Biochimie clinique, 2e édition by Pierre Valdiguié

By Pierre Valdiguié

«Biochimie clinique» se focalise volontairement sur des sujets classiques et des problèmes de pratique quotidienne. Chaque chapitre étudie les notions physiologiques élémentaires, les moyens d'exploration, les functions pathologiques usuelles et l'approche technologique.

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30_____________________________________Biochimie clinique Références bibliographiques M. M. Suc. ). G. Siest, J. Henny et F. Schiele. Références en Biologie Clinique, Eisevier, Paris, 1990. P. Métais et al. Biochimie clinique. Tome 1, 2e édition, Simep, Paris, 1990. fG. i Equilibre E- •ri. Lnydrelectrolytique J -7 . B. Baillière, Paris, 1979^ J. De Graeve et D. Grafmeyer. Annales du contrôle national de qualité. Agence française de • , de sécurité . „„„sanitaire des produits ' ' ' 2 Equilibre acidobasique Marie-Laure Solera, Michel Lagente •s_J Chez l'homme le pH des cellules et des liquides physiologiques de l'organisme ne doit varier que dans des limites étroites.

En cas d'excès d'ions H'1' ceux ci sont éliminés préférentiellement par le rein à la place d'ions potassium et de plus pénétreront dans les cellules faisant sortir le potassium. Une acidose sera génératrice d'hyperkaliémie et réciproquement - En cas de déficit en ions H"1' le potassium sera éliminé préférentiellement au niveau rénal et les ions H"*" sortiront des cellules en échange avec des ions K"1'. Une alcalose sera génératrice d'hypokaliémie et réciproquement. 4 • Échanges cellulaires au cours des perturbations de l'équilibre acidobasique.

Une diminution de la p0^ sera par exemple responsable d'une hyperventilation. Les caractéristiques de cette régulation pulmonaire sont une mise en œuvre rapide et une grande sensibilité aux variations du pH. Cependant son efficacité est limitée car l'hyperventilation ne peut être augmentée indéfiniment et l'hypoventilation doit rester compatible avec la vie. De J18___________________________________Biochimie clinique plus les poumons n'interviennent que sur la composante acide du système bicarbonate/acide carbonique.

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