzat de prezenta în lapte a unei substante ce împiedica
conjugarea bilirubinei.

COMPUSI AZOTATI PROTEICI

Proteine
Valori normale:
6-8 g/100 mL
Scaderi patologice
afectiuni ale ficatului
ingestii scazute de proteine
eliminari mari de proteine în arsuri grave
în pierderi prin urina
Cresteri patologice
în poliglobulii (boala rara)
aparitia de proteine anormale
Disproteinemie = orice afectiune caracterizata printr-o hiperproductie de
imunoglobuline (disglobulinemie = anomalie cantitativa sau calitativa a
globulinelor)

Reactia cu timolul

0-5 unitati Mac Lagan à reactie negativa

5-7 unitati Mac Lagan à reactie slab pozitiva
> 7 unitati Mac Lagan à reactie intens pozitiva.

Proteinele sunt substante organice complexe ale materiei vii, care contin
azot, sulf si fosfor. Ele sunt necesare pentru cresterea organismului pentru
refacerea celulelor uzate, precum si pentru producerea de energie calorica,
un gram de proteine producand 4 calorii. Majoritatea proteinelor din
organismul omului provin din alimente bogate in proteine, fie de origine
animala (carne, lapte, branza, oua), fie de origine vegetala (fasole, mazare,
soia, linte etc.). Analiza proteinelor se face din serul sanguin. Exista mai
multe feluri de analize care exploreaza diferite componente ale proteinelor,
astfel: proteine totale, electroforeza, fibrinogenul, teste hepatice etc.

Cuprins articol
1. Generalitati
2. Proteine totale
3. Electroforeza serului (proteinograma)
4. Probe hepatice
5. Fibrinogen
6. Produsi de degradare ai proteinelor
Proteine totaleSus

Proteinele totale reprezinta cantitatea globala a proteinelor sanguine

exprimate in grame la 100 ml ser sanguin.
Valorile normale ale proteinelor sanguine sunt:
- la adulti = 6,6- 8,6 g la 100ml
- la copii 1-3 ani = 6,0 - 8,6 g la 100ml.
Din acestea, circa 60% (3,6-4,8g) sunt constituite din albumina restul din
globuline. Cantitatea de proteine din ser depinde si de alimentatie, cand
alimentatia este foarte bogata in proteine, creste si concentratia lor in sange
si invers proteinele sanguine scad din sange in subnutritia proteica.
Scaderea proteinelor sanguine se intalneste in diferite boli. Astfel, cand
ficatul care este laboratorul ce fabrica proteinele, se imbolnaveste scade si
concentratia proteinelor din sange. La fel se intampla cand omul pierde
proteinele prin hemoragii sau prin urina (albuminurie). Varsaturile, care
impiedica alimentatia normala, bolile de stomac, intestin si pancreas care
perturba digerarea proteinelor, diareea sunt numai o parte din cauzele care
scad concentratia sanguina de proteine. De asemenea, efortul fizic intens,
stresul nervos, precum si bolile care produc febra prin consumul crescut de
proteine, contribuie la scaderea proteinelor organismului. Scazand proteinele
din sange, organismul cauta sa le inlocuiasca apeland la proteinele din
organele sale si mai ales din muschi, fapt ce duce la slabirea si la scaderea in
greutate a corpului.Deoarece proteinele sanguine au capacitatea de a retine
apa in vasele sanguine, prin scaderea lor, apa din vasele sanguine trece in
tesuturile corpului (maini, picioare etc.) producand edeme.
Mai rar, proteinele sanguine pot sa aiba valori crescute, ca in unele boli
genetice si parazitare sau ca in hipertensiunea arteriala.

Electroforeza serului (proteinograma)

Daca pe o hartie de filtru pusa in legatura cu un curent electric continuu se

pune o picatura de ser sanguin, proteinele totale din ser sunt descompuse in
5 categorii de substante numite fractiuni proteinice. Valorile medii normale
ale acestor fractiuni (care se refera la persoanele de varsta adulta si normal
hranite) pot sa varieze pana la 10% in plus sau in minus, in special la copii,
varstnici sau la persoane care nu se alimenteaza normal.

Valori normale

Fractiunea proteica a Proportii inprocente Proportii in grame

serului
Albumine 52-62% 3,64-4,34
Globuline 38-48% 2,66-3,36
din care:
alfa-1-globuline 2-5% 0,14-0,35
alfa-2-globuline 6-9% 0,42-0,63
beta-globuline 8-11% 0,56-0,77
gama-globuline 14-21% 0,98-1,47

Probe hepaticeSus

Probele hepatice sau testele de disproteinemie, sunt analize care exploreaza

capacitatea ficatului de a sintetiza proteinele normale, necesare
organismului. Un ser cu proteine normale in prezenta reactivilor cu care se
fac probele hepatice, nu produce modificari vizibile. Dar un ser cu proteine
modificate, in urma unor boli, produce cu reactivii respectivi o tulbureala.
Cu cat tulbureala este mai mare, cu atat si modificarile biochimice ale
proteinelor sunt mai intense.
In categoria analizelor care exploreaza functia hepatica intra reactia cu
Timol, reactia Takata, Gros etc. Aceste analize devin anormale (pozitive)
mai ales in bolile de ficat: hepatita acuta si cronica, ciroza, colecistita. Dar
ele devin pozitive si in alte boli, in care se produc fractiuni proteinice
anormale: boli de rinichi, de plamani, de splina, boli de sange si tumorale.
Deci nu orice proba hepatica cu volori crescute arata o boala de ficat dupa
cum nu indica totdeauna nici gradul de gravitate al bolii. De altfel aceste
probe se pot modifica de la o luna la alta dupa tratament si regim alimentar.
De aceea probele hepatice se interpreteaza intotdeauna in corelatie cu alte
analize ajutatoare: proteinele totale, electoforeza etc.
Serul prea gras falsifica rezultatele probelor hepatice. De aceea, persoanele
care isi fac aceste analize nu vor manca cu 12 ore inainte de recoltarea
sangelui. Bolnavii cu diabet, netratat au un sange gras. Inainte de a-si face
probele hepatice, ei trebuie sa-si trateze mai intai diabetul, caci grasimile din
serul lor nu scad numai cu regim alimentar.

Valori normale ale probelor hepatice

Testul, analiza Valori normale

Timol 1-4 unitati Mag Lagan
Takata-Ara Reactia negativa (analiza normala) se
noteaza cu minus
Reactia pozitiva (analiza anormala)
se noteaza cu 1-3 plusuri
Gros Reactia negativa (analiza normala) se

Sulfat de cadmiu
Sulfat de zinc (Kunkel)
noteaza cu minus
Reactia pozitiva (analiza anormala)
se noteaza cu 1-3 plusuri
Reactia negativa (analiza normala) se
noteaza cu minus
Reactia pozitiva (analiza anormala)
se noteaza cu 1-3 plusuri
2-12 unitati

FibrinogenSus

Fibrinogenul este o substanta proteinica din sange care este sintetizata de

ficat si care are rol important in coagularea sangelui.
Valori normale ale fibrinogenului: 200-400 mg la 100 ml sange.
Scaderea fibrinogenului sub aceste valori poate produce hemoragii la
bolnavii cu boli ale ficatului. Fibrinogenul creste insa foarte mult (peste 500
mg la 100 ml sange) in bolile infectioase acute si mai ales in reumatismul
articular acut.

Produsi de degradare ai proteinelorSus

Ca urmare a consumului de proteine de catre organism rezulta si o serie de

produsi de degradaresaudeseuri, care nu mai pot fi utilizate si pe care
organismul le elimina din sange in urina, iar in cantitati mai mici si prin
transpiratie. Cele mai importante deseuri de proteine sunt: acidul uric,
creatinina si ureea. Aceste substante se gasesc in mod normal, in sange, in
concentratii mici, dar ele devin otravitoare pentru organism daca depasesc
un anumit nivel de concentratie. De aceea, organismul le elimina prin rinichi
in urina.

Acidul uric, creatinina si ureea cresc in sange si urina dupa consumul de

alimente bogate in proteine, in bolile care distrug sau consuma in mod
exagerat proteinele corpului (boli infectioase, boli de sange etc.). In bolile de
rinichi (nefrita acuta si cronica, insuficienta renala) aceste substante nu mai
pot fi filtrate si eliminate prin rinichi si atunci se acumuleaza in sange,
producand tulburari grave in organism. In urma efortului fizic, concentratia
acestor substante este de asemenea mai mare decat in stare de repaus.
Acidul uric creste foarte mult la persoanele care consuma cantitati mari de
carne si organe (ficat, rinichi, splina, creier, icre) precum si la unele
persoane predispuse sa produca mult acid uric. Cresterea peste masura a
acidului uric in sange produce boala numita guta asemanatoare cu
reumatismul, iar eliminarea de cantitati mari de acid uric in urina poate sa
duca la formarea de calculi urinari compusi din acid uric. Alcoolul, cafeaua,
ceaiul, unele medicamente (vitamina C, aspirina, antinevralgicele, cortizonul
etc.) cresc concentratia acidului uric din sange. De aceea aceste substante nu
se vor consuma cu 24 ore inainte de efectuarea analizelor.

Valori normale ale deseurilor proteice

Deseurileproteinice In sange In urina

Acidul uric 2-5 mg/100 ml 0,30-0,80 g/24h
Ureea 20-50 mg/100 ml 15-35 g/24h
Creatinina 0,6-1,2 mg/100 ml 0,8-1,9 g/24h

Concentratia ureei sanguine este mai mica la femei si la copii, la persoanele

subnutrite, in bolile de ficat, cand acest organ nu mai poate produce uree.
Insuficienta renala acuta si cronica, infectiile insotite de febra, obstructia
cailor urinare (litiaza urinara, marirea prostatei) sunt cauze patologice care
cresc peste normal ureea sanguina.

Proteins are complex organic substances of living matter, containing

nitrogen, sulfur and phosphorus. They are necessary for cell growth
to restore the body waste to produce energy and heat, producing one
gram of protein 4 calories. Most proteins in the human body from
protein foods or animal origin (meat, milk, cheese, eggs) or vegetable
(beans, peas, soybeans, lentils, etc.).. Analysis is made of blood
serum proteins. There are several kinds of analysis that explores
different protein components, as follows: total protein,
electrophoresis, fibrinogen, liver tests, etc..

Article Contents
GeneralitatiProteine totaleElectroforeza serum (proteinograma)
Evidence of protein degradation hepaticeFibrinogenProdusi
TotaleSusProteinele protein represents total global amount of blood
protein expressed in grams per 100 ml of blood serum.
Normal values of blood proteins are:
- Adults = 6.6 to 8.6 g per 100ml
- Children 1-3 years = 6.0 to 8.6 g per 100ml.
Of these, about 60% (3,6-4,8 g) consisting of albumin rest of
globulins. Serum protein depends on nutrition when food is very rich
in protein, and increases their concentration in the blood and blood
proteins reverse the decline in blood protein malnutrition.

Lowering blood protein is found in various diseases. Thus, when the

liver is the laboratory to produce proteins, falls ill and protein
concentration in the blood. Same happens when man loses proteins
by bleeding or urine (albuminuria). Vomiting, which prevents the
normal diet, stomach, intestine and pancreas that disrupt protein
digestion, diarrhea cases are only part of lowering blood protein
concentration. Also, strenuous physical effort, nervous stress, and
diseases that cause fever by increased consumption of protein,
contributes to lower body proteins. Lowering of blood proteins, the
body tries to replace them appealing to its organs and proteins mostly
muscle, which leads to weakness and weight loss of
corpului.Deoarece blood proteins have the capacity to retain water in
the blood vessels by decreasing their water from blood vessels in
tissue cross body (hands, feet, etc..) causing swelling.
More rarely, blood proteins may have increased, as in some genetic
diseases and parasitic or in hypertension.

Serum electrophoresis (proteinograma)

If a filter paper placed in connection with an ongoing power put a drop
of blood serum, total serum proteins are broken down into 5
categories of substances called protein fractions. Normal mean
values of these fractions (which refers to people of adult age and fed
normally) can vary up to 10% more or less, especially in children,
elderly or people who do not eat normally.

Normal

Serum protein fraction

 Proportion inprocente
 Proportions in grams
 
Albumins
 52-62%
 3,64-4,34
 
Globulins
of which:
 38-48%
 2,66-3,36
 
alpha-1-globulins
 2-5%
 0,14-0,35
 
alpha-2-globulins
 6-9%
 0,42-0,63
 
beta globulins
 8-11%
 0,56-0,77
 
gamma-globulins
 14-21%
 0,98-1,47
 

HepaticeSusProbele liver samples or tests disproteinemie are tests

that explore the ability of normal liver to synthesize proteins
necessary for the body. A normal serum protein in the presence of
reagents that are liver samples, produces no visible changes. But a
modified serum proteins, because of illness, those reagents produce
a slurry. As the slurry is higher, with both protein and biochemical
changes are more intense.
In the category of liver function tests that explore intra reaction with
thymol, Takata reaction, etc. Thick. These tests become abnormal
(positive), especially in liver diseases: acute and chronic hepatitis,
cirrhosis, cholecystitis. But they are positive and other diseases in
which abnormal proteins are produced fractions: kidney disease,
lungs, spleen, blood diseases and cancer. So not any evidence
showing an increased valorem hepatica liver disease as not always
indicate any degree of severity of disease. Besides these tests may
change from month to month after treatment and diet. Liver samples
are therefore always performs in conjunction with other review
helpful: total protein, etc. electoforeza.
Serum samples too fatty liver falsify results. Therefore, people who
do these tests will not eat 12 hours before blood collection. Patients
with diabetes treated with a blood fat. Before-and liver samples do
they have to first treat diabetes, serum because of their lower fat only
diet.

Samples of normal liver

Test analysis

 Normal
 
Thymol
 Mag Lagan 1-4 units
 
Takata-Ara
 Negative reaction (normal analysis) is denoted by minus
Positive reaction (abnormal analysis) is denoted by pluses 1-3
 
Thick
 Negative reaction (normal analysis) is denoted by minus
Positive reaction (abnormal analysis) is denoted by pluses 1-3
 
Cadmium sulfate
 Negative reaction (normal analysis) is denoted by minus
Positive reaction (abnormal analysis) is denoted by pluses 1-3
 
Zinc sulfate (Kunkel)
 2-12 units
 
FibrinogenSusFibrinogenul substance is a blood protein that is
synthesized by the liver and has important role in blood clotting.
Normal levels of fibrinogen: 200-400 mg per 100 ml of blood.
Loss of fibrinogen in these values may cause bleeding in patients
with liver disease. But greatly increases fibrinogen (500 mg per 100
ml of blood) in acute infectious diseases and especially in rheumatic
fever.

ProteinelorSusCa degradation products following consumption of

protein by the body follows a series of degradaresaudeseuri product
that can not be used on the body and remove them from the blood in
the urine and in smaller quantities and by sweating. The most
important protein wastes are uric acid, creatinine and urea. These
substances are found naturally in blood in low concentrations, but are
poisonous to the body if they exceed a certain level of concentration.
Therefore, we remove the body by the kidneys in urine.

Uric acid, creatinine and urea increased in blood and urine after
consumption of foods rich in protein, in diseases that destroy or
unduly consume protein the body (infectious diseases, blood
diseases, etc.).. In kidney disease (acute and chronic nephritis, renal
failure), these substances can not be filtered and eliminated by the
kidneys and then accumulates in the bloodstream, causing serious
disturbances in the body. After physical effort, concentration of these
substances is also higher than at rest.

Uric acid increase in people consuming very large amounts of meat

and offal (liver, kidney, spleen, brain, eggs) and to some people more
prone to produce uric acid. Growth beyond measure uric acid in the
blood produces similar disease called gout rheumatism, and disposal
of large quantities of uric acid in the urine can lead to formation of
urinary calculi composed of uric acid. Alcohol, coffee, tea, some
medications (vitamin C, aspirin, antinevralgicele, cortisone, etc..)
Increase in blood uric acid concentration. Therefore these substances
will not eat 24 hours before testing.
Normal levels of protein waste

Deseurileproteinice

 Blood
 In urine
 
Uric acid
 2-5 mg/100 ml
 0,30-0,80 g/24h
 
Urea
 20-50 mg/100 ml
 15-35 g/24h
 
Creatinine
 0,6-1,2 mg/100 ml
 0,8-1,9 g/24h
 

Blood urea concentration is lower in women and children,

malnourished persons in liver disease, when the body can not
produce urea. Acute and chronic renal failure, infections
accompanied by fever, urinary tract obstruction (bladder stones,
prostate enlargement) are pathological cases that increase above
normal blood urea.