‫اﻟﻔﺤﻮﺻﺎت اﻟﻤﺨﺒﺮﯾﺔ‬

The Laboratory Tests

Dr. Ammar Mashlah

mashlah@scs-net.org

The Laboratory Tests

What are lab tests ?

Laboratory tests are medical

procedures that involve testing
samples of blood, urine, or other
tissues or substances in the
body.

The Laboratory Tests

Why does your doctor use lab tests ?

Your doctor uses laboratory tests to help :

* identify changes in your health condition before any

symptoms occur
* diagnose a disease or condition before you have symptoms
* plan your treatment for a disease or condition
* evaluate your response to a treatment, or monitor the
course of a disease over time.

The Laboratory Tests

What factors affect your lab test results ?

Many factors can affect test results, including :

sex
age
race
medical history
general health
specific foods
drugs you are taking
how closely your follow preparatory instructions
variations in laboratory techniques
variation from one laboratory to another
The Laboratory Tests
The Laboratory Tests
 ‫ﻣﻘﺪﻣﺔ‬

‫ﺗﻌﺪ اﻟﻔﺤﻮص اﻟﻤﺨﺒﺮﯾﺔ ﻣﻦ اﻟﻮﺳﺎﺋﻞ اﻟﻤﺴﺎﻋﺪة ﻓﻲ اﻟﺘﺸﺨﯿﺺ‬ ‫‪n‬‬

‫ﯾﺘﻢ وﺿﻊ اﻟﺘﺸﺨﯿﺺ ﺑﻌﺪ ﻣﺮاﺟﻌﺔ دﻗﯿﻘﺔ ﻟﻠﻘﺼﺔ اﻟﻤﺮﺿﯿﺔ و‬ ‫‪n‬‬

‫اﻟﻤﺪﻟﻮﻻت اﻟﺴﺮﯾﺮﯾﺔ و ﺗﻔﺴﯿﺮ ﻧﺘﺎﺋﺞ اﻻﺧﺘﺒﺎرات‬

‫ﺗﺠﺮى اﻟﻔﺤﻮﺻﺎت اﻟﻤﺨﺒﺮﯾﺔ ﺑﺸﻜﻞ أﻗﻞ ﺗﻜﺮارا ﻣﻦ اﻟﺼﻮر‬ ‫‪n‬‬

‫اﻟﺸﻌﺎﻋﯿﺔ و اﻟﺨﺰﻋﺎت ‪..‬‬

‫‪The Laboratory Tests‬‬

 ‫ﺗﺤﻠﯿﻞ اﻟﺪم اﻟﺮوﺗﯿﻨﻲ‬
‫ﺗﻌﺪاد اﻟﻜﺮﯾﺎت اﻟﺤﻤﺮاء‬

‫‪ n‬ھﻮ ﺗﻘﺪﯾﺮ ﻋﺪد اﻟﻜﺮﯾﺎت اﻟﺤﻤﺮاء ﻓﻲ ‪ ١‬ﻣﻢ‪ ٣‬ﻣﻦ اﻟﺪم‬

‫‪ n‬اﻟﺮﺟﺎل ‪ ٦ – ٤٫٥ :‬ﻣﻠﯿﻮن ﻛﺮﯾﺔ ‪ /‬ﻣﻢ‪٣‬‬
‫‪ n‬اﻟﻨﺴﺎء ‪ ٥٫٥ – ٤ :‬ﻣﻠﯿﻮن ﻛﺮﯾﺔ ‪ /‬ﻣﻢ‪٣‬‬
‫‪ n‬اﻷﻃﻔﺎل ‪ ٥ – ٤ :‬ﻣﻠﯿﻮن ﻛﺮﯾﺔ ‪ /‬ﻣﻢ‪٣‬‬

‫‪The Laboratory Tests‬‬

 ‫أھﻤﯿﺔ ﺗﻌﺪاد اﻟﻜﺮﯾﺎت اﻟﺤﻤﺮاء ‪:‬‬
‫ﯾﺰداد ﺗﻌﺪاد اﻟﻜﺮﯾﺎت اﻟﺤﻤﺮاء ﻓﻲ اﺣﻤﺮار اﻟﺪم اﻟﺒﺪﺋﻲ و‬ ‫‪n‬‬
‫اﺣﻤﺮار اﻟﺪم اﻟﺜﺎﻧﻮي‬
‫ﯾﻨﻘﺺ ﺗﻌﺪاد اﻟﻜﺮﯾﺎت اﻟﺤﻤﺮاء ﻓﻲ اﻟﻔﺎﻗﺎت اﻟﺪﻣﻮﯾﺔ ﺑﺸﻜﻞ‬ ‫‪n‬‬
‫ﻋﺎم‬
‫ﯾﻔﯿﺪ ﺗﻌﺪاد اﻟﻜﺮﯾﺎت اﻟﺤﻤﺮاء ﻓﻲ ﺣﺴﺎب اﻟﺤﺠﻢ اﻟﻮﺳﻄﻲ‬ ‫‪n‬‬
‫ﻟﻠﻜﺮﯾﺔ اﻟﺤﻤﺮاء ‪ MCV‬و اﻟﻮزن اﻟﻮﺳﻄﻲ ﻟﻠﺨﻀﺎب ‪MCH‬‬
‫وھﺬﯾﻦ اﻟﻤﺸﻌﺮﯾﻦ ﯾﻮﻓﺮان ﻣﻌﻠﻮﻣﺎت ھﺎﻣﺔ ﻋﻦ ﻧﻮع ﻓﻘﺮ اﻟﺪم‬
‫ھﻞ ھﻮ ﺻﻐﯿﺮ أو ﺳﻮي أو ﻛﺒﯿﺮ ﺣﺠﻢ اﻟﻜﺮﯾﺎت‬

‫‪The Laboratory Tests‬‬

 ‫اﻟﻔﺎﻗﺎت اﻟﺪﻣﻮﯾﺔ‬
‫اﻟﻜﺮﯾﺎت ﻛﺒﯿﺮة اﻟﺤﺠﻢ‬ ‫اﻟﻜﺮﯾﺎت ﺳﻮﯾﺔ اﻟﺤﺠﻢ و اﻟﺼﺒﺎغ‬ ‫اﻟﻜﺮﯾﺎت ﺻﻐﯿﺮة اﻟﺤﺠﻢ ﻧﺎﻗﺼﺔ اﻟﺼﺒﺎغ‬
‫ﻧﻘﺺ ﻓﯿﺘﺎﻣﯿﻦ ب ‪١٢‬‬ ‫ﺑﻌﺪ اﻟﻨﺰوف‬ ‫ﻋﻮز اﻟﺤﺪﯾﺪ‬

‫ﻓﻘﺮ دم ﺧﺒﯿﺚ‬ ‫اﻷﻣﺮاض اﻟﻤﺰﻣﻨﺔ و اﻻﻟﺘﮭﺎﺑﺎت‬ ‫اﻟﺘﻼﺳﯿﻤﯿﺎ‬

‫ﻗﺼﻮر اﻟﺪرﻗﯿﺔ‬ ‫ﻓﻘﺮ اﻟﺪم اﻟﻼﻣﺼﻨﻊ‬ ‫اﻟﻮراﺛﺔ‬
‫ﻧﻘﺺ ﺣﻤﺾ اﻟﻔﻮﻟﯿﻚ‬ ‫اﺑﯿﻀﺎض اﻟﺪم‬ ‫ﻓﻘﺮ اﻟﺪم اﻟﻤﻨﺠﻠﻲ‬

‫اﻟﻘﺼﻮر اﻟﻜﻠﻮي‬
‫اﻷورام اﻟﺨﺒﯿﺜﺔ‬
‫اﻷﻣﺮاض اﻟﻐﺪﯾﺔ‬

‫اﻟﺤﻤﻞ‬

‫‪The Laboratory Tests‬‬

 ‫اﻟﺤﺠﻢ اﻟﻮﺳﻄﻲ ﻟﻠﻜﺮﯾﺔ اﻟﺤﻤﺮاء‬
‫‪Mean Cell Volume MCV‬‬
‫‪ = MCV‬اﻟﮭﯿﻤﺎﺗﻮﻛﺮﯾﺖ ‪ /‬ﻋﺪد اﻟﻜﺮﯾﺎت اﻟﺤﻤﺮاء‬ ‫‪n‬‬

‫‪ MCV‬اﻟﻄﺒﯿﻌﻲ ‪ ٩٢ – ٨٢ :‬ﻣﯿﻜﺮوﻣﺘﺮ ﻣﺮﺑﻊ‬ ‫‪n‬‬

‫‪ MCV‬ﻓﻲ ﻓﻘﺮ اﻟﺪم ﻃﺒﯿﻌﻲ ﺣﺠﻢ اﻟﻜﺮﯾﺎت ‪Mm3 ٩٢ -٨٢ :‬‬ ‫‪n‬‬

‫‪ MCV‬ﻓﻲ ﻓﻘﺮ اﻟﺪم ﺻﻐﯿﺮ ﺣﺠﻢ اﻟﻜﺮﯾﺎت ‪Mm3 ٨٠ -٥٠ :‬‬ ‫‪n‬‬

‫‪ MCV‬ﻓﻲ ﻓﻘﺮ اﻟﺪم ﻛﺒﯿﺮ ﺣﺠﻢ اﻟﻜﺮﯾﺎت ‪Mm3 ١٠٠ – ٩٥ :‬‬ ‫‪n‬‬

‫‪The Laboratory Tests‬‬

 ‫اﻟﻮزن اﻟﻮﺳﻄﻲ ﻟﻠﺨﻀﺎب‬
‫‪Mean Cell Hemoglobin MCH‬‬
‫‪ =MCH‬اﻟﺨﻀﺎب ‪ /‬ﺗﻌﺪاد اﻟﻜﺮﯾﺎت اﻟﺤﻤﺮاء‬ ‫‪n‬‬

‫‪ MCH‬اﻟﻄﺒﯿﻌﻲ ‪ ) pg ٩٢ -٢٧ :‬ﺑﯿﻜﻮﻏﺮام (‬ ‫‪n‬‬

‫‪ MCH‬ﻓﻲ ﻓﻘﺮ اﻟﺪم ﺳﻮي ﺣﺠﻢ اﻟﻜﺮﯾﺎت ‪pg ٣٠ -٢٥ :‬‬ ‫‪n‬‬

‫‪ MCH‬ﻓﻲ ﻓﻘﺮ اﻟﺪم ﺻﻐﯿﺮ ﺣﺠﻢ اﻟﻜﺮﯾﺎت ‪pg ٢٥ -١٥ :‬‬ ‫‪n‬‬

‫‪ MCH‬ﻓﻲ ﻓﻘﺮ اﻟﺪم ﻛﺒﯿﺮ ﺣﺠﻢ اﻟﻜﺮﯾﺎت ‪pg ٥٠ -٣٠ :‬‬ ‫‪n‬‬

‫‪The Laboratory Tests‬‬

 ‫‪Hematocrit Hct‬‬ ‫اﻟﺮﺳﺎﺑﺔ ‪:‬‬
‫ھﻲ اﻟﻨﺴﺒﺔ اﻟﻤﺌﻮﯾﺔ ﻟﺤﺠﻢ رﺳﺎﺑﺔ اﻟﻜﺮﯾﺎت اﻟﺤﻤﺮاء اﻟﻤﻔﺼﻮﻟﺔ ﻋﻦ‬ ‫‪n‬‬
‫اﻟﺒﻼﺳﻤﺎ ﺑﺎﻟﺘﺜﻔﯿﻞ اﻟﺴﺮﯾﻊ و ذﻟﻚ ﺑﺎﻟﻨﺴﺒﺔ ﻟﺤﺠﻢ اﻟﺪم اﻟﻜﻠﻲ اﻟﻤﺠﻤﻮع ﻋﻠﻰ‬
‫ﻣﺎﻧﻊ ﺗﺨﺜﺮ ﻣﻨﺎﺳﺐ‬
‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ﻋﻨﺪ اﻟﺮﺟﺎل ‪% ٥٤ – ٤٠ :‬‬ ‫‪n‬‬

‫ﻋﻨﺪ اﻟﻨﺴﺎء ‪% ٤٧ – ٣٨ :‬‬ ‫‪n‬‬

‫ﻋﻨﺪ اﻷﻃﻔﺎل ‪% ٤٤ – ٣٦ :‬‬ ‫‪n‬‬

‫ﯾﻌﻄﻲ ﻓﻜﺮة ﻋﻦ ﻛﻔﺎﯾﺔ اﻟﺪم ﻓﻲ اﻟﻌﻀﻮﯾﺔ ﻗﺒﻞ إﺟﺮاء اﻟﻌﻤﻠﯿﺎت اﻟﺠﺮاﺣﯿﺔ‬ ‫‪n‬‬

‫ﯾﻨﺨﻔﺾ ﻓﻲ ﻓﻘﺮ اﻟﺪم ﺑﺸﻜﻞ ﻋﺎم و ﯾﺮﺗﻔﻊ ﻓﻲ اﺣﻤﺮار اﻟﺪم‬ ‫‪n‬‬

‫‪The Laboratory Tests‬‬

 ‫‪Hemoglobin Hgb‬‬ ‫اﻟﺨﻀﺎب ‪:‬‬
‫ھﻮ اﻟﻤﻜﻮن اﻟﺮﺋﯿﺲ ﻟﻠﻜﺮﯾﺔ اﻟﺤﻤﺮاء و ﯾﺘﺄﻟﻒ ﻣﻦ ﻗﺴﻤﯿﻦ ھﻤﺎ اﻟﮭﯿﻢ و‬ ‫‪n‬‬

‫اﻟﻐﻠﻮﺑﯿﻦ‬
‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ﻋﻨﺪ اﻟﺮﺟﺎل ‪ ١٨ – ١٣٫٥ :‬غ ‪١٠٠ /‬ﻣﻞ‬ ‫‪n‬‬

‫ﻋﻨﺪ اﻟﻨﺴﺎء ‪ ١٦ – ١٢ :‬غ ‪ ١٠٠ /‬ﻣﻞ‬ ‫‪n‬‬

‫ﻋﻨﺪ اﻷﻃﻔﺎل ‪ ١٣٫٥ – ١١ :‬غ ‪ ١٠٠ /‬ﻣﻞ‬ ‫‪n‬‬

‫ھﻮ اﻟﻤﻜﻮن اﻟﺤﺎﻣﻞ ﻟﻸوﻛﺴﺠﯿﻦ ﻓﻲ اﻟﻜﺮﯾﺔ اﻟﺤﻤﺮاء‬ ‫‪n‬‬

‫ﺗﺸﯿﺮ اﻟﻤﺴﺘﻮﯾﺎت اﻟﻤﺘﺪﻧﯿﺔ إﻟﻰ ﻓﻘﺮ اﻟﺪم‬ ‫‪n‬‬

‫ﺗﺆﺷﺮ اﻟﻘﯿﻢ اﻟﻌﺎﻟﯿﺔ ﻻﺣﻤﺮار اﻟﺪم‬ ‫‪n‬‬

‫‪The Laboratory Tests‬‬

 ‫ﺳﺮﻋﺔ ﺗﺜﻔﻞ اﻟﻜﺮﯾﺎت اﻟﺤﻤﺮاء‬
‫‪Erythrocyte Sedimentation Rate ESR‬‬
‫ﺗﻌﻨﻲ ﻗﯿﺎس ارﺗﻔﺎع ﻋﻤﻮد اﻟﺒﻼﺳﻤﺎ اﻟﺬي ﯾﻌﻠﻮ اﻟﻜﺮﯾﺎت اﻟﺤﻤﺮاء ﺑﻌﺪ‬ ‫‪n‬‬
‫ﺗﺮك اﻟﺪم اﻟﻤﺠﻤﻮع ﻋﻠﻰ ﻣﺎﻧﻊ ﺗﺨﺜﺮ ﻣﻨﺎﺳﺐ ﻓﻲ أﻧﺒﻮب وﺳﺘﺮﻏﺮﯾﻦ‬
‫ﺑﻮﺿﻌﯿﺔ ﻋﻤﻮدﯾﺔ و ذﻟﻚ ﺑﻌﺪ ﺳﺎﻋﺔ واﺣﺪة ﺛﻢ ﺑﻌﺪ ﺳﺎﻋﺘﯿﻦ ‪.‬‬
‫ﻋﻨﺪ اﻟﺬﻛﻮر ﺗﺤﺖ ‪ ٥٠‬ﺳﻨﺔ ‪ ١٥ :‬ﻣﻢ ‪ /‬ﺳﺎ‬ ‫‪n‬‬
‫ﻓﻮق ‪ ٥٠‬ﺳﻨﺔ ‪ ٢٠ :‬ﻣﻢ ‪ /‬ﺳﺎ‬
‫ﻋﻨﺪ اﻹﻧﺎث ﺗﺤﺖ ‪ ٥٠‬ﺳﻨﺔ ‪ ٢٠ :‬ﻣﻢ ‪ /‬ﺳﺎ‬ ‫‪n‬‬
‫ﻓﻮق ‪ ٥٠‬ﺳﻨﺔ ‪ ٣٠ :‬ﻣﻢ ‪ /‬ﺳﺎ‬
‫ﺗﺮﺗﻔﻊ ﺳﺮﻋﺔ اﻟﺘﺜﻔﻞ ﻓﻲ ‪ :‬اﻟﻄﻤﺚ و اﻟﺤﻤﻞ و اﻟﺘﻘﺪم ﺑﺎﻟﺴﻦ و‬ ‫‪n‬‬
‫اﻻﻧﺘﺎﻧﺎت اﻟﮭﻀﻤﯿﺔ و اﻷﻣﺮاض اﻻﻟﺘﮭﺎﺑﯿﺔ ﻛﺎﻟﺤﻤﻰ اﻟﺮﺛﻮﯾﺔ و اﻟﺪاء‬
‫اﻟﺮﺛﻮاﻧﻲ و اﻷورام اﻟﺨﺒﯿﺜﺔ و اﺑﯿﻀﺎض اﻟﺪم ‪..‬‬

‫‪The Laboratory Tests‬‬

 ‫ﺗﻌﺪاد اﻟﻜﺮﯾﺎت اﻟﺒﯿﻀﺎء‬
‫)‪White Cell Count (WBC‬‬

‫ھﻮ ﻋﺪد اﻟﻜﺮﯾﺎت اﻟﺒﯿﻀﺎء ﻓﻲ ‪ ١‬ﻣﻢ‪ ٣‬ﻣﻦ اﻟﺪم‬ ‫‪n‬‬

‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ‪ ١١٠٠٠ -٤٥٠٠ :‬ﺧﻠﯿﺔ ‪ /‬ﻣﻢ‪٣‬‬ ‫‪n‬‬

‫ﯾﺮﺗﻔﻊ ﻓﻲ ﺣﺎﻻت اﺑﯿﻀﺎض اﻟﺪم و اﺣﻤﺮاره و اﻷﻣﺮاض‬ ‫‪n‬‬

‫اﻻﻧﺘﺎﻧﯿﺔ و ﺑﻌﺪ اﻟﺤﺮوق و اﻟﺮﺿﻮض‬

‫ﯾﻨﺨﻔﺾ ﻓﻲ ﺑﻌﺾ اﻻﻧﺘﺎﻧﺎت اﻟﻔﯿﺮوﺳﯿﺔ ﻛﺎﻻﻧﻔﻠﻮﻧﺰا و‬ ‫‪n‬‬

‫اﻟﺘﮭﺎب اﻟﻜﺒﺪ اﻻﻧﺘﺎﻧﻲ و ﻓﻘﺮ اﻟﺪم اﻟﻼﻣﺼﻨﻊ و اﻟﺘﻌﺮض‬

‫ﻟﻺﺷﻌﺎﻋﺎت و اﻻﻧﺴﻤﺎﻣﺎت اﻟﺪواﺋﯿﺔ‬

‫‪The Laboratory Tests‬‬

 ‫اﻟﺘﻌﺪاد اﻟﺘﻔﺮﯾﻘﻲ ﻟﻠﻜﺮﯾﺎت اﻟﺒﯿﻀﺎء‬
‫)‪Differential White Blood Cell Count (DIFF‬‬

‫‪ n‬ﺗﺼﻨﻒ اﻟﻜﺮﯾﺎت اﻟﺒﯿﻀﺎء إﻟﻰ ﻛﺮﯾﺎت ﺑﯿﻀﺎء ﺣﺒﯿﺒﯿﺔ ‪ granulocytes‬و ﻏﯿﺮ ﺣﺒﯿﺒﯿﺔ‬
‫‪nongranuloleukocytes‬‬
‫‪ n‬اﻟﺤﺒﯿﺒﯿﺔ ‪:‬‬
‫_ اﻟﻌﺪﻻت ‪ Neutrophils‬و ﺗﺴﺠﻞ ﻛـ ‪ band‬و ھﻲ ﻋﺪﻻت ﻏﯿﺮ ﻧﺎﺿﺠﺔ ) ‪ ( % ٣ -٢‬ﻗﺪ‬
‫ﺗﺸﯿﺮ زﯾﺎدﺗﮭﺎ ﻟﺤﺪوث إﻧﺘﺎن ﺣﺎد و ‪ seg‬و ھﻲ ﻋﺪﻻت ﻧﺎﺿﺠﺔ ) ‪ ( %٥٦‬ﻗﺪ ﺗﺸﯿﺮ اﻟﺰﯾﺎدة‬
‫إﻟﻰ اﻧﺴﻤﺎم دواﺋﻲ ﺑﯿﻨﻤﺎ ﻗﺪ ﯾﺪل اﻟﻨﻘﺺ ﻋﻠﻰ وﺟﻮد ﻓﻘﺮ دم ﻻ ﻣﺼﻨﻊ ‪...‬‬
‫_ ﻣﺤﺒﺎت اﻟﺤﻤﺾ أو اﻟﺤﻤﻀﺎت ‪ ( % ٢٫٧ ) Eosinophils‬ﺗﺤﺪث اﻟﺰﯾﺎدة ﻓﻲ ﺣﺎﻻت‬
‫اﻟﺘﺤﺴﺲ و اﻻﻧﺘﺎﻧﺎت اﻟﻄﻔﯿﻠﯿﺔ و داء ھﻮدﺟﻜﯿﻦ و ﺗﻨﻘﺺ ﻋﻨﺪ اﻟﻤﺮﺿﻰ اﻟﻤﻌﺎﻟﺠﯿﻦ‬
‫ﺑﺎﻟﻜﻮرﺗﯿﺰوﻧﺎت‪..‬‬
‫_ ﻣﺤﺒﺎت اﻷﺳﺎس أو اﻷﺳﺴﺔ ‪ ( %٠٫٣ ) Basophils‬ﻗﯿﻤﮭﺎ ﻧﺎدرة اﻟﺘﻐﯿﺮ‬

‫‪The Laboratory Tests‬‬

 ‫اﻟﺘﻌﺪاد اﻟﺘﻔﺮﯾﻘﻲ ﻟﻠﻜﺮﯾﺎت اﻟﺒﯿﻀﺎء‬
‫)‪Differential White Blood Cell Count (DIFF‬‬

‫‪ n‬ﻏﯿﺮ اﻟﺤﺒﯿﺒﯿﺔ ‪:‬‬

‫_ اﻟﻠﻤﻔﺎوﯾﺎت ‪ ( % ٣٤ ) Lymphocytes‬ﺗﺤﺪث اﻟﺰﯾﺎدة ﻓﻲ اﺑﯿﻀﺎض‬
‫اﻟﺪم اﻟﻠﻤﻔﺎوي و اﻻﻧﺘﺎﻧﺎت اﻟﻤﺰﻣﻨﺔ و اﻻﻧﺘﺎﻧﺎت اﻟﻔﯿﺮوﺳﯿﺔ و ﯾﺤﺪث‬
‫اﻟﻨﻘﺺ ﻓﻲ ﻓﻘﺮ اﻟﺪم اﻟﻼﻣﺼﻨﻊ‪..‬‬
‫_ وﺣﯿﺪات اﻟﻨﻮى ‪ ( % ٤ ) Monocytes‬ﺗﺸﺎھﺪ اﻟﺰﯾﺎدة ﻓﻲ اﺑﯿﻀﺎض‬
‫اﻟﺪم ﺑﺎﻟﻮﺣﯿﺪات و داء ھﻮدﺟﻜﯿﻦ و اﻟﺴﻞ و اﻟﺘﮭﺎب اﻟﺸﻐﺎف اﻟﺠﺮﺛﻮﻣﻲ‬
‫ﺗﺤﺖ اﻟﺤﺎد ﺑﯿﻨﻤﺎ ﯾﺸﺎھﺪ اﻟﻨﻘﺺ ﻓﻲ ﻓﻘﺮ اﻟﺪم اﻟﻼﻣﺼﻨﻊ ‪..‬‬

‫‪The Laboratory Tests‬‬

 ‫ﺗﻌﺪاد اﻟﺼﻔﯿﺤﺎت‬
‫)‪Platelet Count (PC‬‬

‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ‪ ٤٠٠٠٠٠-١٠٠٠٠٠ :‬ﺻﻔﯿﺤﺔ ‪ /‬ﻣﻢ‪٣‬‬ ‫‪n‬‬

‫ﯾﻨﻘﺺ ﻋﺪد اﻟﺼﻔﯿﺤﺎت ﻓﻲ ‪ :‬ﻓﺮﻓﺮﯾﺔ ﻧﻘﺺ اﻟﺼﻔﯿﺤﺎت‬ ‫‪n‬‬

‫اﻷﺳﺎﺳﻲ – ﻓﻘﺮ اﻟﺪم اﻟﻼﻣﺼﻨﻊ – اﻻﺑﯿﻀﺎﺿﺎت اﻟﺤﺎدة –‬

‫ﻓﺮط ﻧﺸﺎط اﻟﻄﺤﺎل‬
‫ﯾﺮﺗﻔﻊ ﻓﻲ ‪ :‬اﺣﻤﺮار اﻟﺪم اﻟﺒﺪﺋﻲ – ﺑﻌﺪ اﺳﺘﺌﺼﺎل اﻟﻄﺤﺎل –‬ ‫‪n‬‬

‫ﺑﻌﺪ اﻟﻨﺰوف اﻟﺤﺎدة – زﯾﺎدة اﻟﺼﻔﯿﺤﺎت اﻷﺳﺎﺳﻲ‬

‫‪The Laboratory Tests‬‬

 ‫اﻹرﻗﺎء‬
‫‪Hemostasis‬‬

‫‪ n‬ﺗﮭﺪف ﺣﺎدﺛﺔ اﻹرﻗﺎء ﻓﻲ اﻟﻌﻀﻮﯾﺔ اﻟﺤﯿﺔ إﻟﻰ إﯾﻘﺎف اﻟﻨﺰف و‬

‫ﺗﺸﻜﻞ اﻟﻌﻠﻘﺔ اﻟﺪﻣﻮﯾﺔ و اﻟﺘﻲ ﺗﺘﺄﻟﻒ ﺑﺸﻜﻞ أﺳﺎﺳﻲ ﻣﻦ‬
‫اﻟﺼﻔﯿﺤﺎت و اﻟﻠﯿﻔﯿﻦ‬
‫‪ n‬ﯾﻤﻜﻦ ﺗﻘﺴﯿﻢ ﺣﺎدﺛﺔ اﻹرﻗﺎء إﻟﻰ ﺛﻼث ﻣﺮاﺣﻞ ‪:‬‬
‫‪ -١‬اﻹرﻗﺎء اﻟﺒﺪﺋﻲ ) ﺗﻘﺒﺾ وﻋﺎﺋﻲ – اﻟﺘﺼﺎق اﻟﺼﻔﯿﺤﺎت – ﺗﺤﺮﯾﺮ ﻣﺮﻛﺒﺎﺗﮭﺎ – ﺗﺠﻤﻊ اﻟﺼﻔﯿﺤﺎت (‬

‫‪ -٢‬اﻟﺘﺨﺜﺮ‬
‫‪ -٣‬اﻧﺤﻼل ﻋﻠﻘﺔ اﻟﻠﯿﻔﯿﻦ‬

‫‪The Laboratory Tests‬‬

 ‫زﻣﻦ اﻟﺒﺮوﺗﺮﻣﺒﯿﻦ ‪ PT‬و زﻣﻦ اﻟﺘﺮﻣﺒﻮﺑﻼﺳﺘﯿﻦ اﻟﺠﺰﺋﻲ ‪PTT‬‬

‫ﯾﺒﺪأ اﻟﺘﺨﺜﺮ ﻣﻦ ﺧﻼل ﻃﺮﯾﻘﯿﻦ ‪ :‬اﻟﻄﺮﯾﻖ اﻟﺨﺎرﺟﻲ و اﻟﺬي ﯾﻤﻜﻦ اﺧﺘﺒﺎره ﻋﻦ ﻃﺮﯾﻖ‬ ‫‪n‬‬
‫‪ PT‬و اﻟﻄﺮﯾﻖ اﻟﺪاﺧﻠﻲ و ﯾﺤﺪده ‪PTT‬‬
‫‪ ١٤ -١٢ = PT‬ﺛﺎﻧﯿﺔ‬ ‫‪n‬‬

‫‪ ٥٠ -٣٥ = PTT‬ﺛﺎﻧﯿﺔ‬ ‫‪n‬‬

‫إذا ﻛﺎن ‪ PT‬ﻃﻮﯾﻞ و ‪ PTT‬ﻃﺒﯿﻌﻲ ﻓﺎﻟﺨﻠﻞ ﻓﻲ اﻟﻄﺮﯾﻖ اﻟﺨﺎرﺟﻲ‬ ‫‪n‬‬

‫إذا ﻛﺎن ‪ PT‬ﻃﺒﯿﻌﻲ و ‪ PTT‬ﻃﻮﯾﻞ ﻓﺎﻟﺨﻠﻞ ﻓﻲ اﻟﻄﺮﯾﻖ اﻟﺪاﺧﻠﻲ‬ ‫‪n‬‬

‫ﯾﺘﻄﺎول زﻣﻦ ‪ PT‬ﻓﻲ ﻋﻮز ﻋﻮاﻣﻞ اﻟﺘﺨﺜﺮاﻟﻤﺼﻮرﯾﺔ ‪ ١٠-٧-٥-٢-١‬و ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ‬ ‫‪n‬‬

‫اﻟﻤﻀﺎدة ﻟﻠﺘﺨﺜﺮ – ﺗﺸﻤﻊ اﻟﻜﺒﺪ – اﻟﺘﮭﺎب اﻟﻜﺒﺪ – اﻟﻤﻌﺎﻟﺠﺔ ﺑﺎﻟﺴﺎﻟﯿﺴﯿﻼت‬
‫ﯾﺘﻄﺎول زﻣﻦ ‪ PTT‬ﻓﻲ ﻋﻮز ﻋﻮاﻣﻞ اﻟﺘﺨﺜﺮ ‪ ١٢-١١-٩ -٨‬و اﻟﻤﻌﺎﻟﺠﺔ اﻟﻤﻀﺎدة‬ ‫‪n‬‬
‫ﻟﻠﺘﺨﺜﺮ‬

‫‪The Laboratory Tests‬‬

 ‫زﻣﻦ اﻟﻨﺰف‬
‫‪Bleeding Time‬‬

‫و ھﻮ اﻟﺰﻣﻦ ﻣﻨﺬ إﺣﺪاث اﻟﺠﺮح ﺣﺘﻰ ﺗﺸﻜﻞ اﻟﻌﻠﻘﺔ اﻟﺒﯿﻀﺎء‬ ‫‪n‬‬

‫اﻟﺰﻣﻦ اﻟﻄﺒﯿﻌﻲ ‪ ٤ -١ :‬دﻗﺎﺋﻖ ﺣﺴﺐ ‪Duke‬‬ ‫‪n‬‬

‫‪ ٨ - ٢‬دﻗﺎﺋﻖ ﺣﺴﺐ ‪Ivy‬‬

‫ﯾﺘﻄﺎول ﻋﺎدة ﻓﻲ ﻧﻘﺺ اﻟﺼﻔﯿﺤﺎت أو اﺿﻄﺮاب وﻇﯿﻔﺘﮭﺎ‬ ‫‪n‬‬

‫و ﻣﺮض ﻓﻮن وﯾﻠﺒﺮاﻧﺪ‬

‫‪The Laboratory Tests‬‬

 ‫زﻣﻦ اﻟﺘﺨﺜﺮ‬
‫‪Coagulation Time‬‬

‫ﯾﻤﺜﻞ اﻟﺰﻣﻦ ﻣﻦ ﻟﺤﻈﺔ ﺣﺪوث اﻟﺠﺮح و ﺣﺘﻰ ﺗﺸﻜﻞ أﻟﯿﺎف‬ ‫‪n‬‬

‫اﻟﻔﯿﺒﺮﯾﻦ ﻓﻲ اﻷﻧﺎﺑﯿﺐ اﻟﺸﻌﺮﯾﺔ‬

‫اﻟﺰﻣﻦ اﻟﻄﺒﯿﻌﻲ ‪ ١٠-٥ :‬دﻗﺎﺋﻖ‬ ‫‪n‬‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬
‫‪Blood Chemistry and Electrolytes‬‬

‫ﺗﺤﺪد ﻗﯿﻢ اﻟﺪم اﻟﻜﯿﻤﯿﺎﺋﯿﺔ ﻓﻲ ﻣﻌﻈﻢ اﻟﻔﺤﻮص اﻟﻤﺨﺒﺮﯾﺔ‬ ‫‪n‬‬

‫اﻟﺴﺮﯾﺮﯾﺔ ﺑﻮاﺳﻄﺔ أﺟﮭﺰة أوﺗﻮﻣﺎﺗﯿﻜﯿﺔ‬

‫ﯾﻤﻜﻦ ﻟﺠﮭﺎز واﺣﺪ أن ﯾﻘﻮم ﺑﺘﺤﺎﻟﯿﻞ ﻋﺪﯾﺪة ﺑﺎﺳﺘﻌﻤﺎل ‪٣-٢‬‬ ‫‪n‬‬

‫ﻣﻞ ﻣﻦ اﻟﻤﺼﻞ‬
‫ﺗﺆﻣﻦ ﻣﻌﻈﻢ اﻷﺟﮭﺰة اﻵﻟﯿﺔ ﻗﯿﻤﺎ ﻟـ ‪ ١٤-١٢‬ﻣﺤﺘﻮى‬ ‫‪n‬‬

‫ﻛﯿﻤﯿﺎﺋﻲ ﻓﻲ اﻟﺪم ‪..‬‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫اﻟﻜﺎﻟﺴﯿﻮم‬
‫‪Calcium‬‬
‫ﯾﺘﻮﺿﻊ ﻏﺎﻟﺒﯿﺔ اﻟﻜﺎﻟﺴﯿﻮم ﻓﻲ اﻟﺠﺴﻢ ﻓﻲ اﻟﮭﯿﻜﻞ اﻟﻌﻈﻤﻲ و اﻷﺳﻨﺎن و‬ ‫‪n‬‬

‫اﻟﺒﻘﯿﺔ ﻓﻲ اﻟﺴﺎﺋﻞ ﺧﺎرج اﻟﺨﻠﻮي‬

‫ﯾﻜﻮن ﺣﻮاﻟﻲ ‪ %٥٠‬ﻣﻦ اﻟﻜﺎﻟﺴﯿﻮم ﺧﺎرج اﻟﺨﻠﻮي ﻣﺮﺗﺒﻄﺎ ﺑﺎﻟﺒﺮوﺗﯿﻦ‬ ‫‪n‬‬
‫و اﻟﻨﺼﻒ اﻵﺧﺮ ﻣﺆﯾﻦ ﯾﺘﺤﻜﻢ ﺑﮫ ھﺮﻣﻮن ﺟﺎرات اﻟﺪرق اﻟﺬي ﯾﺮﻓﻊ‬
‫ﻣﻦ ﻣﺴﺘﻮى اﻟﻜﺎﻟﺴﯿﻮم ﻓﻲ اﻟﻤﺼﻞ ﻛﻤﺎ أن ﻓﯿﺘﺎﻣﯿﻦ د ﺿﺮوري ﻣﻦ‬
‫أﺟﻞ اﻣﺘﺼﺎص اﻟﻜﺎﻟﺴﯿﻮم ﻣﻦ اﻷﻣﻌﺎء‬
‫اﻟﻜﺎﻟﺴﯿﻮم ﺿﺮوري ﻟﻠﻨﻘﻞ اﻟﻌﺼﺒﻲ و ﺗﺨﺜﺮ اﻟﺪم و ﺗﻘﻠﺺ اﻟﻌﻀﻼت‬ ‫‪n‬‬

‫و ﻧﻔﻮذﯾﺔ اﻷﻏﺸﯿﺔ‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫اﻟﻜﺎﻟﺴﯿﻮم‬
‫‪Calcium‬‬

‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ‪ ١٠،٦ – ٩٫٠ :‬ﻣﻎ ‪١٠٠ /‬ﻣﻞ‬ ‫‪n‬‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﺮﺗﻔﻌﺔ ﻓﻲ ‪:‬‬ ‫‪n‬‬

‫‪ -‬ﻓﺮط ﻧﺸﺎط اﻟﺪرق‬

‫‪ -‬اﻻﻧﺘﻘﺎﻻت اﻟﺨﺒﯿﺜﺔ إﻟﻰ اﻟﻌﻈﺎم‬
‫‪ -‬اﻻﻧﺴﻤﺎم ﺑﻔﯿﺘﺎﻣﯿﻦ د‬
‫‪ -‬اﻟﺴﺎرﻛﻮﺋﯿﺪ‬
‫‪ -‬داء ﺑﺎﺟﯿﺖ‬
‫‪The Laboratory Tests‬‬
 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫اﻟﻜﺎﻟﺴﯿﻮم‬
‫‪Calcium‬‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﻨﺨﻔﻀﺔ ﻓﻲ ‪:‬‬ ‫‪n‬‬

‫‪ -‬ﻧﻘﺺ ﻧﺸﺎط اﻟﺪرق‬

‫‪ -‬ﻋﻮز ﻓﯿﺘﺎﻣﯿﻦ د ) اﻟﻜﺴﺎح و ﺗﻠﯿﻦ اﻟﻌﻈﺎم (‬
‫‪ -‬اﻟﻤﻌﺎﻟﺠﺔ اﻟﻤﺪﯾﺪة ﺑﻤﻀﺎدات اﻻﺧﺘﻼج‬
‫‪ -‬اﻷﻣﺮاض اﻟﻜﺒﺪﯾﺔ اﻟﻤﺰﻣﻨﺔ‬
‫‪ -‬اﻟﻘﺼﻮر اﻟﻜﻠﻮي اﻟﻤﺰﻣﻦ‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫اﻟﻔﻮﺳﻔﻮر‬
‫)‪Phosphorus ( PO4‬‬
‫ﻋﻨﺪﻣﺎ ﺗﺰداد ﻣﺴﺘﻮﯾﺎت اﻟﻜﺎﻟﺴﯿﻮم ﺗﻨﻘﺺ ﻣﺴﺘﻮﯾﺎت اﻟﻔﻮﺳﻔﺎت‬ ‫‪n‬‬

‫ﻏﯿﺮ اﻟﻌﻀﻮي ﻓﻲ اﻟﺪم‬

‫ﯾﻨﻈﻢ ھﺮﻣﻮن ﺟﺎرات اﻟﺪرق ﻣﺴﺘﻮى اﻟﻔﻮﺳﻔﻮر‬ ‫‪n‬‬

‫ﯾﺘﺤﻜﻢ ﻓﯿﺘﺎﻣﯿﻦ د ﺑﺎﻻﻣﺘﺼﺎص اﻟﻤﻌﻮي ﻟﻠﻔﻮﺳﻔﻮر‬ ‫‪n‬‬

‫ﻟﻠﻔﻮﺳﻔﻮر دور ﻓﻲ اﺳﺘﻘﻼب اﻟﺴﻜﺮﯾﺎت و اﻧﺘﺎج اﻷدﯾﻨﻮزﯾﻦ‬ ‫‪n‬‬

‫ﺛﻼﺛﻲ اﻟﻔﻮﺳﻔﺎت و ﺗﻤﻌﺪن اﻟﻌﻈﻢ و اﻷﺳﻨﺎن و ﻓﻲ ﺻﯿﺎﻏﺔ‬

‫اﻟﺤﻤﻮض اﻟﻨﻮوﯾﺔ‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫اﻟﻔﻮﺳﻔﻮر‬
‫)‪Phosphorus ( PO4‬‬

‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ﻟﺪى اﻟﺒﺎﻟﻐﯿﻦ ‪ ٤٫٥ – ٣٫٠ :‬ﻣﻎ ‪ ١٠٠ /‬ﻣﻞ‬ ‫‪n‬‬

‫ﻟﺪى اﻷﻃﻔﺎل ‪ ٧٫٠ – ٤٫٠ :‬ﻣﻎ ‪ ١٠٠ /‬ﻣﻞ‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﺮﺗﻔﻌﺔ ﻓﻲ ‪ :‬اﻟﻤﺮض اﻟﻜﻠﻮي اﻟﻤﺰﻣﻦ –‬ ‫‪n‬‬

‫اﻻﻧﺴﻤﺎم ﺑﻔﯿﺘﺎﻣﯿﻦ د – ﻗﺼﻮر ﺟﺎرات اﻟﺪرق‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﻨﺨﻔﻀﺔ ﻓﻲ ‪ :‬ﻓﺮط ﻧﺸﺎط ﺟﺎرات اﻟﺪرق –‬ ‫‪n‬‬

‫ﻓﺮط اﺳﺘﻌﻤﺎل ﻣﻀﺎدات اﻟﺤﻤﻮﺿﺔ ‪..‬‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫ﻏﻠﻮﻛﻮز اﻟﺪم أو ﺳﻜﺮ اﻟﺪم ﻋﻠﻰ اﻟﺮﯾﻖ‬

‫)‪Blood Glucose or Fasting Blood Sugar ( Gluc or FBS‬‬

‫ﺗﮭﻀﻢ اﻟﻜﺮﺑﻮھﯿﺪرات اﻟﻤﻮﺟﻮدة ﻓﻲ اﻷﻏﺬﯾﺔ اﻟﻤﺘﻨﺎوﻟﺔ‬ ‫‪n‬‬

‫ﻟﺘﺘﺤﻮل إﻟﻰ ﺳﻜﺎﻛﺮ أﺣﺎدﯾﺔ‬

‫ﺗﺘﺤﻮل ھﺬه اﻟﺴﻜﺎﻛﺮ ﺑﻌﺪ اﻻﻣﺘﺼﺎص إﻟﻰ ﻏﻠﻮﻛﻮز ﻓﻲ اﻟﻜﺒﺪ‬ ‫‪n‬‬

‫ﯾﺴﺘﺨﺪم اﻟﻐﻠﻮﻛﻮز ﻣﻦ ﻗﺒﻞ اﻟﺨﻠﯿﺔ ﻻﻧﺘﺎج اﻟﻄﺎﻗﺔ‬ ‫‪n‬‬

‫ﯾﻌﺘﺒﺮ ھﺮﻣﻮن اﻷﻧﺴﻮﻟﯿﻦ ﺿﺮورﯾﺎ ﻟﻠﺘﻮﺳﻂ ﻻﺳﺘﺨﺪام‬ ‫‪n‬‬

‫اﻟﻐﻠﻮﻛﻮز ﻓﻲ اﻟﺨﻼﯾﺎ اﻟﻤﻌﻨﯿﺔ‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫ﻏﻠﻮﻛﻮز اﻟﺪم أو ﺳﻜﺮ اﻟﺪم ﻋﻠﻰ اﻟﺮﯾﻖ‬

‫)‪Blood Glucose or Fasting Blood Sugar ( Gluc or FBS‬‬

‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ‪ ١١٠ – ٧٠ :‬ﻣﻎ ‪١٠٠ /‬ﻣﻞ ) اﻟﻤﺼﻞ (‬ ‫‪n‬‬

‫‪ ١٠٠ – ٦٠‬ﻣﻎ ‪١٠٠ /‬ﻣﻞ ) ﻛﺎﻣﻞ اﻟﺪم (‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﺮﺗﻔﻌﺔ ﻓﻲ ‪ :‬اﻟﺪاء اﻟﺴﻜﺮي – داء ﻛﻮﺷﯿﻨﻎ –‬ ‫‪n‬‬

‫اﻟﺘﮭﺎب اﻟﺒﻨﻜﺮﯾﺎس و اﺳﺘﺌﺼﺎﻟﮭﺎ – اﻟﻮرم اﻟﻤﻨﺘﺞ ﻟﻠﻐﻠﻮﻛﺎﻛﻮن‬

‫أﻣﺎ اﻟﻘﯿﻢ اﻟﻤﻨﺨﻔﻀﺔ ﻓﺘﺸﺎھﺪ ﻓﻲ ‪ :‬ﺗﺸﻤﻊ اﻟﻜﺒﺪ – داء أدﯾﺴﻮن –‬ ‫‪n‬‬

‫ﺳﻮء اﻣﺘﺼﺎص اﻟﺴﻜﺎﻛﺮ اﻻﺣﺎدﯾﺔ‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫ﺣﻤﺾ اﻟﺒﻮل‬
‫‪Uric Acid‬‬
‫ﺣﻤﺾ اﻟﺒﻮل ھﻮ اﻟﻤﻨﺘﺞ اﻟﻨﮭﺎﺋﻲ ﻓﻲ اﺳﺘﻘﻼب اﻟﺒﻮرﯾﻨﺎت‬ ‫‪n‬‬

‫إن اﻟﺒﻮرﯾﻨﺎت ﻛﺎﻷدﻧﯿﻦ و اﻟﻐﻮاﻧﯿﻦ و اﻟﺘﯿﻮزﯾﻦ ھﻲ ﻣﻜﻮﻧﺎت‬ ‫‪n‬‬

‫ﻟﻠﺤﻤﻮض اﻟﻨﻮوﯾﺔ‬
‫ﻛﺬﻟﻚ ﯾﻨﺘﺞ ﺣﻤﺾ اﻟﺒﻮل ﻣﻦ ﺗﺤﻄﻢ اﻟﻤﻮاد اﻟﺤﺎوﯾﺔ ﻋﻠﻰ اﻟﺒﻮرﯾﻦ ﻓﻲ‬ ‫‪n‬‬
‫اﻷﻏﺬﯾﺔ اﻟﻤﺘﻨﺎوﻟﺔ‬
‫ﯾﻄﺮح ﺣﻤﺾ اﻟﺒﻮل ﻣﻦ اﻟﻜﻠﯿﺘﯿﻦ ﻋﻦ ﻃﺮﯾﻖ اﻟﺮﺷﺢ اﻟﻜﺒﻲ‬ ‫‪n‬‬

‫إن ﺣﻤﺾ اﻟﺒﻮل ﻣﺎدة ﺳﺎﻣﺔ ﻟﻠﻜﻠﯿﺘﯿﻦ ﻟﺬﻟﻚ ﻓﺈن اﻷﻣﺮاض اﻟﺘﻲ‬ ‫‪n‬‬
‫ﺗﻨﻄﻮي ﻋﻠﻰ ﻓﺮط ﺣﻤﺾ اﻟﺒﻮل ﻓﻲ اﻟﺪم ﻛﺪاء اﻟﻨﻘﺮس ﯾﻤﻜﻦ أن‬
‫ﺗﺴﺒﺐ ﻗﺼﻮرا ﻛﻠﻮﯾﺎ ‪.‬‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫ﺣﻤﺾ اﻟﺒﻮل‬
‫‪Uric Acid‬‬

‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ‪ :‬ﻋﻨﺪ اﻟﺬﻛﻮر ‪ ٧٫٨ -٢٫١‬ﻣﻎ ‪١٠٠ /‬ﻣﻞ‬ ‫‪n‬‬

‫ﻋﻨﺪ اﻹﻧﺎث ‪ ٦٫٤ -٢٫٠‬ﻣﻎ ‪١٠٠ /‬ﻣﻞ‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﺮﺗﻔﻌﺔ ﻓﻲ داء اﻟﻨﻘﺮس – اﻟﻘﺼﻮر اﻟﻜﻠﻮي –‬ ‫‪n‬‬

‫اﺑﯿﻀﺎض اﻟﺪم – اﻟﻮرم اﻟﻠﻤﻔﺎوي – اﺳﺘﻌﻤﺎل اﻟﻤﺪرات‬

‫اﻟﺘﯿﺎزﯾﺪﯾﺔ – اﻟﺠﻮع – اﻻﻧﺴﻤﺎم اﻟﺮﺻﺎﺻﻲ – اﻟﻌﻼج‬
‫اﻟﻜﯿﻤﺎوي ﻟﻠﺴﺮﻃﺎن‬
‫اﻟﻘﯿﻢ اﻟﻤﻨﺨﻔﻀﺔ ﺗﻌﺘﺒﺮ ﻧﺎدرة‬ ‫‪n‬‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫اﻟﻜﻮﻟﯿﺴﺘﺮول‬
‫)‪Cholesterol (CHOL‬‬
‫إن اﻟﻜﻮﻟﯿﺴﺘﺮول اﻟﺬي ﯾﻤﻜﻦ اﻧﺘﺎﺟﮫ ﻓﻲ ﻧﺴﺞ ﻋﺪﯾﺪة ﻣﻦ‬ ‫‪n‬‬

‫اﻟﺠﺴﻢ ﯾﻤﺘﺺ ﻓﻲ اﻷﻣﻌﺎء و ﯾﺘﺤﺪ ﻣﻊ اﻟﺤﻤﻮض اﻟﺪﺳﻤﺔ‬

‫ﯾﻨﻘﻞ اﻟﺸﻜﻞ اﻟﻤﺘﺤﺪ إﻟﻰ اﻟﻜﺒﺪ و ﯾﺴﺘﺨﺪم ﻓﻲ ﺻﻨﻊ اﻷﻣﻼح‬ ‫‪n‬‬

‫اﻟﺼﻔﺮاوﯾﺔ‬
‫ﺗﺸﺎھﺪ ﺗﻮﺿﻌﺎت اﻟﻜﻮﻟﯿﺴﺘﺮول ﻓﻲ أﻣﺮاض ﻋﺪﯾﺪة أھﻤﮭﺎ‬ ‫‪n‬‬

‫ﺗﺼﻠﺐ اﻟﺸﺮاﯾﯿﻦ ‪Atherosclerosis‬‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫اﻟﻜﻮﻟﯿﺴﺘﺮول‬
‫)‪Cholesterol (CHOL‬‬

‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ‪ ٢٥٠ – ١٥٠‬ﻣﻎ ‪١٠٠ /‬ﻣﻞ‬ ‫‪n‬‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﺮﺗﻔﻌﺔ ﻓﻲ ‪ :‬اﻷﻣﺮاض اﻟﻘﻠﺒﯿﺔ اﻟﻮﻋﺎﺋﯿﺔ –‬ ‫‪n‬‬

‫اﻧﺴﺪاد اﻟﻘﻨﺎة اﻟﺼﻔﺮاوﯾﺔ – اﻟﺘﮭﺎب اﻟﻜﺒﺪ اﻟﻤﺰﻣﻦ – اﻟﺪاء‬

‫اﻟﺴﻜﺮي ﻏﯿﺮ اﻟﻤﻌﺎﻟﺞ – ﻗﺼﻮر اﻟﺪرق‬
‫ﻓﻲ ﺣﯿﻦ ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﻨﺨﻔﻀﺔ ﻓﻲ‪ :‬اﻻﻧﺘﺎﻧﺎت اﻟﺤﺎدة –‬ ‫‪n‬‬

‫اﻟﺘﮭﺎب اﻟﻜﺒﺪ اﻟﺤﺎد – ﻓﻘﺮ اﻟﺪم – اﻟﯿﺮﻗﺎن اﻻﻧﺤﻼﻟﻲ – ﺳﻮء‬

‫اﻟﺘﻐﺬﯾﺔ – أﺣﯿﺎﻧﺎ ﻓﺮط ﻧﺸﺎط اﻟﺪرق‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫اﻟﺒﯿﻠﻮروﺑﯿﻦ‬
‫‪Bilirubin‬‬
‫اﻟﺒﯿﻠﯿﺮوﺑﯿﻦ ﺻﺒﺎغ ﺻﻔﺮاوي ﻧﺎﺗﺞ ﻋﻦ ﺗﺤﻄﻢ اﻟﮭﯿﻤﻮﻏﻠﻮﺑﯿﻦ‬ ‫‪n‬‬

‫ﯾﻄﺮح اﻟﺒﯿﻠﯿﺮوﺑﯿﻦ ﺑﺴﺮﻋﺔ ﻣﻦ اﻟﺪم ﺑﻮاﺳﻄﺔ اﻟﻜﺒﺪ ﺛﻢ ﯾﻄﺮح‬ ‫‪n‬‬

‫ﺟﺰء ﻣﻨﮫ ﻣﻊ اﻟﺒﺮاز‬

‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ‪ ١٫٢ – ٠٫١ :‬ﻣﻎ ‪١٠٠ /‬ﻣﻞ‬ ‫‪n‬‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﺮﺗﻔﻌﺔ ﻓﻲ ﻓﻘﺮ اﻟﺪم اﻻﻧﺤﻼﻟﻲ – اﻟﯿﺮﻗﺎن‬ ‫‪n‬‬

‫اﻻﻧﺴﺪادي – اﻟﺘﮭﺎب اﻟﻜﺒﺪ – أﻣﺮاض اﻟﻜﺒﺪ اﻟﺨﺒﯿﺜﺔ – داء‬

‫‪Gilbert‬‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫اﻟﻔﻮﺳﻔﺎﺗﺎز اﻟﻘﻠﻮﯾﺔ‬
‫)‪Alkaline Phosphatase (Alk phos‬‬

‫اﻟﻔﻮﺳﻔﺎﺗﺎز اﻟﻘﻠﻮﯾﺔ أﻧﺰﯾﻢ ﯾﻨﺘﺠﮫ اﻟﻜﺒﺪ ﺑﻤﻘﺎدﯾﺮ ﺻﻐﯿﺮة و ﺗﻨﺘﺠﮫ اﻟﺨﻼﯾﺎ‬ ‫‪n‬‬
‫اﻟﺼﺎﻧﻌﺔ ﻟﻠﻌﻈﻢ ‪ Osteoblasts‬ﺑﻤﻘﺎدﯾﺮ ﻛﺒﯿﺮة و ھﻮ ﻓﻌﺎل ﻓﻲ ﺗﺸﻜﻞ‬
‫اﻟﻌﻈﺎم‬
‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ﻋﻨﺪ اﻟﺒﺎﻟﻐﯿﻦ ‪ ٨٥-٣٠‬وﺣﺪة دوﻟﯿﺔ ‪/‬ﻟﯿﺘﺮ‬ ‫‪n‬‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻌﺎﻟﯿﺔ ﻓﻲ أﻣﺮاض اﻟﻜﺒﺪ اﻻﻧﺴﺪادﯾﺔ – اﻻﻧﺘﻘﺎﻻت اﻟﺨﺒﯿﺜﺔ‬ ‫‪n‬‬

‫اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻟﻌﻈﺎم – ﻓﺮط ﻧﺸﺎط ﺟﺎرات اﻟﺪرق – داء ﺑﺎﺟﯿﺖ ﻟﻠﻌﻈﺎم‬
‫– ﺗﻠﯿﻦ اﻟﻌﻈﺎم – اﻟﻜﺴﺎح‬
‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﻨﺨﻔﻀﺔ ﻓﻲ ﻧﻘﺺ ﻧﺸﺎط ﺟﺎرات اﻟﺪرق – داء اﻟﺤﻔﺮ‬ ‫‪n‬‬
‫) ‪( Scurvy‬‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫أﻧﺰﯾﻢ ‪LDH‬‬
‫‪Lactic Dehydrogenase‬‬
‫ھﻮ اﻟﻤﺴﺆول ﻋﻦ أﻛﺴﺪة ﺣﻤﺾ اﻟﻠﺒﻦ و ﺣﻤﺾ اﻟﺒﯿﺮوﻓﻲ‬ ‫‪n‬‬

‫ﻟﮭﺬا اﻹﻧﺰﯾﻢ ﻋﺪة إﻧﺰﯾﻤﺎت ﻣﻤﺎﻛﺒﺔ ﻣﻨﻔﺼﻠﺔ ﻋﻦ ﺑﻌﻀﮭﺎ‬ ‫‪n‬‬

‫ﻣﻮﺟﻮدة ﻓﻲ ﻋﺪة أﻧﺴﺠﺔ ﻓﻲ اﻟﺠﺴﻢ ﺧﺎﺻﺔ ﻓﻲ اﻟﻜﺮﯾﺎت‬

‫اﻟﺤﻤﺮاء و اﻟﻘﻠﺐ و اﻟﻜﺒﺪ و اﻟﻌﻀﻼت اﻟﻤﺨﻄﻄﺔ و اﻟﻜﻠﻰ و‬
‫اﻟﺪﻣﺎغ‬
‫ﯾﺘﺤﺮر ھﺬا اﻹﻧﺰﯾﻢ ﻓﻲ اﻟﺪورة اﻟﺪﻣﻮﯾﺔ ﺑﻌﺪ اﻟﺘﺨﺮب اﻟﺨﻠﻮي‬ ‫‪n‬‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫أﻧﺰﯾﻢ ‪LDH‬‬
‫‪Lactic Dehydrogenase‬‬

‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ‪ ٢٠٧-٧١‬وﺣﺪة دوﻟﯿﺔ ‪ /‬ﻟﯿﺘﺮ‬ ‫‪n‬‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﺮﺗﻔﻌﺔ ﻓﻲ اﺣﺘﺸﺎء اﻟﻌﻀﻠﺔ اﻟﻘﻠﺒﯿﺔ اﻟﺤﺎد –‬ ‫‪n‬‬

‫اﺑﯿﻀﺎض اﻟﺪم اﻟﺤﺎد – ﻓﻘﺮ اﻟﺪم اﻻﻧﺤﻼﻟﻲ – ﻓﻘﺮ اﻟﺪم‬

‫اﻟﺨﺒﯿﺚ – اﻻﺣﺘﺸﺎءات اﻟﻜﻠﻮﯾﺔ – اﻻﻧﺘﺎﻧﺎت اﻟﻔﯿﺮوﺳﯿﺔ‬
‫اﻟﻤﻌﻤﻤﺔ‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫إﻧﺰﯾﻢ ‪SGOT‬‬
‫‪Serum Glutamic Oxaloacetic Ttansaminase‬‬

‫ﯾﻮﺟﺪ ھﺬا اﻹﻧﺰﯾﻢ ﻓﻲ اﻟﻤﻘﺎم اﻷول ﻓﻲ اﻟﻘﻠﺐ و اﻟﻜﺒﺪ‬ ‫‪n‬‬

‫ھﻮ اﻟﻤﻌﻨﻲ ﺑﺘﺤﻮﯾﻞ اﻟﺤﻤﻮض اﻷﻣﯿﻨﯿﺔ إﻟﻰ ﺣﻤﻮض ﻛﯿﺘﻮﻧﯿﺔ‬ ‫‪n‬‬

‫ﯾﻮﺟﺪ ھﺬا اﻹﻧﺰﯾﻢ ﻋﺎدة داﺧﻞ اﻟﺨﻼﯾﺎ و ﻻ ﯾﺘﺤﺮر ﻣﻨﮭﺎ إﻻ ﺑﻌﺪ‬ ‫‪n‬‬

‫اﻹﺻﺎﺑﺔ‬
‫اﻟﻘﯿﻢ اﻟﻄﺒﯿﻌﯿﺔ ‪٣٣-٨‬وﺣﺪة دوﻟﯿﺔ ‪ /‬ﻟﯿﺘﺮ‬ ‫‪n‬‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﺮﺗﻔﻌﺔ ﻓﻲ اﻟﺘﮭﺎب اﻟﻜﺒﺪ اﻟﺤﺎد – اﺣﺘﺸﺎء اﻟﻌﻀﻠﺔ‬ ‫‪n‬‬

‫اﻟﻘﻠﺒﯿﺔ اﻟﺤﺎد – ﺗﺸﻤﻊ اﻟﻜﺒﺪ – أﻣﺮاض اﻟﻌﻀﻼت اﻟﮭﯿﻜﻠﯿﺔ –‬
‫اﻹﻧﺘﺎﻧﺎت اﻟﻤﻌﻤﻤﺔ – ﻗﺼﻮر اﻟﻘﻠﺐ اﻻﺣﺘﻘﺎﻧﻲ‬

‫‪The Laboratory Tests‬‬

 ‫ﻛﯿﻤﯿﺎء اﻟﺪم و اﻟﻜﮭﺮﻟﯿﺎت‬

‫إﻧﺰﯾﻢ ‪SGPT‬‬
‫‪Serum Glutamic Pyruvic Transaminase‬‬

‫اﻟﻤﻘﺎدﯾﺮ اﻟﻄﺒﯿﻌﯿﺔ ‪ ٣٦ -٦ :‬وﺣﺪة دوﻟﯿﺔ ‪ /‬ﻣﻞ‬ ‫‪n‬‬

‫ﯾﺮﺗﻔﻊ ﻓﻲ أذﯾﺎت اﻟﻜﺒﺪ أﻛﺜﺮ ﻣﻦ أذﯾﺎت اﻟﻌﻀﻠﺔ اﻟﻘﻠﺒﯿﺔ‬ ‫‪n‬‬

‫‪The Laboratory Tests‬‬

 ‫ﻓﺤﺺ اﻟﺒﻮل‬
‫‪Examination of the Urine‬‬
‫ﯾﻌﺘﺒﺮ ﻓﺤﺺ اﻟﺒﻮل أﺣﺪ أﻗﺪم اﻷﻣﺜﻠﺔ ﻋﻠﻰ اﻻﺧﺘﺒﺎرات‬ ‫‪n‬‬
‫اﻟﻤﺨﺒﺮﯾﺔ إذ ﯾﻘﺪم ﻣﻌﻠﻮﻣﺎت ﻷﺟﻞ ﺗﺸﺨﯿﺺ أﻣﺮاض اﻟﻜﻠﻰ‬
‫و اﻟﺠﮭﺎز اﻟﺒﻮﻟﻲ و ﺑﻌﺾ اﻷﻣﺮاض اﻟﺠﮭﺎزﯾﺔ اﻷﺧﺮى‬
‫ﺗﺠﻤﻊ ﻋﯿﻨﺔ اﻟﺒﻮل ﻓﻲ ﻣﻨﺘﺼﻒ اﻟﺘﺒﻮل ﻓﻲ وﻋﺎء ﻧﻈﯿﻒ و‬ ‫‪n‬‬
‫ﺟﺎف و ﺗﻔﻀﻞ ﻋﯿﻨﺔ اﻟﺼﺒﺎح ﺑﻌﺪ ‪ ١٢‬ﺳﺎﻋﺔ ﻣﻦ اﻟﺘﻮﻗﻒ ﻣﻦ‬
‫أﺧﺬ اﻟﺴﻮاﺋﻞ و ﯾﺤﺮص ﻋﻠﻰ ﻋﺪم ﺗﻠﻮﯾﺚ اﻟﻌﯿﻨﺔ ﺑﻤﻔﺮزات‬
‫ﻣﮭﺒﻠﯿﺔ أو ﻧﺰﻓﯿﺔ إذا أﻣﻜﻦ‬
‫ﯾﺠﺐ إﺟﺮاء اﻟﺘﺤﻠﯿﻞ ﺧﻼل ﺳﺎﻋﺘﯿﻦ ﻣﻦ ﺑﺪء ﺟﻤﻊ اﻟﺒﻮل‬ ‫‪n‬‬

‫‪The Laboratory Tests‬‬

 ‫ﻓﺤﺺ اﻟﺒﻮل‬

‫ﻣﻈﮭﺮ اﻟﺒﻮل و ﻟﻮﻧﮫ‬

‫‪Appearance and Color‬‬
‫ﯾﻜﻮن اﻟﻠﻮن اﻟﻄﺒﯿﻌﻲ ﻋﺎدة أﺻﻔﺮ ‪ Yellow‬أو ﻋﻨﺒﺮي ‪Amber‬‬ ‫‪n‬‬

‫إذا ﻛﺎن اﻟﻠﻮن أﺣﻤﺮ – أﺣﻤﺮ ﺑﻨﻲ ﻓﮭﺬا ﯾﺸﺎھﺪ ﻓﻲ اﻷﻣﺮاض اﻻﻧﺘﺎﻧﯿﺔ أو‬ ‫‪n‬‬
‫اﻟﺨﺒﯿﺜﺔ أو ﻓﻘﺮ اﻟﺪم اﻻﻧﺤﻼﻟﻲ اﻟﻤﻨﺎﻋﻲ اﻟﺬاﺗﻲ و ﻓﻲ ﺣﺎﻻت اﻟﺒﯿﻠﺔ اﻟﺪﻣﻮﯾﺔ‬
‫ﯾﻨﺘﺞ ﻟﻮن اﻟﺒﻮل اﻷﺻﻔﺮ اﻟﺒﻨﻲ أو اﻷﺧﻀﺮ اﻟﺒﻨﻲ ﻣﻦ اﻟﯿﺮﻗﺎن اﻻﻧﺴﺪادي‬ ‫‪n‬‬

‫ﯾﻨﺘﺞ اﻟﻠﻮن اﻷﺻﻔﺮ اﻟﺒﺮﺗﻘﺎﻟﻲ ﻣﻦ اﻟﺘﺠﻔﺎف أو اﻟﺤﺮارة أو ﻓﺮط وﺟﻮد‬ ‫‪n‬‬

‫اﻟﯿﻮروﺑﯿﻠﯿﻨﻮﺟﯿﻦ‬
‫ﯾﻼﺣﻆ اﻟﻠﻮن اﻟﺒﻨﻲ اﻟﺪاﻛﻦ أو اﻷﺳﻮد ﻓﻲ اﻷورام اﻟﻘﯿﺘﺎﻣﯿﻨﯿﺔ اﻟﺨﺒﯿﺜﺔ‬ ‫‪n‬‬
‫اﻟﺸﺪﯾﺪة أو داء أدﯾﺴﻮن‬

‫‪The Laboratory Tests‬‬

 ‫ﻓﺤﺺ اﻟﺒﻮل‬

‫اﻟﻮزن اﻟﻨﻮﻋﻲ ) ﻛﺜﺎﻓﺔ اﻟﺒﻮل (‬

‫‪Specific Gravity‬‬

‫ھﻮ ﻛﺘﻠﺔ ﺟﺤﻢ ﻣﻦ اﻟﺒﻮل إﻟﻰ ﻛﺘﻠﺔ ﺣﺠﻢ ﻣﺴﺎو ﻣﻦ اﻟﻤﺎء ﻋﻨﺪ‬ ‫‪n‬‬

‫درﺟﺔ ﺣﺮارة ﻣﻌﯿﻨﺔ‬

‫اﻟﻘﯿﻤﺔ اﻟﻄﺒﯿﻌﯿﺔ ‪١٫٠٣٥ -١٫٠٠١ :‬‬ ‫‪n‬‬

‫ﯾﺰداد ﻓﻲ ﺣﺎﻻت اﻟﺘﺠﻔﺎف – اﻟﺒﯿﻠﺔ اﻟﺪﻣﻮﯾﺔ – اﻟﺪاء اﻟﺴﻜﺮي‬ ‫‪n‬‬

‫– داء أدﯾﺴﻮن‬
‫ﯾﻨﺨﻔﺾ ﻓﻲ اﻟﺒﯿﻠﺔ اﻟﺘﻔﮭﺔ اﻟﻤﺮﻛﺰﯾﺔ أو اﻟﻜﻠﻮﯾﺔ اﻟﻤﻨﺸﺄ –‬ ‫‪n‬‬

‫اﻟﻘﺼﻮر اﻟﻜﻠﻮي اﻟﻤﺰﻣﻦ‬

‫‪The Laboratory Tests‬‬

 ‫ﻓﺤﺺ اﻟﺒﻮل‬

‫درﺟﺔ اﻟﺤﻤﻮﺿﺔ ‪PH‬‬

‫إن اﻟﺒﻮل اﻟﻄﺒﯿﻌﻲ ﺣﺎﻣﻀﻲ اﻟﺘﻔﺎﻋﻞ‬ ‫‪n‬‬

‫اﻟﻄﺒﯿﻌﻲ ‪ ٦‬و ﯾﻤﻜﻦ أن ﺗﺘﺮاوح ﺑﯿﻦ ‪٨ - ٤٫٦‬‬ ‫‪n‬‬

‫ﯾﻜﻮن اﻟﺒﻮل ﺣﺎﻣﻀﯿﺎ ﻓﻲ اﻟﺪاء اﻟﺴﻜﺮي ) ﺑﯿﻠﺔ ﺧﻠﻮﻧﯿﺔ ( – اﻟﻨﻘﺮس‬ ‫‪n‬‬

‫– ﺑﻌﺪ ﺗﻨﺎول ﻛﻤﯿﺎت ﻛﺒﯿﺮة ﻣﻦ اﻟﻠﺤﻮم‬

‫ﯾﻜﻮن اﻟﺒﻮل ﻗﻠﻮﯾﺎ ﻓﻲ ﻗﺼﻮر اﻟﻜﻠﻰ – اﻟﻘﻼء اﻻﺳﺘﻘﻼﺑﻲ‬ ‫‪n‬‬

‫) اﻹﻗﯿﺎءات اﻟﺸﺪﯾﺪة و اﻟﻤﺪﯾﺪة – اﻟﻤﻌﺎﻟﺠﺔ ﺑﺎﻟﻘﻠﻮﯾﺎت ( – ازدﯾﺎد‬

‫ﺗﻨﺎول ﺛﻤﺎر اﻟﺤﻤﻀﯿﺎت‬

‫‪The Laboratory Tests‬‬

 ‫ﻓﺤﺺ اﻟﺒﻮل‬

‫اﻟﺒﺮوﺗﯿﻦ ﻓﻲ اﻟﺒﻮل‬
‫‪Protein‬‬
‫ﻓﻲ اﻟﺤﺎﻟﺔ اﻟﻄﺒﯿﻌﯿﺔ ﻻ ﯾﺤﺘﻮي اﻟﺒﻮل ﻋﻠﻰ أي ﺑﺮوﺗﯿﻦ‬ ‫‪n‬‬

‫ﺣﯿﺚ ﺗﻤﻨﻊ اﻟﻜﺒﺐ اﻟﻄﺒﯿﻌﯿﺔ ﺑﺮوﺗﯿﻨﺎت اﻟﻤﺼﻞ اﻟﻜﺒﯿﺮة ﻣﻦ‬ ‫‪n‬‬

‫اﻟﻤﺮور ﻋﺒﺮھﺎ‬
‫ﻋﻨﺪﻣﺎ ﯾﻮﺟﺪ اﻟﺒﺮوﺗﯿﻦ ﻓﻲ اﻟﺒﻮل ﯾﺠﺐ ﻣﻌﺮﻓﺔ ﻧﻮع اﻟﺒﺮوﺗﯿﻦ‬ ‫‪n‬‬

‫و ﻣﺎ ھﻮ ﺳﺒﺐ ﺗﺴﺮﺑﮫ‬
‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻤﺮﺗﻔﻌﺔ ﻓﻲ أﻣﺮاض اﻟﻜﺒﺐ اﻟﻜﻠﻮﯾﺔ و اﻟﻮرم‬ ‫‪n‬‬

‫اﻟﻨﺨﺎﻋﯿﻨﻲ اﻟﻤﺘﻌﺪد و ﻗﺼﻮر اﻟﻘﻠﺐ اﻻﺣﺘﻘﺎﻧﻲ‬

‫‪The Laboratory Tests‬‬

 ‫ﻓﺤﺺ اﻟﺒﻮل‬

‫اﻟﻐﻠﻮﻛﻮز ﻓﻲ اﻟﺒﻮل‬
‫‪Glucose‬‬

‫ﺣﺘﻰ ﯾﻈﮭﺮ اﻟﻐﻠﻮﻛﻮز ﻓﻲ اﻟﺮﺷﺎﺣﺔ اﻟﻜﺒﯿﺔ ﯾﺠﺐ أن ﯾﻜﻮن‬ ‫‪n‬‬

‫ﺗﺮﻛﯿﺰه ﻓﻲ اﻟﻤﺼﻞ ﻓﻮق ‪ ١٤٠ -١٣٠‬ﻣﻎ ‪١٠٠/‬ﻣﻞ‬

‫اﻟﻘﯿﻤﺔ اﻟﻄﺒﯿﻌﯿﺔ ‪ :‬اﻟﺘﻔﺎﻋﻞ ﺳﻠﺒﻲ ) ﻏﯿﺮ ﻣﻮﺟﻮدة (‬ ‫‪n‬‬

‫أﻣﺎ إذا ﻛﺎن اﻟﺘﻔﺎﻋﻞ إﯾﺠﺎﺑﻲ ﻓﮭﺬا ﯾﺸﯿﺮ إﻟﻰ اﻟﺪاء اﻟﺴﻜﺮي –‬ ‫‪n‬‬

‫ﺗﺄذي اﻟﻜﺒﺪ – اﻟﺘﮭﺎب اﻟﺒﻨﻜﺮﯾﺎس – ﻓﺮط ﻧﺸﺎط اﻟﺪرق‬

‫‪The Laboratory Tests‬‬

 ‫ﻓﺤﺺ اﻟﺒﻮل‬

‫اﻟﻜﯿﺘﻮﻧﺎت‬
‫‪Ketones‬‬

‫ﻻ ﺗﻮﺟﺪ اﻟﻜﯿﺘﻮﻧﺎت ﻓﻲ اﻟﺒﻮل ﻓﻲ اﻟﺤﺎﻟﺔ اﻟﻄﺒﯿﻌﯿﺔ‬ ‫‪n‬‬

‫ﯾﻤﻜﻦ أن ﺗﺘﺴﺮب إﻟﯿﮫ ﻛﻨﺘﯿﺠﺔ ﻟﻼﺳﺘﻘﻼب ﻏﯿﺮ اﻟﻜﺎﻣﻞ ﻟﻠﺪﺳﻢ‬ ‫‪n‬‬

‫أو اﺳﺘﺨﺪام اﻟﺪﺳﻢ ﻛﻤﺼﺪر ﻟﻠﻄﺎﻗﺔ‬

‫ﯾﻤﻜﻦ ﻟﻠﻘﯿﻢ ﻏﯿﺮ اﻟﻄﺒﯿﻌﯿﺔ أن ﺗﺤﺪث ﻓﻲ اﻟﺪاء اﻟﺴﻜﺮي‬ ‫‪n‬‬

‫اﻟﺸﺪﯾﺪ – اﻟﺠﻮع – اﻟﺤﻤﯿﺔ‬

‫‪The Laboratory Tests‬‬

 ‫ﻓﺤﺺ اﻟﺒﻮل‬

‫اﻟﺒﯿﻠﯿﺮوﺑﯿﻦ‬
‫‪Bilirubin‬‬
‫ﻓﻲ اﻟﺤﺎﻟﺔ اﻟﻄﺒﯿﻌﯿﺔ ﯾﺮﺗﺸﺢ اﻟﺒﯿﻠﯿﺮوﺑﯿﻦ اﻟﻤﺮﺗﺒﻂ ﻋﺒﺮ اﻟﺼﻔﺮاء‬ ‫‪n‬‬

‫ﻓﻲ اﻟﺤﺎﻻت ﻏﯿﺮ اﻟﻄﺒﯿﻌﯿﺔ ﻗﺪ ﺗﺮﺗﺸﺢ ﻛﻤﯿﺎت ﻛﺒﯿﺮة ﻣﻦ‬ ‫‪n‬‬

‫اﻟﺒﯿﻠﯿﺮوﺑﯿﻦ اﻟﻤﺮﺗﺒﻂ ﻣﻦ اﻟﻜﻠﯿﺘﯿﻦ‬

‫اﻟﻘﯿﻤﺔ اﻟﻄﺒﯿﻌﯿﺔ ‪ ٠٫٠٢ -٠ :‬ﻣﻎ ‪١٠٠ /‬ﻣﻞ‬ ‫‪n‬‬

‫ﻗﺪ ﺗﻨﺠﻢ اﻟﻘﯿﻢ اﻟﻌﺎﻟﯿﺔ ﻋﻦ اﻟﯿﺮﻗﺎن اﻻﻧﺴﺪادي – اﻟﺘﮭﺎب اﻟﻜﺒﺪ أو‬ ‫‪n‬‬

‫أي ﻣﺮض ﻛﺒﺪي آﺧﺮ‬

‫‪The Laboratory Tests‬‬

 ‫ﻓﺤﺺ اﻟﺒﻮل‬

‫اﻟﯿﻮروﺑﯿﻠﯿﻨﻮﺟﯿﻦ‬
‫‪Urobilinogen‬‬
‫اﻟﯿﻮروﺑﯿﻠﯿﻨﻮﺟﯿﻦ ﻣﺸﺘﻖ ﻧﺎﺗﺞ ﻋﻦ إرﺟﺎع اﻟﺒﯿﻠﯿﺮوﺑﯿﻦ و ذﻟﻚ‬ ‫‪n‬‬
‫ﻓﻲ اﻷﻣﻌﺎء‬
‫ﯾﻌﺎد اﻣﺘﺼﺎص ﺟﺰء ﻣﻦ اﻟﯿﻮروﺑﯿﻠﯿﻨﻮﺟﯿﻦ إﻟﻰ اﻟﺪوران و‬ ‫‪n‬‬
‫ﯾﻤﻜﻦ أن ﯾﻄﺮح ﻓﻲ اﻟﺒﻮل‬
‫اﻟﻘﯿﻤﺔ اﻟﻄﺒﯿﻌﯿﺔ ‪ ٢٫٥ – ٠٫٥ :‬ﻣﻎ ‪ ٢٤ /‬ﺳﺎﻋﺔ‬ ‫‪n‬‬

‫ﺗﺸﺎھﺪ اﻟﻘﯿﻢ اﻟﻌﺎﻟﯿﺔ ﻓﻲ أﻣﺮاض اﻟﻜﺒﺪ و ﻓﻘﺮ اﻟﺪم اﻻﻧﺤﻼﻟﻲ‬ ‫‪n‬‬

‫أﻣﺎ اﻟﻘﯿﻢ اﻟﻤﻨﺨﻔﻀﺔ ﻓﺘﺸﺎھﺪ ﺑﻌﺪ اﻻﻧﺴﺪاد اﻟﻜﺎﻣﻞ ﻟﻠﻘﻨﺎة‬ ‫‪n‬‬

‫اﻟﺼﻔﺮاوﯾﺔ‬
‫‪The Laboratory Tests‬‬
 ‫اﻟﺰرع اﻟﺠﺮﺛﻮﻣﻲ و اﺧﺘﺒﺎر اﻟﺘﺤﺴﺲ‬
‫‪Bacterial Culture and Sensitivity Testing‬‬

‫ﺗﺴﺘﺨﺪم اﺧﺘﺒﺎرات اﻟﺰرع و اﻟﺘﺤﺴﺲ ﻟﻌﺰل و ﺗﻌﯿﯿﻦ‬ ‫‪n‬‬

‫اﻟﻌﻀﻮﯾﺎت اﻟﺪﻗﯿﻘﺔ اﻟﻤﻤﺮﺿﺔ اﻟﻤﺴﺒﺒﺔ ﻟﻼﻧﺘﺎن و ﻣﻦ أﺟﻞ‬

‫ﺗﺤﺪﯾﺪ اﻟﺼﺎد اﻟﺬي ﯾﺆﺛﺮ ﻋﻠﻰ ﻧﻤﻮھﺎ‬
‫ﯾﻔﯿﺪ اﺧﺘﺒﺎر اﻟﺘﺤﺴﺲ ﻋﻨﺪﻣﺎ ﻻ ﯾﺴﺘﺠﯿﺐ اﻟﻤﺮﯾﺾ ﻟﻠﻤﻌﺎﻟﺠﺔ‬ ‫‪n‬‬

‫ﻗﺪ ﯾﻄﻠﺐ ﻣﻦ اﻟﻤﺮﯾﺾ اﺧﺘﺒﺎرات اﻟﺘﺤﺴﺲ ﻋﻨﺪ ﻧﻜﺲ‬ ‫‪n‬‬

‫ﻣﺮﺿﮫ أو ﻋﻨﺪﻣﺎ ﯾﻜﻮن ﺗﺤﺪﯾﺪ ﻧﻮع اﻟﻌﻀﻮﯾﺔ اﻟﻤﻤﺮﺿﺔ‬

‫ﻏﯿﺮ ﻣﺆﻛﺪ أو ﻋﻨﺪﻣﺎ ﯾﻜﻮن اﻟﻤﺮض ﺷﺪﯾﺪا أو ﺧﺎﻃﻔﺎ‬

‫‪The Laboratory Tests‬‬

 ‫اﻟﺰرع اﻟﺠﺮﺛﻮﻣﻲ و اﺧﺘﺒﺎر اﻟﺘﺤﺴﺲ‬
‫‪Bacterial Culture and Sensitivity Testing‬‬

‫ﻟﻠﺰرع و اﺧﺘﺒﺎر اﻟﺘﺤﺴﺲ ﻓﺎﺋﺪة ﻋﻠﻰ وﺟﮫ اﻟﺨﺼﻮص ﻓﻲ‬ ‫‪n‬‬

‫ﺗﻘﯿﯿﻢ اﻧﺘﺎﻧﺎت اﻟﺤﻠﻖ و اﻟﺮﺷﺎﺣﺎت اﻟﻨﺎﺟﻤﺔ ﻋﻦ إﻧﺘﺎﻧﺎت‬

‫اﻟﺠﯿﻮب‬
‫إﻧﺘﺎﻧﺎت أﻗﻨﯿﺔ اﻟﺠﺬر و اﻟﺠﻠﺪ و اﻷﻏﺸﯿﺔ اﻟﻤﺨﺎﻃﯿﺔ‬ ‫‪n‬‬

‫اﻹﻧﺘﺎﻧﺎت اﻟﻌﻈﻤﯿﺔ ) اﻟﺘﮭﺎب اﻟﻌﻈﻢ و اﻟﻨﻘﻲ (‬ ‫‪n‬‬

‫ﯾﻤﻜﻦ إﺟﺮاء اﺧﺘﺒﺎر زرع ﻟﻠﻔﻄﻮر اﻟﻔﻤﻮﯾﺔ‬ ‫‪n‬‬

‫ﯾﻤﻜﻦ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﻤﺰارع اﻟﺠﺮﺛﻮﻣﯿﺔ ﻣﻦ اﻟﺪم أو اﻟﺒﻮل‬ ‫‪n‬‬

‫‪The Laboratory Tests‬‬

How can you get more information about
lab tests ?

The American Association for Clinical Chemistry

(AACC) and other prominent laboratory
associations have created a detailed website
about clinical lab testing. You can use this
website to learn general information about lab
tests as well as specific information about lab
tests your doctor may prescribe …
http://www.fda.gov

The Laboratory Tests