Serum Chemistry Test

The serum chemistry test is a chemical analysis using a serum-tested material (sample) to investigate the health status or disease history. Regular examination of serum secondary ion concentrations, total bilirubin, triglycerides, etc. Basic Information Specialist classification: growth and development check classification: biochemical examination Applicable gender: whether men and women apply fasting: fasting Tips: Do not wear too small, too tight clothing before the inspection, in order to avoid the sleeves rolled up when the blood is drawn or the sleeves are too tight after the blood is drawn, causing blood vessels in the arms. Normal value Abnormal result 1. Total bilirubin is less than 17.1 μmol/L (1-10 mg/L). 2. The triglyceride check value is less than 500 mg/dL (5.65 mmol/L). 3. Cholesterol is 130-200mg/dl. 4. Anion 98-106 mmol/L (98-106 mEq/L). 5. The cation is 135-145 mmol/L (135-145 mEq/L). Clinical significance Abnormal result 1. Total bilirubin is greater than 17.1 μmol/L (1-10 mg/L) and direct bilirubin is greater than 7 μmol/L (1-4 mg/L). May be liver disease such as acute jaundice hepatitis, acute yellow liver necrosis, chronic active hepatitis, cirrhosis. It may also be an extrahepatic disease such as hemolytic jaundice, blood group incompatibility, cholecystitis, cholelithiasis, and the like. 2, triglyceride examination value is greater than 500mg / dL (5.65mmol / L), can diagnose hypertriglyceridemia, that is, hyperlipidemia. Hyperlipidemia is closely related to coronary heart disease, especially cholesterol and triglycerides are increased, and the risk of coronary heart disease is greater. 3, cholesterol is higher than 190mg / dl, can be suspected of familial hypercholesterolemia, continued hypercholesterolemia. When it is less than 130-200mg/dl, it may be cirrhosis and hyperthyroidism. 4, an increase in anions, there may be: (1) Acute glomerulonephritis and chronic glomerulonephritis, with Cl-retention, which is often retained simultaneously with Na+. (2) loss of bicarbonate, often relative to the increase of Cl-, leading to high chloride acidosis, such as type II renal tubular acidosis; or input of drugs containing high Cl-, such as the input of arginine hydrochloride A large amount of ammonium chloride can cause an increase in serum chlorine. When the anion is reduced, there may be: (1) Frequent vomiting and gastrointestinal decompression, loss of a large amount of gastric juice, so that serum chloride ions are reduced. (2) acute renal insufficiency, often hypochloremia, which is due to the effect of urea retention on plasma osmotic pressure, plasma NaCl decreased, in order to regulate the changes in osmotic pressure. (3) Adrenal hyperfunction, such as Cushing's syndrome, can show low potassium and low chloride alkalosis. (4) Chronic respiratory insufficiency, such as respiratory acidosis caused by pulmonary heart disease, due to CO2 retention, plasma [HCO3-] increased, Cl- increased from renal excretion, serum Cl- decreased. (5) cardiac insufficiency, cirrhosis ascites, inappropriately restricting salt and applying an astringent diuretic. For example, furosemide can cause Cl- to be lost, resulting in a decrease in serum Cl-. 5, the increase in cations is less common in clinical, can be seen in: 1 severe dehydration, excessive sweating, high fever, burns, diabetic polyuria. 2 adrenal hyperfunction, primary or secondary aldosteronism, cerebral hypernatremia (brain trauma, cerebrovascular accident and pituitary tumors, etc.). 3 improper diet or treatment leads to excessive intake of sodium. Cation reduction: 1 kidney loss of sodium, such as renal cortical insufficiency, severe pyelonephritis, diabetes and so on. Increased urinary sodium excretion, severe damage to the renal tubules, reduced reabsorption, and a large loss of sodium in the urine. 2 gastrointestinal loss of sodium (such as gastrointestinal drainage, pyloric obstruction, vomiting and diarrhea). 3 Apply excessive antidiuretic hormone. 4 heart failure, kidney failure, excessive water supply. 5 hyperlipidemia, due to more lipids in the serum, sodium concentration decreased. 6 cardiovascular diseases, such as congestive heart failure, acute myocardial infarction, etc. can cause hyponatremia. 7 brain diseases such as encephalitis, brain trauma, cerebral hemorrhage, brain abscess, meningitis, etc., due to a series of neurohumoral factors leading to a decrease in serum sodium. After extensive burns, trauma, loss of sodium in the skin, and sweating, body fluids and sodium are largely lost from the wound surface, only water is added and the electrolyte is added. Precautions Taboo before the test: pay attention to rest, keep blood on an empty stomach. Do not wear clothes that are too small or too tight in cuffs to avoid the sleeves being too tight when blood is drawn or the sleeves are too tight after blood draw, causing blood vessels in the arms. Avoid strenuous exercise. Requirements for inspection: No special requirements. Inspection process The peripheral blood mainly has ear lobe blood and fingertips to take blood. The baby can take blood from the heel. The earlobe has a lighter blood pressure, but the blood volume is less, especially those with smaller earlobes are more difficult to take blood. The blood pressure of the fingertips is more obvious, but the blood collection is more, especially for the blood routine test, the stable measurement results can be obtained. The skin should be cleaned before blood collection. Do not take blood immediately after entering the room in the cold outdoor winter. After the body is warm, especially the ear drops and hands should be warmed up. Do not use hot water to heat your hands before taking blood. Keep your fingers dry. If your fingertips have wounds, paronychia, redness or skin disease, avoid using this finger. Fingertip blood collection generally uses the ring finger, because the ring finger will not affect the daily function of the hand after piercing, of course, the middle finger or index finger can also be used, no special difference. When collecting blood in the ear, remove the earrings and other hanging ornaments on the earlobe. Do not hang up immediately after blood collection. After blood collection, apply sterile cotton blocks or other disinfecting hemostatic articles to pinch the needle and puncture the area. Do not touch the dirt. Do not wash your hands immediately. Not suitable for the crowd A patient with hemophilia and severe clotting factor deficiency. Adverse reactions and risks Subcutaneous hemorrhage: subcutaneous hemorrhage due to less than 5 minutes of compression time or blood draw technique.