《医学检验技术》课件-Biochemical constituents in Blood血液中的生化成分

EnglishforMedicalLaboratoryTechnologyBiochemicalConstituentsinBlood--DiagnosticCluesRevealed

血液中的生化成分：隐藏的诊断密码

BiochemicalComponentsWe'llexplorethevitalbiochemicalconstituents[kən'stituənts]inblood，thechemicalmessengersthatrevealourhealthstatus.我们将探索血液中重要的生化成分,它们是揭示我们健康状况的化学信使Let'sbeginwiththemostabundantplasmaproteins.

PlasmaProteins血浆蛋白

1.Albuminmaintainsosmotic[ɒzˈmɒtɪk]pressure,lowlevelscauseedema[ɪˈdiːmə].白蛋白维持渗透压，低水平引起水肿2.Globulinincludesantibodiesfightinginfections.球蛋白包括抵抗感染的抗体3.Fibrinogenenables[ɪˈneɪbəlz]clotting.纤维蛋白原使血液凝固Plasmaproteinsconstitute[ˈkɒnstɪtjuːt]7%ofbloodvolume.血浆蛋白占血容量的7%

1.Albumin[ˈælbjʊmɪn]白蛋白:35-50g/LMaintainsosmoticpressure.Edema<35g/L2.Globulin[ˈɡlɒbjʊlɪn]球蛋白:20-35g/LIncludeantibodies→Fightinfections

↓inimmunodeficiency3.Fibrinogen[faɪˈbrɪnədʒən]纤维蛋白原:2-4g/LClottingfactor→CriticalforhemostasisBleedingrisk<1.5g/L

Bilirubin胆红素4.Direct[dəˈrekt]orConjugated[ˈkɒndʒʊɡeɪtɪd]bilirubin直接胆红素,结合胆红素5.1-17.1μmol/L;Water-soluble,excretedviabile

5.IndirectorUnconjugatedbilirubin

间接胆红素,未结合胆红素3.4-10.3μmol/L;Lipid-soluble,neurotoxicif↑↑6.Totalbilirubin[ˌbɪlɪˈruːbɪn]总胆红素5.1-17.1μmol/L↑inhemolysisorliverdisease4.Directbilirubiniswater-soluble,risesinbileductobstruction.直接胆红素是水溶性的，在胆管阻塞时升高5.Indirectbilirubinisfat-soluble,spikesinhemolysis[hiːˈmɒlɪsɪs].间接胆红素是脂溶性的，在溶血时有峰值6.Total[ˈtəʊtəl]bilirubincombinesbothtypes.总胆红素结合了这两种类型

Enzymes酶7.Alanine[ˈæləniːn]transaminase,ALT丙氨酸转氨酶

♂<40U/L,♀<35U/LMostspecifictoliverdamage(90%hepatic)Pathology:>100U/L=Activehepatitis/toxicity8.Aspartate[əˈspɑːteɪt]

transaminase,AST天冬氨酸转氨酶

8-40U/L

Live/heart/muscleinjurymarkerAST:ALT>2→Alcoholicliverdisease7.ALTisourmostloyal['lɒɪəl]liversentinel[ˈsentɪnəl].丙氨酸转氨酶是我们最忠诚的肝脏哨兵WhenALTexceeds100U/L,hepatocytes[hɪˈpætəˌsaɪt]aredying,thinkviralhepatitisordrugtoxicity.

当ALT高于100U/L时，说明肝细胞正在死亡，可能是病毒性肝炎或药物中毒8.AST,lessspecificbutcrucial,whileisolated[ˈaɪsəleɪtɪd]ASTspikessuggestcardiacormuscleinjury.

天冬氨酸转氨酶特异性较低但至关重要，而孤立的AST峰值提示心脏或肌肉损伤9.Alkaline[ˈælkəlaɪn]Phosphatase[ˈfɒsfəˌteɪs],ALP碱性磷酸酶

30-110U/LRole:Bileduct&bonediseaseindicator胆管及骨病指标Pathology:>300U/L→Biliaryobstruction10.γ-Glutamyl[ˈɡluːtəmɪl]Transferase,GGTγ谷酰基转移酶♂11-50,♀7-32U/LRole:Alcohol&cholestasis[kəʊlɪ'steɪsɪs]sensitivityClinicalTip:GGT+ALP↑=Biliarypathology9.ALPrises[ˈraɪzɪz]withbileductobstruction[əbˈstrʌkʃn].胆总管梗阻时ALP升高Note:childrenorpregnantwomenhavehigherbaselines.儿童/孕妇的基线较高

10.GGT,alcohol'sfavoritebiomarker.PairedwithALP,itpinpointsbiliary[ˈbɪliəri]disease.酒精肝增高，与ALP诊断胆道疾病

Remember:ALT+ASTassess[əˈses]hepatocytes,ALP+GGTmonitorbileflow,togethertheymapliverhealth!ALT+AST评估肝细胞，ALP+GGT监测胆汁，共同绘制肝脏健康图

Enzyme酶

代谢废物metabolicwaste：11.Urea[jʊˈriːə]尿素:2.5-6.5mmol/LRenalfailure>7.5mmol/LKidneyfunctionmarker↑inrenalfailure12.Creatinine[kriːˈætəˌniːn]肌酐:♂60-110♀45-90μmol/LMusclemetabolismindicator13.Uric[ˈjʊərɪk]Acid尿酸:♂210-420♀150-350μmol/LGout>480g/Lpurinebreakdownproduct→Goutif↑11.Ureaconcentrationreflectsrenalefficiency,>7.5mmol/Lsuggestkidneyimpairment.尿素浓度反映肾功能，>7.5提示肾损害12.Creatinine,amusclemetabolism[məˈtæbəlɪzəm]product,risesproportionally[prəˈpɔːʃənli]torenalinsufficiency

肌酐是一种肌肉代谢产物，随着肾功能不全而增加.13.uricacidaccumulation[əˌkjuːmjəˈleɪʃn]

causes[ˈkɔːzɪz]

gout.尿酸积聚引起痛风Theresultsrefletthefiltration,secretionandreabsorptionfunctionofkidney.结果反映了肾脏的滤过、分泌和重吸收功能。14.Troponin[ˈtrɒpənɪn]n.肌钙蛋白(cTnI/cTnT),cTnI<0.04ng/mL,cTnT<0.1ng/mLGoldstandardformyocardial[ˌmaɪəʊˈkɑːdiəl]infarction[ɪnˈfɑːkʃn](MI)

诊断心肌梗死的黄金标准Pathology:>0.5ng/mL(cTnT)→AcuteMI

15.Creatine[ˈkriːətɪn]Kinase,CK-MB肌酸激酶;0-24U/LSpecificformyocardialinjury对心肌损伤有特异性CK-MBmass>5%oftotalCKconfirmscardiacorigin

Theincreaseoftroponinandcreatinekinase

indicates

thattheheartcellsaredamagedtosomeextent.

肌钙蛋白和激酸激酶浓度升高说明心肌细胞受到了一定程度的损伤CardiacMarkers心脏标志物

BloodLipids&Glucose血脂和血糖1.Triglyceridesstoreenergy,elevated[ˈelɪveɪtɪd]aftermeals.甘油三酯储存能量，餐后升高2.Cholesterolbuildscells,LowDensityLipoprotein,LDL(bad')deposits[dɪˈpɒzɪts]inarteries,HDL('good')removesit.

胆固醇构建细胞，低密度脂蛋白沉积在动脉中，高密度脂蛋白可将之转移到肝脏

3.Glucosefuels[ˈfjuːəlz]cells,diabetic[ˌdaɪəˈbetɪk]monitoringreliesonfastinglevels.

葡萄糖是细胞能量来源，糖尿监测依赖于空腹血糖值

fastinglevels>7.0mmol/Ldefinediabetes.当高于7.0可诊断糖尿病16.Triglyceride[traɪˈɡlɪsəraɪd]n.甘油三酯<1.7mmol/L

Energystorage↑post-meal↑Cardiovascularrisk心血管风险17.Cholesterol[kəˈlestərɒl]n.胆固醇<5.2mmol/L18.Glucose[ˈɡluːkəʊs]n.葡萄糖

Fasting3.9-6.1mmol/LDiabetes>7.0mmol/L

Primaryenergysource→Diabetesmonitorelectrolytesincludepotassium[pəˈtæsiəm],sodium[ˈsəʊdiəm],chloride[ˈklɔːraɪd]andcalcium[ˈkælsiəm].电解质包括钾、钠、氯、钙Potassium(K⁺):3.5-5.0mmol/LCriticalforcardiacrhythm;<3.5→arrhythmiaSodium(Na⁺):135-145mmol/LGovernsfluidbalance;<135→cerebraledemaChloride(Cl⁻):98-106mmol/LMaintainsacid-basebalanceCalcium(Ca²⁺):2.1-2.6mmol/LEssentialformusclecontraction/coagulation

电解质electrolytesThebiochemicalconstituents[kən'stituənts]ofbloodadditionallyencompass[ɪnˈkʌmpəs