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Colesterol total

Laborator Synevo

 

Informatii generale

Determinarea nivelului colesterolului evalueaza statusul lipidic si tulburarile metabolice, riscul de ateroscleroza, stenoza coronariana si infarct miocardic.

Recomandari pentru determinarea colesterolului

Pregatire pacient

Specimen recoltat  sange venos5.

Recipient de recoltare – vacutainer fara anticoagulant, cu/fara gel separator5.

Prelucrare necesara dupa recoltare  se separa serul prin centrifugare; se lucreaza in aceeasi zi sau se stocheaza la 4ºC sau la -20ºC5.

Volum proba – minim 0.5 mL ser5.

Cauze  de respingere a probei – specimen intens hemolizat / sange recoltat interprandial5.

Stabilitate proba  serul separat este stabil 5-7 zile la 2-8°C; 3 luni la -20ºC; cativa ani la -70ºC5.

Metoda  spectrofotometrica (enzimatica-colorimetrica)5.

Valori de referinta 

Valorile normale variaza in functie de sex, varsta, dieta si regiune geografica1.

Adult:

Optim

<200 mg/dl

Borderline crescut

200-240 mg/dl

Crescut

≥240 mg/dl

Copii si adolescenti ( 12-18 ani):

Optim

170 mg/dl

Borderline crescut

170-199 mg/dl

Crescut

≥200 mg/dl

 Factor de conversie: mg/dL x 0.026= mmol/L

                                 mmol/L x 38.66= mg/dL

Limita de detectie – 3 mg/dL (0.08 mmol/L)5.

Valori de alerta clinica   > 300 mg/ dL2.

Interpretarea rezultatelor

Cresteri

Scaderi

• hiperlipoproteinemie tip IIb, III, V;

• hipercolesterolemia familiala de tip IIa;

• obstructie biliara: colestaza, ciroza biliara, •nefroza, •boli pancreatice, • neoplasm pancreatic si prostatic,

• hipotiroidism, • diabet zaharat, • alcoolism, • boala von  Gierke (glicogenoza), • dieta bogata in grasimi si colesterol, • obezitate2;4.

• hipo-/a-beta-lipoproteinemie, • boala Tangier, • leziuni hepatocelulare severe,• hipertiroidism,

• boli mieloproliferative, • steatoree cu malabsorbtie, • malnutritie, inanitie, • anemie cronica (megaloblastica/sideroblastica), • boli acute, inflamatii, arsuri severe, infectii,

• BPOC, • retard mental2;4.

Limite interferente

Cresteri : acid ascorbic, acid chenodeoxicolic (chenodiol),  amiodarona, androgeni, aspirina, catecolamine, antibiotice, beta-blocante,carbamazepina, clonidina, clopidogrel, ciclosporina, corticosteroizi glucogenici, ibuprofen, vitamina D, ciclosporine, disulfiram, diuretice (efect mic), ergocalciferol (doze mari), etretinat, izotretinoin, levodopa, miconazol3;4.

Scaderi : acid aminosalicilic, asparaginaza, carbutamida, colestiramina, clomifen, clonidina, colestipol, ciproteron acetat, doxazosin, estrogeni, fenfluramina, derivati ai acidului fibric (clofibrat, gemfibrozil), inhibitori ai 3-hidroxi-3 metilglutaril-CoA reductazei (lovastatin, pravastatin, simvastatin), hidralazina, interferon, ketoconazol (doze mari), niacina, neomicina, prazosin, probucol, tiroxina, coenzima „Q10”3;4 .

 Bibliografie

  1. Cleeman JI. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. In JAMA 285:2486-97. 2001. Ref Type: Journal (Full).
  2. Frances Fischbach. Chemistry Studies. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams & Wilkins, USA, 8 ed., 2009, 448-450.
  3. Frances Fischbach. Effects of the Drugs on Laboratory Tests. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams & Wilkins, USA, 8 ed., 2009, 1232-1233.
  4. Jacques Wallach. Boli metabolice si ereditare. In Interpretarea testelor de diagnostic. Editura Stiintelor Medicale, Romania, 7 ed., 2001, 653-752.
  5. Laborator Synevo. Referintele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog.
  6. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Cholesterol,total. www.labcorp.com 2010. Ref Type: Internet Communication.
  7. U.S.Department of Health and Human Services. Detection, Evaluation and Treatment of High Cholesterol in Adults. In NIH Pub # 93-3036. 1993. Ref Type: Report.
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