간단한 Lab 종류

일반화학

Adm.panel

Ca ; 혈장 Ca농도의 총화(ionic + binded), Hormon조절(PTH,vitamin D,흡수,

대사,배설의 이상

Pi ; determined by PTH,vitamin D,intestinal absorption,renal func.,bone

metabolism,and nutrition

Glucose ; increase ; D.M.,Cushing's,corticosteloid,Phenytoin,estrogen,

thiazides

decrease ; insulin ,ad.cortical insufficiency,diffuse liver

Ds.,Malignancy,alcohol,hypoglycemic drug

BUN ; end product of prot.metabolism,excreated by kidney

prot.intake,N metabolism

Uric acid ; end production of nucleoprot. metabolism

increase ; nucleoprot. synthesis의증가,ctabolism,UA의 요배출감소

Cholesterol ; Lipid metabolism

증가 ; primary ; hereditary

secondary ; biary obstruction,corticosteroid증가

hypothyroidism,nephrotic syndrom,DM(uncontroled)

감소 ; liver Ds(severe),hyperthyroidism,malnutrition,

lymphangiectasia

Prot.,total ; nutritional state

hepatic func.,renal func.,hydration

colloidal osmotic pr.와 관계

alb.(Major)+glob.

Albumin ; nutritional state,sever liver Ds

Bilirubin ; Hb metabooolism의 product

liver에서 mono&di-glucuronides로 conjugation되어 bile에서 배설

increase in liver Ds,biliary obstruction,hemolysis

A.phosphatase ; increase in bone growth와 관계, obstructive hepatobiliary Ds

decrease in hypophospatasia

* normal in osteoporosis

GOT ; a.a.meta의 intracellular enz.

large conc.in liver,skeketal m.,brain,red cell,heart

이조직들의 손상시 증가

* alcoholic hepatitis,cirrhosis ; GOT>GPT

GPT ; large conc. in liver,kidney

low conc.in skeletal m.,heart

* acute viral hepatitis ;GPT>GOT

Creatinine ; gromerulus통한 filtration과 tubular에 의해 배설

->GFR측정

increase in renal failure

decrease in redused m.mass

e'panel

Na ; hypernatremia는 thirst현상에 의해 잘 발생되지 않으나 소모성질환

으로 음식습취가 곤란한 환자에서 발생

K ; intracellular cation

plasma level은 renal secration에 의해 조절

neuromuscular irritability,m.contraction에 관계

* prolonged tourniqet placement

Cl ; acid-base balance,osmolarity

decrease (as HCL or NH4Cl)->alkalosis

increase->acidosis

CO2,total ; bicarbonate(95%) + corbonic acid + dissoved C02

이상시 계속적인 pH,pCO2측정으로 acid-base state평가

 

혈액응고검사

PT ; extrinsic pathway

sensitive in factor II,VII,IX,V

insensitive in fibrinogen,heparin

warfarin therapy monitor

aPTT ; pt's plasma + activator sub. + phospholipid -> clot

intrinsic pathway

XIII,VII제외한 모든factor에 sensitive

BT ; Test of platelet,not coagulation factor

관계 drug ; aspirin

 

혈청검사

VDRL ; T.P.이 host T.와 interact할때 생산되는 nontreponemal Ab를 measure

Syphilis 1st ; 59~87%

2nd ; 100%

late latent ; 79~91%

3rd ; 37~94%

collagen vascular Ds,infection,pregnancy,drug abuse

* confirm위해 FTA-ABS test필요

HBsAg ; symptom전 2~5주 detect가능

no other test needed if HBsAg positive

Anti-HBs ;

Anti-HIV ; 1.선별검사 ->위양성의 가능성

1) 효소면역법(ELISA)

2) 입자응집법(PA)

2.확인검사

1)간적면역형광법(IFA)

2)Western Blot(WB)

 

혈액은행검사

ABO typing ; 1.항원검사(front typing test)

2.anti-A,anti-B 항체의 검사(back typing test)

* 수혈자는 항원보다 항체유무가 문재가 되기때문에 back typing

tsst를 반드시 시행

Rh typing ; 항원으로서 D,C,E,c,e,f,Cw,V등이 있으며,임상적으로 중요한 것은 D

항원으로 anti-D를 적혈구와 반응->응집이 있으면 Rh+

Cross matching ; 수혈자가 공혈자혈구와 반응하는 불규칙항체의 생산여부를 check