NGHA CC CH S CN LM SNG

XT NGHIM

BNH
THN
G

NGHA

IN GII

Na+

K+

Cl-

Tng: Khi n, ung qu nhiu mui, mt nc,

suy tim, vim thn khng c ph, vim no, ph
135tim hoc ph thn, khi iu tr bng corticoid,...
145mmo
Gim: Trong trng hp mt nhiu mui, say
l/l
nng, ra nhiu m hi, nn ma, a chy, suy v
thng thn, khi iu tr thuc li tiu ko di,...
Tng: Trong vim thn, thiu nng thn (c v
niu hoc thiu niu), nhim xetonic i ng,
ng c nicotin, thuc ng, Addison- thiu nng
3,5v thng thn,...
5,5mmol
Gim: Khi thiu kali a vo c th, mt kali bt
thng ng tiu ho: nn ma ko di, a
chy, tc rut, hp thc qun,...
Tng: Trong u nng tuyn cn gip, dng nhiu
Vitamin D, ung th (xng, v, ph qun), a u
98tu xng.
108mmo Gim: Trong thiu nng tuyn cn gip, gy co
l/l
git, tetani, thiu vitamin D, ci xng, cc bnh
v thn, vim ty cp, tha xng, long
xng,...

HUYT HC

WBC: S
lng bch
cu

4,010.109

Tng: trong vim nhim, bnh mu c tnh, cc

bnh bch cu, v d nh: bnh bch cu dng
tu cp, bnh bch cu lympho cp, bnh bch
cu dng tu mn, bnh bch cu lympho mn,
bnh u bch cu. Vic s dng mt s thuc cng
c th gy tng s lng bch cu, v d:
corticosteroid
Gim: trong thiu mu do bt sn (gim sn
xut), thiu ht vitamin B12 hoc folate (khng
trng thnh c), nhim khun (gim s sng
st). Vic s dng mt s thuc cng c th gy
gim s lng bch cu: cc phenothiazine,
chloramphenicol, aminopyrine.

RBC: S lng
hng cu

3,85,8.1012

Tng: trong mt nc, chng tng hng cu.

Gim: trong thiu mu.
Tng: trong mt nc, bnh tim v bnh phi.

HGB: Lng
huyt sc t

HCT: Th tch
khi hng cu

12,016,0g/dl

0,350,48l/l

Gim: trong thiu mu, chy mu v cc phn

ng gy tan mu.

Tng: trong cc ri lon d ng, chng tng hng

cu, ht thuc l, bnh phi tc nghn mn tnh
(COPD), bnh mch vnh, trn ni cao, mt
nc, chng gim lu lng mu (hypovolemia).
Gim: trong mt mu, thiu mu, thai nghn.

MCV: Th tch
trung bnh
hng cu

MCH: Lng
huyt sc t
trung bnh
hng cu
MCHC: Nng
huyt sc
t trung bnh
hng cu

Tng: trong thiu ht vitamin B12, thiu acid

folic, bnh gan, nghin ru, chng tng hng
cu, suy tuyn gip, bt sn tu xng, x ho
tu xng.
85-95f

28-32pg

Gim: trong thiu ht st, hi chng thalassemia

v cc bnh hemoglobin khc, thiu mu trong
cc bnh mn tnh, thiu mu nguyn hng cu
(sideroblastic anemia), suy thn mn tnh, nhim
c ch.
Tng: trong thiu mu tng sc hng cu bnh
thng, chng hng cu hnh trn di truyn nng,
s c mt ca cc yu t ngng kt lnh.
Gim: trong bt u thiu mu thiu st, thiu
mu ni chung, thiu mu ang ti to.

32,036,0g/dl

Tng: Trong thiu mu tng sc hng cu bnh

thng, chng hng cu hnh trn di truyn nng,
s c mt ca cc yu t ngng kt lnh.
Gim: Trong thiu mu ang ti to, c th bnh
thng hoc gim trong thiu mu do gim folate

hoc vitamin B12, x gan, nghin ru

Tng: Trong nhng ri lon tng sinh tu xng:
chng tng hng cu, bnh bch cu dng tu
mn, chng tng tiu cu v cn, x ho tu
xng, sau chy mu, sau phu thut ct b lch,
chng tng tiu cu dn n cc bnh vim.
PTL: s lng
tiu cu

LYM%: T l
bch cu
lympho

MXD%:T l
bch cu
mono

Gim: sn xut: c ch hoc thay th tu xng,

150cc cht ho tr liu, cc thuc khc, v d:
350.109/l
ethanol. Tng ph hy hoc loi b: chng ph i
lch, s ng mu trong lng mch ri rc, cc
khng th tiu cu (ban xut huyt do gim tiu
cu t pht, st Dengue, ban xut huyt sau
truyn mu, gim tiu cu do min dch ng loi
tr s sinh, cc thuc: quinidin, cephalosporin.

Tng: trong nhim khun mn, chng tng bch

cu n nhn do nhim khun v nhim virus
khc, bnh bch cu dng lympho mn, bnh
Hodgkin, vim lot i trng, suy tuyn thng
thn, ban xut huyt do gim tiu cu t pht ITP.
17-48%

Gim: trong hi chng suy gim min dch mc

phi (AIDS), c ch ty xng do cc ho cht tr
liu, thiu mu bt sn, cc ung th, cc steroid,
tng chc nng v thng thn, cc ri lon thn
kinh (bnh x cng ri rc, nhc c, hi chng
thn kinh ngoi bin do ri lon t min GuillainBarr syndrome)

1-8%
Tng: trong cc trng hp bnh nhim virus,
nhim k sinh trng, nhim khun, cc ung th,

vim rut, bnh bch cu dng monocyte, u

lympho, u tu, sarcoidosis.
Gim: trong cc trng hp thiu mu do bt
sn, bnh bch cu dng lympho, s dng
glucocorticoid.

NEUT%: T l
bch cu
on trung
tnh

LYM#: S
lng bch
cu lympho

NEUT#: S
lng bch
cu on
trung tnh

RDW-CV:
phn b hng
cu-h s
bin thin

43-76%

Tng: Trong cc nhim khun cp, nhi mu c

tim cp, stress, cc ung th (neoplasms), bnh
bch cu dng tu.
Gim: Trong cc nhim virus, thiu mu bt sn,
cc thuc c ch min dch, x tr .
Tng: Trong nhim khun mn, chng tng bch
cu n nhn do nhim khun v nhim virus
khc, bnh bch cu dng lympho mn, bnh
Hodgkin, vim lot i trng, suy tuyn thng
thn, ban xut huyt do gim tiu cu t pht ITP.

0,63,4G/l

2,06,9g/l

1016,5%

Gim: trong hi chng suy gim min dch mc

phi (AIDS), c ch ty xng do cc ho cht tr
liu, thiu mu bt sn, cc khi u, cc steroid,
tng chc nng v thng thn, cc ri lon thn
kinh (bnh x cng ri rc, nhc c, hi chng
thn kinh ngoi bin do ri lon t min GuillainBarr syndrome).
Tng: trong cc nhim khun cp, nhi mu c
tim cp, stress, cc khi u (neoplasms), bnh
bch cu dng tu.
Gim: Trong cc trng hp nhim virus, thiu
mu do bt sn, s dng cc thuc c ch min
dch, x tr.
phn b hng cu RDW bnh thng v:
MCV tng, gp trong: thiu mu bt sn, trc
bnh bch cu.

MCV bnh thng, gp trong: thiu mu trong cc

bnh mn tnh, mt mu hoc tan mu cp tnh,
bnh enzym hoc bnh hemoglobin khng thiu
mu.
MCV gim: thiu mu trong cc bnh mn tnh,
bnh thalassemia d hp t.
RDW tng v:
MCV tng: thiu ht vitamin B12, thiu ht folate,
thiu mu tan huyt do min dch, ngng kt
lnh, bnh bch cu lympho mn.
MCV bnh thng: thiu st giai on sm, thiu
ht vitamin B12 giai on sm, thiu ht folate
giai on sm, thiu mu do bnh globin.

PDW: phn
b tiu cu

MPV: Th tch
trung bnh
tiu cu

EO%: T l %
bch cu
on a acid

6,0-18f

Gim MCV: thiu st, s phn mnh hng cu,

bnh HbH, thalassemia.
Tng: Trong ung th phi (PDW ung th phi t
bo nh SCLC cao hn ung th phi t bo
khng nh NSCLC), bnh hng cu lim, nhim
khun huyt gram dng, gram m.
Gim: trong nghin ru.
Tng: Trong bnh tim mch (sau nhi mu c
tim, sau tc mch no, i tho ng, tin sn
git, ht thuc l, ct lch, stress, chng nhim
c do tuyn gip, ...

6,5-11f

0,1-7,0%

Gim: Trong thiu mu do bt

nguyn hng cu khng l, ho
bnh bch cu cp, lupus ban
tng nng lch, gim sn ty
chng tng tiu cu hot ng.

sn, thiu mu
tr liu ung th,
h thng, chng
xng, du c,

Tng: trong cc trng hp hn ng d ng nh

st, hen hoc tng nhy cm thuc.
Gim: trong cc trng hp: s dng cc thuc
corticosteroid.

Tng: Trong cc trng hp: cc ri lon d ng.

BASO%: T l
% bch cu
on a kim

0,1
2,5%

EO#: S lng
bch cu a
acid

0-1

Gim: Trong cc trng hp: s dng cc thuc

corticosteroid, cc phn ng min dch, nhim
khun cp.
Tng: trong d ng, nhim k sinh trng (bnh
giun xon, bnh nm aspergillus, bnh nang sn),
bnh ph thn kinh-mch, cc phn ng thuc,
nhy cm warfarin, cc bnh mch mu-collagen,
hi chng tng bch cu i toan cp, vim mi a
bch cu i toan khng do d ng, cc ri lon
tng sn tu (u bch huyt Hodgkin, x tr,...
Gim: trong s dng cc thuc corticosteroid.

BASO#: S
lng bch
cu a base

0-0,7G/l

PCT: Khi tiu

cu

0,1-0,5%

Tc mu
lng (VSS) 1h

Tng: trong bnh bch cu, vim, chng a hng

cu, Hodgkin's, thiu mu tan mu, sau ct lch,
d sn tu xng, chng ph nim.
Gim: trong stress, phn ng qu mn, cc
steroid, thai nghn, cng gip, sau x tr.
Tng: trong ung th i trc trng.

Gim: trong nghin ru, nhim ni c t.

<15mm/ Tc mu lng tng: gp trong nhiu bnh l,
h
trng thi khc nhau:
Thay i sinh l:
Tr s sinh.
Ngi c tui (gi u c th ti 20-30mm).
Ph n ang hnh kinh.
C thai t thng th 4.
Bnh l:
Thp khp cp, mn.
Lao tin trin.
Bnh globulin mu (v d Waldenstrom),
bnh ny tc lng mu rt nhanh.
Cc bnh nhim khun cp, cc bnh c st.
Cc bnh thiu mu, x gan, nhi mu c
tim, thn h nhim m, ung th, bnh
collagen.

Sau chn thng, phu thut.

Tc lng mu gim trong:
Bnh a hng cu
D ng
Tng natriclorua, mui mt, phospholipid,
CO2...
Tc lng mu l mt yu t c ngha
nht nh trong vic chn on, theo di
qu trnh tin trin v tin lng nhiu bnh
l khc nhau.
NC TIU

SG: t trng
nc tiu

1,014
1,028

PH: PH
trong nc
tiu

56

LEU: Bch cu

Neg

NIT: Nitrit

Neg

PRO: Protein

Neg

GLU: Glucose

Neg

KET: Keton

Neg

Tng trong: Nhim khun, gim ngng thn,

bnh l ng thn. X gan, bnh l gan, tiu
ng, nhim (keton) do tiu ng, tiu chy
mt nc, i ma, suy tim xung huyt.
Gim trong: vim thn cp, suy thn mn, vim
cu thn, vim i b thn.
pH nc tiu tng trong nhim khun thn (tng
hoc c lc gim), suy thn mn, hp mn v, nn
ma.
pH nc tiu gim trong nhim ceton do i
ng, tiu chy mt nc.
Bch cu trong nc tiu xut hin trong: nhim
khun thn, nhim trng nc tiu, nhim trng
khng c triu chng, vim ni tm mc do vi
khun.
Nitrit trong nc tiu xut hin trong: nhim
khun thn, nhim khun nc tiu, vim ni tm
mc, nhim khun nc tiu khng triu chng.
Protein xut hin trong nc tiu khi: vim thn
cp, bnh thn do i tho ng, vim cu
thn, hi chng suy tim xung huyt, K Wilson, cao
huyt p c tnh hi chng thn h, bnh thn a
nang, vim i b thn, bnh l ng thn, cao
huyt p lnh tnh, vim ni tm mc bn cp.
Glucose xut hin trong nc tiu khi: gim
ngng thn, bnh l ng thn, i tho ng,
vim tu, glucose niu do ch n ung.
Th ceton xut hin trong nc tiu khi: nhim
ceton do i tho ng, tiu chy mt nc, nn
ma.

UBG:
Urobilinogen
(mui mt)

Norm

BIL: Bilirubin

Neg

ERY: Hng cu

Neg

COLOR: mu
sc nc tiu

yellow

X gan, bnh l gan, vim gan do nhim khun,

virus, hu t bo gan, tc ng mt ch, K u
ty, suy tim xung huyt c vng da.
X gan, bnh l gan, vng da tc mt (nghn tc
mt phn hoc ton phn, vim gan do virus hoc
do ng c thuc, K u ty, si mt).
Hng cu xut hin trong nc tiu khi: vim thn
cp (ung th thn, bng quang, si thn, si tin
lit tuyn), vim cu thn, xung huyt thn th
ng, hi chng K Wilson, hi chng thn h, thn
a nang, vim i b thn, au qun thn, nhim
trng niu, nhim khun nc tiu, nhim khun
nc tiu khng c triu chng, x gan vim ni
tm mc bn cp, cao huyt p c tan huyt
ngoi mch thn, tan huyt ni mch c tiu
hemoglobin.

SINH HA

AST (GOT)

ALT (GPT)

Cholesterol Tp

Triglycerid

Enzym AST c nhiu trong c bo tng v ty th

ca cc t bo gan, tim v c.
Hot AST huyt tng tng (>ALT) trong nhi
mu c tim.
<=37U/I
Hot AST huyt tng tng trong bnh c (lon
dng c, vim c, tiu myoglobin) v cc bnh
khc nh vim da, vim tu cp, tn thng rut,
nhi mu phi, nhi mu thn, nhi mu no.
Enzym ALT c nhiu trong bo tng ca t bo
gan.
Hot ALT huyt tng tng trong bnh l gan
<=40U/I
mt: vim gan cp, nht l vim gan do virus cc
tp A, B, C, D, E, nhim k sinh trng (sn l gan),
nhim c ru, nm c, ng c thc n.
Tng cholesterol bm sinh, ri lon glucid-lipid,
va x ng mch, cao huyt p, nhi mu c tim
cp, n nhiu tht, trng.
3,7-5,20
Gim khi b i ko di, nhim ure huyt, ung th
giai on cui, nhim trng huyt, cng gip,
bnh Basedow, thiu mu, suy gan.
< 2,29 Tng trong hi chng tng lipid mu nguyn pht
v th pht, va x ng mch, bnh l v d tr

HDL-Cho

LDL-Cho
CK-MB
Troponin T

Glucose

Ure

Creatinin

Calci ton
phn

glycogen, hi chng thn h, vim ty, suy gan.

Nu qu 11 mmol/L c th dn n vim ty cp
tnh.
Gim trong x gan, mt s bnh mn tnh, suy
kit, cng tuyn gip.
Tng c tc dng lm gim nguy c x va ng
mch v bnh mch vnh.
>=0,9
Gim trong x va ng mch, bnh mch vnh,
bo ph, ht thuc l.
Tng trong nguy c x va ng mch v bnh
<=3,4
mch vnh.
Hot CK-MB huyt tng tng trong nhi mu
< 24U/I c tim cp, vim c tim, au tht ngc, lon nhp
tim nng, chn thng tim hoc phu thut tim.
Nguy c nhi mu c tim, suy thn mn, vim
< 0,1
mng ngoi tim, suy tim cp, vim c tim
Glucose huyt tng thng tng trong i tho
ng tp I v tp II.
3,61
Glucose huyt tng cng c th tng trong mt
6,2
s bnh khc nhim ty, sau n, ... bnh tuyn
mmol/L
gip (Basedow), u no, vim mng no, cc sang
chn s no, suy gan, bnh thn, vv.
Ure mu gim do i tiu t, mt nc, bnh cu
thn, u tin lit tuyn, suy gan, ch n ngho
m, n ch nhiu rau, cc tn thng gan
nng gy gim kh nng to ure t NH3, ...
2,0 7,5
Ure mu tng trong st ko di, nhim trng
mmol/L
huyt, chn thng, ung th hoc u lnh tin lit
tuyn, si, do ch n giu m, tng chuyn
ho m, chc nng thn b tn thng, suy tim
tr.
Nng creatinin huyt tng tng trong thiu
nng thn, tn thng thn, vim thn cp v
53 120
mn, b i, suy thn, tng huyt p v cn, nhi
umol/24
mu c tim cp.
h
Nng creatinin huyt tng gim trong ph
vim, vim thn, suy gan
Trong u nng tuyn cn gip, dng nhiu
Vitamin D, ung th (xng, v, ph qun), a u
2,02
tu xng.
2,6
Trong thiu nng tuyn cn gip, gy co git,
tetani, thiu vitamin D, ci xng, cc bnh v
thn, vim ty cp, tha xng, long xng,...

CRP huyt thanh tng trong cc phn ng vim

cp nh nhi mu c tim, tc mch, nhim khun,
bnh mn tnh nh bnh khp, vim rut, cng
06
nh trong mt s ung th nh bnh Hodgkin, K
Xn CRP hs
mg/L
thn.
CRP cn l xt nghim nh gi mc nng
v tin lng ca vim tu cp, CRP 150 mg/L
l vim tu cp nng.
VI SINH, K SINH TRNG
Tb (lao nhanh) m tnh