There are two main types of blood test - clinical (it is also called general) and biochemical. Both types of analysis may include a different number of studies. Therefore, they talk about a general and extended blood test. This applies to the first type of research. In the second case, we are talking about a biochemical and biochemical extended blood test.
UAC
In the case of a preventive examination, patients are prescribed a routine clinical blood test. In another way, it is called "general blood test (CBC)". With its help, the content of hemoglobin, the number of formed elements - platelets, erythrocytes, leukocytes are evaluated, the leukocyte formula, color index and erythrocyte sedimentation rate are determined. Given these indicators, the doctor can identify the inflammatory process and establish its stage, anemia, and assess the condition of the vascular wall. This is a non-specific analysis, that is, for example, an increase in the number of leukocytes in the bloodwill not tell about a specific pathology, but will report on its presence and on the general condition of the body.
When extended UAC is prescribed
If any abnormalities are detected or when examining the blood of patients with already established diseases, more specific studies are prescribed. These include a clinical extended blood test. The latter includes a more detailed study of the cellular composition of the blood. Results may include erythrocyte, leukocyte, and platelet indices.
For example, if a myocardial infarction is suspected, the doctor will need to know the ESR, the number of leukocytes, since their change indicates this disease, and the duration of the disease can be determined by the degree of deviation from the norm of these indicators. These indicators are included in the regular list of complete blood tests.
If the CBC data indicate a pathology such as anemia, then to find out its cause, it is necessary to pass an extended blood test, including erythrocyte indices.
What does the extended UAC include
General advanced blood test may include the following groups of indicators:
1. Regular indicators:
- hemoglobin concentration,
- RBC count,
- leukocytes,
- platelets,
- color indicator,
- hematocrit.
2. RBC indices:
- average erythrocyte volume,
- mean erythrocyte hemoglobin (Hb),
- average concentration of hemoglobin (Hb) inerythrocyte,
- normoblasts,
- delta hemoglobin.
3. Platelet indices:
- mean platelet count,
- platelet distribution width by volume,
- thrombocrit,
- immature granulocytes.
4. Leukoformula:
- lymphocytes,
- neutrophils,
- basophils,
- eosinophils,
- monocytes.
5. Reticulocyte test:
- reticulocytes,
- hemoglobin content in reticulocytes,
- fraction of immature reticulocytes,
- adjusted reticulocyte count,
- reticulocyte production index.
The complex of the obtained results of studies on indicators of the CBC is called a hemogram. It is a table in which indicators are indicated, their norm, units of measurement and the result of the study.
For what diseases is an extended OAC prescribed
General extended blood test the doctor will prescribe in the following cases:
- diagnosis of diseases of the blood system and hematopoiesis,
- detection of inflammatory diseases,
- treatment assessment.
It is also indicated for other pathologies. The main groups of diseases for which an extended complete blood count can be prescribed are:
- anemia,
- hemorrhagic diathesis - bleeding disorders,
- hemoblastoses - oncological diseases of the blood.
Some of these diseases are characterized bya change in the number of formed elements (for example, with anemia, the number of red blood cells decreases), some with a change in structure (for example, with sickle cell anemia), some are accompanied by a change in the number of blood cells and their properties. The last group of diseases is called blood cancer. Therefore, the hemogram includes indicators of the number of blood cells (for example, the number of platelets) and indicators of changes in the size and other properties of cells (for example, the width of the distribution of platelets by volume).
Normal UAC values
The table shows the normal values of the KLA. The norm of an extended blood test is a rather arbitrary concept. Although the composition of a person's blood is fairly constant, many factors can affect the result. In addition, in different population groups - children, pregnant women, athletes - the norm is somewhat different. Therefore, the decoding must be carried out by a doctor.
| Indicator | Units of measure |
Norma women |
Norma men |
| ESR | mm/h |
under 30: 8-15 after 30: no more than 25 |
under 30: 2-10 after 30: no more than 15 |
| Hemoglobin | g/l | 115-140 | 140-160 |
| Leukocytes | x109 /l |
under 30: 4, 2-9 after 30: 3-7, 9 |
under 30: 4, 2-9 after 30years: 3-8, 5 |
| Erythrocytes | x1012 /l | 3, 5-4, 7 | 3, 9-5, 5 |
| Hematocrit | % |
under 30: 35-45 after 30: 35-47 |
under 30: 39-49 after 30: 40-50 |
| Reticulocytes | % | 2-12 | |
| Mean erythrocyte volume | fl | 80-100 | |
| Mean erythrocyte Hb | pg | 27-31 | |
| RBC volume distribution width | % | 11, 5-14, 5 | |
| Color indicator | 0, 85-1 | ||
| Platelets | g/l | 150-380 | 180-320 |
| Mean platelet volume | fl | 7, 4-10, 4 | |
Extended UAC decryption
Deciphering an advanced blood test is a difficult task even for a therapist. It should be de alt with only by a narrow specialist who directs the patient to this study. After all, the diagnosis cannot be made by one or two indicators, it is necessary to take into account the whole complex of indicators plus clinical signs and additional studies.
For example, consider such an indicator as the width of the distribution of platelets by volume. A completely incomprehensible name for an ordinary person, even if he knows that platelets provide blood clotting. Shows the heterogeneity of platelets in their volume. Platelets are sized:
- normal,
- giant - pathological,
- large - young,
- small - old.
It is possible to establish what kind of platelet it is - young or old, that is, no longer performing its functions - only by their size - volume. The indicator indicates what percentage of the total is occupied by small and too large cells. Normally, they should be no more than 15-17%. A change in the indicator indicates a pathology in the bone marrow leading to excessive production of platelets, for example, polycythemia vera, myeloid leukemia, myelofibrosis, essential thrombocythemia. However, a change in this indicator can also be observed in other pathologies, including helminthic invasions and Alzheimer's disease. Therefore, only a change in this indicator cannot indicate any specific pathology, but can only complement a whole range of studies.
Blood chemistry
The work of each organ is accompanied by the release of certain substances into the blood - enzymes, hormones, metabolic products of cells. When an organ is diseased, the amount or composition of these substances in the blood will change. Therefore, biochemical analysis will allow us to assess the functional state of various systems and organs and the state of metabolism in general.
When extended biochemical AK is prescribed
An extended biochemical blood test may include about 40 indicators. However, there is no need to examine the blood for all these indicators. From the entire list, the doctor will select those studieswhich will allow to clarify the state of a particular organ or systems. For example, during a myocardial infarction, a large amount of certain enzymes and myoglobin protein enters the bloodstream. Therefore, the establishment of the activity of the enzymes AST, ALT, LDH, CP and their isoenzymes will tell the doctor about the presence of a heart attack and indicate its duration. These indicators are included in the usual list of biochemical studies. However, the most specific indicator of myocardial infarction is the level of troponins in the blood. This test is not performed on all patients, it is included in the list of advanced blood biochemistry tests and is prescribed only if a heart attack is suspected.
The second example of the appointment of an additional biochemical study is to find out the cause of anemia. If anemia is suspected, the patient will have a blood test for iron, which is part of an advanced blood test.
What does Advanced Biochemical AK include
The usual form of "blood test for biochemistry" includes about 20-30 indicators. During the initial study, the therapist ticks off only a few indicators that need to be investigated. Usually these are: total protein, total bilirubin, glucose, urea, enzyme activity - AST, ALT, alkaline phosphatase.
If a disease is suspected, an extended blood test is prescribed to establish an accurate diagnosis, which shows the condition of a particular organ. For example, if atherosclerosis is suspected, the list of tests will include, in addition to total cholesterol: triglycerides, lipoproteinshigh density (HDL), low density (LDL) and very low density (VLDL). The list can be further expanded by studying the content of lipoprotein a, apolipoprotein A1, apolipoprotein B.
Deciphering a biochemical blood test
If necessary, the following biochemical studies may be included in the list of advanced biochemical blood tests:
| Biochemical indicator | Meaning |
| Glucose (or blood sugar) | Indicator of carbohydrate metabolism, a marker of problems in the endocrine system or liver. The indicator provides control of blood sugar in diabetes. Overweight patients should monitor this indicator and be tested more often. |
| Bilirubin | The level of direct bilirubin shows the ability to drain bile from the gallbladder, the level of indirect bilirubin indicates the condition of the liver. |
| Urea (or residual nitrogen) | Product of protein processing. It is excreted by the kidneys, so the level shows their condition. |
| Creatinine | The level shows the work of the kidneys and energy metabolism in the body. Considered in combination with urea. |
| Cholesterol (or cholesterol) | Indicator of fat metabolism. Patients with cardiovascular disease should monitor this indicator. |
| ACT | Intracellular enzyme, so normally its activity in the blood is minimal. Enters the blood (increased activity is detectedin the analysis) in case of damage to any organ, most often the heart, liver, pancreas. |
| ALT | Intracellular enzyme, so normally its activity in the blood is minimal. It enters the blood (increased activity is detected in the analysis) in case of damage mainly to the liver. |
| Amylase | Enzyme, a change in activity indicates a pathology of the stomach or pancreas. |
| GTF | Enzyme, a change in activity indicates a violation of the liver, biliary tract. |
| LDG | Enzyme, its different isoforms are localized in different organs. Therefore, a change in the activity of certain isoforms indicates damage to a particular organ, for example, LDH4 - the liver. |
| Alkaline Phosphatase | Enzyme, activity shows the state of the bile ducts, bones, intestines, kidneys, placenta. |
| Total protein | The level indicates the intensity of metabolism in general, the availability of nutrients. |
| Albumin | Major blood protein, low levels indicate dehydration, high levels are rare. |
| Triglycerides | Energy substrates. Fat metabolism indicator. |
| Blood iron | It is part of the hemoglobin of red blood cells. A decrease in the indicator confirms the diagnosis of iron deficiency anemia. |
Blood collection procedure
Usually, for a general analysis, blood is taken from a finger, and forbiochemical and other types - from a vein. However, if a detailed general analysis is needed, then more material will be required, and it is difficult to take a lot of blood from a finger. Anyone who has donated blood from a finger at least once remembers how hard it is for a he alth worker to squeeze out just a few drops.
For an extended analysis, blood will be taken from a vein, usually from the cubital fossa or from the veins of the forearm or hand. The hand is freed from clothing. Place an oilcloth pad under the elbow. The hand is lowered down. A tourniquet (venous cuff) is applied slightly above the elbow on a napkin or underwear. The he alth worker feels the pulse and finds the most filled vein. Then you need to clench your fist several times, then clamp it.
Blood is taken using vacuum systems. It is collected in several test tubes, externally differing in the color of the caps. Each tube is designed for its own - one or more analysis. For example, hematological studies are carried out only in whole - not coagulated blood. To prevent blood from clotting, special reagents are added to the test tube. These tubes have purple (EDTA) or green (heparin) caps. Conversely, all biochemical analyzes are performed with serum. It settles during blood clotting. Silicon dioxide is used for this. Silica tubes have red caps.
After taking blood, the tourniquet will first be removed, only then the needle will be removed from the vein. An alcohol cotton ball is applied to the puncture site. You need to hold your hand at the elbow and hold it like that for about 3-5 minutes. If the hand is not clamped properly, a hematoma will form. Therefore, it is not necessary to check whether blood is coming from the puncture or not. Hold your hand for at least 3 minutes!
