Biochemical combination test is usually also called biochemical test in clinical practice. It is currently included in the physical examination of the human body and is the most commonly used clinical examination. At the same time, it can also be used for routine inspections during discharge, regular inspections during hospitalization and follow-up inspections after surgery. Under normal circumstances, the biochemical combination test mainly includes liver function, kidney function, blood sugar, blood lipid analysis, ion analysis, myocardial enzyme spectrum, etc., which can basically reflect the liver, kidney, heart and internal environment. Liver function mainly includes transaminase, bilirubin, total protein, albumin, alkaline phosphatase, glutamyl transpeptidase, cholinesterase, etc.; kidney function mainly includes creatinine, urea nitrogen, uric acid, etc.; myocardial enzyme spectrum includes Lactate dehydrogenase, creatine kinase and related isoenzymes, etc. When there is an obvious abnormality in the biochemical combination test, it is necessary to comprehensively evaluate and distinguish the patient’s symptoms, signs and related auxiliary tests, and give timely medical treatment.
① Serum alkaline phosphatase (ALP) test:
increase: usually occurs in liver diseases such as liver cancer and hepatitis; or skeletal diseases such as osteocytoma, bone metastasis and fracture recovery. In addition, children’s skeletal system is very active in the process of growth and development, which can reduce ALP.
Note: When using different gears, the results can be significantly different.
②Examination of serum total cholesterol:
(1) Diagnosis and classification of hyperlipoproteinemia and lipoproteinemia;
(2) Identify risk factors of heart and cerebrovascular diseases;
③ Serum low-density lipoprotein:
increase: high lipoprotein Blood disease.
Decrease: This condition is more common in hyperlipidemia, coronary heart disease and liver essential disease.
④Examination of serum apolipoprotein B:
Apolipoprotein B is the structural protein of low-density lipoprotein, which mainly represents the degree of LDL. APOB changes under pathological conditions are usually more pronounced than LDL.
Increase: Usually, it is more common in hyperlipidemia, coronary heart disease and psoriasis.
Decrease: This situation is more common in liver disease.
⑤ Test of serum creatine kinase (CK):
Increase: Normally, myocardial infarction starts to increase in the first few hours, and it will reach the peak after more than ten hours, and it will return to normal within 4 days. In addition, viral myocarditis, muscle damage, muscular dystrophy, cerebrovascular accidents and heart surgery can increase CK.
⑥ Serum α-hydroxybutyrate dehydrogenase (HBDH) test:
increase: roughly the same as LDH, this enzyme can maintain a high value of up to 2 times in the blood during acute myocardial infarction.
⑦ Serum glucose (GLU) test:
Hyperglycemia: Certain physiological factors (such as mood pressure within 1-2 hours after a meal) and intravenous adrenaline can cause blood sugar to increase. All kinds of grain diabetes, chronic pancreatitis, myocardial infarction, acromegaly and certain endocrine diseases (such as hyperthyroidism, eosinophiloma of the anterior pituitary gland and basophilia of the anterior pituitary gland, adrenal hypertrophy, etc. ) Are rarely pathologically reduced. Bleeding, intracranial injury, etc. can also cause the patient’s blood sugar to increase. Hypoglycemia: Abnormal glucose metabolism, islet cell tumors, pancreatic tumors, severe liver disease, neonatal hypoglycemia, pregnancy, breastfeeding, etc. can cause hypoglycemia.
⑧ Serum creatinine (CREA) test:
Increase: This type of patients will experience severe renal insufficiency, various kidney diseases, and acromegaly.
Decrease: Patients usually suffer from decreased muscle mass (eg malnutrition, elderly people) and polyuria.
⑨ Serum uric acid (UA) test:
increase: the disease caused by the accumulation of uric acid in the body, such as gout, multiple myeloma, acute and chronic glomerulonephritis, severe liver disease, lead poisoning.
Decline: After drug treatment, this situation is more common in pernicious anemia, celiac disease and adrenal cortex hormones
. Clinical significance of blood ammonia test:
Increase: severe liver damage, >117.8umol/L, hepatic coma. Hepatic coma, sexually active hepatitis and acute viral hepatitis are often reduced, and are highest in hepatic coma.
Decline: Temporary low-protein diet.
Serum amylase (AMY) test:
Increase: This type of disease usually occurs in acute and chronic pancreatitis, pancreatic cancer, gastric perforation, intestinal obstruction, and mumps.
Decline: This condition is more common in liver diseases (such as liver cancer, liver cirrhosis, etc.).
Glycated serum protein test:
Glycated serum protein test is an important goal to control the blood glucose concentration of diabetic patients. It can reflect the patient’s average blood sugar level in 1 to 2 weeks (especially type II diabetes).
Potassium test:
decreased: (1) decreased oral and intravenous intake (2) potassium influx into extracellular fluid, severe hemolysis and infection burns, tissue destruction, insulin deficiency. (3) Tissue hypoxia, cardiac insufficiency, respiratory obstruction, and shock. (4) Obstruction of urine excretion, renal failure and hypofunction of adrenal cortex. (5) a small amount of a toxin digitalis
reduction: (1) oral intake (2) using potassium insulin was transferred into the cell, decreased secretion alkalosis and IRI. (3) Loss of potassium in the digestive tract, frequent vomiting and diarrhea. (4) Loss of urine potassium and renal tubular acidosis.
Urine potassium: Urinary potassium excretion is reduced when using diuretics. The ratio of sodium to potassium in the urine of patients with primary aldosteronism decreased to 0.6:1. When aldosterone secretion decreases, urinary potassium excretion decreases.
Serum sodium test:
Increase: (1) Severe dehydration, excessive sweating, high fever, burns, diabetes and polyuria. (2) Adrenal hyperfunction, primary and secondary hyperaldosteronism.
Decline: (1), loss of renal sodium, such as renal cortex insufficiency, severe pyelonephritis, diabetes. (2) Loss of sodium in the gastrointestinal tract, such as gastrointestinal drainage, vomiting and diarrhea. (3) Too much antidiuretic hormone.
Sodium test:
Urine sodium test is usually to observe whether the patient has salt loss, so that it can determine whether the patient has enough salt intake, and help to distinguish vomiting and severe electrolyte balance in patients with diarrhea and heat exhaustion. The sodium chloride content in the urine of the former is very low, while the sodium chloride content in the urine of the latter is normal or increased, as well as tumors, adrenal cortex dysfunction, severe renal tubular damage, and reduced urine sodium levels in patients with bronchial lung cancer.
Serum chlorine test:
Increase: In this case, the patient has hypernatremia, respiratory alkalosis, hypertonic dehydration, nephritis, oliguria and urethral obstruction.
Decline: This condition is more common in hyponatremia, severe vomiting, diarrhea, massive loss of gastric juice, pancreatic juice and bile, decreased renal function and Addison’s disease.
Urine Chlorine Test: Under normal conditions, the sodium and chlorine in the urine of the tested patients remain relatively balanced. But the two are not always balanced. For example, when sodium chloride is used continuously, the chloride in the urine is higher than the sodium in the urine. Conversely, when the sodium salt is used continuously, the sodium in the urine is higher than the chlorine.
Serum calcium test:
Increased: This condition is more common in bone tumors, hyperparathyroidism, acute bone atrophy, low adrenal sebum and excessive intake of vitamin D.
Decrease: This condition is more common in vitamin D deficiency, disease, illness, pediatric hand and foot twitching, senile osteoporosis, hypoparathyroidism, and certain chronic nephritis, uremia, low calcium diet and malabsorption, etc. symptom.
Serum magnesium test:
Increase: This condition is more common in patients with acute and chronic renal insufficiency and patients with hypothyroidism, or multiple myeloma, severe dehydration and diabetic coma. Increase: Usually, it is more common in congenital familial hypomagnesemia, hyperthyroidism, temporary diarrhea, vomiting, malabsorption, diabetic acidosis, primary aldosteronism and corticosteroids.
Serum phosphorus test:
increase: This situation is more common in hypoparathyroidism, acute and chronic renal insufficiency, uremia, myeloma and fracture healing.
Decrease: This condition is more common in hyperthyroidism, metabolic acidosis, illness, kidney failure, temporary diarrhea and malabsorption.
Serum lactate dehydrogenase (LDH) test:
increase: 2 to 48 hours after the onset of acute myocarditis, it begins to decrease, and can reach a peak in 8-9 days, and return to normal days in 2-4 days. In addition, liver disease and malignant tumors can also cause an increase in LDH.