CBC
CBC
-2 ﻗﺴﻢ ﺍﻟﻤﺨﺘﺒﺮﺍﺕ ﺍﻟﻄﺒﻴﺔ ﻭﺑﻨﻚ ﺍﻟﺪﻡ . Department of
Medical Laboratory and Blood Bank :
ﺟﻬﺎﺯ ﺗﻌﺪﺍﺩ ﺍﻟﺪﻡ ﺍﻟﻜﺎﻣﻞ - ( CBC) . Complete Blood Count
:device
ﺍﻟﻔﺤﻮﺻﺎﺕ ﺍﻟﺘﻲ ﻳﻘﻮﻡ ﺑﻬﺎ ﺍﻟﺠﻬﺎﺯ :
ﺇﻥ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ ﻋﺒﺎﺭﺓ ﻋﻦ ﺟﻬﺎﺯ ﺍﺧﺘﺒﺎﺭ ﻭﺗﺤﻠﻴﻞ ﺍﻟﺪﻡ ﺍﻷﻭﺗﻮﻣﺎﺗﻴﻜﻲ
ﻟﺤﺎﻻﺗﺎﻟﺘﺸﺨﻴﺺ ﺍﻟﺨﺎﺭﺟﻲ ﻟﻺﻧﺴﺎﻥ ( Invitro ) ﻭﺍﻟﺬﻱ ﻳﺴﺘﺨﺪﻡ ﻓﻲ
ﺍﻟﻤﺨﺘﺒﺮﺍﺕ ﺍﻟﻄﺒﻴﺔ ﻭﻳﺘﻢ ﻣﻦ ﺧﻼﻟﻪ ﺇﺟﺮﺍﺀ ﺍﻟﻔﺤﻮﺻﺎﺕ ﺍﻟﺘﺎﻟﻴﺔ:
ﻋﺪﺩ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ ( WBC ) .
ﻋﺪﺩ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ)) .RBC
ﻋﺪﺩ ﺍﻟﺼﻔﺎﺋﺢ ﺍﻟﻤﻮﻳﺔ ﻓﻲ ﺍﻟﺪﻡ (PLT ) .
ﺗﺮﻛﻴﺰ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ( Hgb ) .
ﺍﻟﺤﺠﻢ ﺍﻟﺠﺴﻴﻤﻲ ﻟﻜﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ( MVC ) .
ﻧﺴﺒﺔ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻓﻲ ﺍﻟﺪﻡ ( HCT).
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ﻳﺴﺘﺨﺪﻡ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ ﻹﻋﻄﺎﺀ ﺻﻮﺭﺓ ﻛﺎﻣﻠﺔ ﻟﻤﻜﻮﻧﺎﺕ ﺍﻟﺪﻡ ﻭﻳﺘﻢ ﺍﺳﺘﺨﺪﺍﻡ
ﺃﻧﺎﺑﻴﺐ ﺍﻟﺪﻡ ﺍﻟﻤﺤﺘﻮﻳﺔ ﻋﻠﻰ ﻣﺎﻧﻊ ﺍﻟﺘﺠﻠﻂ EDTA ﻛﺄﻓﻀﻞ ﻣﺎﻧﻊ ﺗﺠﻠﻂ
ﻟﻘﺴﻢ ﻋﻠﻢ ﺍﻟﺪﻡ , ﺣﻴﺚ ﻳﻤﻨﻊ ﺗﺮﺍﺹ ﻛﺮﺍﺕ ﺍﻟﺪﻡ ﻭﺍﻟﻤﻜﻮﻧﺎﺕ ﺍﻷﺧﺮﻯ ﻋﻠﻰ
ﺑﻌﻀﻬﺎ ﻣﻤﺎ ﻳﺴﺎﻋﺪ ﻋﻠﻰ ﺇﻋﻄﺎﺀ ﻧﺘﺎﺋﺞ ﺻﺤﻴﺤﺔ , ﻭﺿﻤﺎﻥ ﺳﻼﻣﺔ ﺟﻬﺎﺯ ﺍﻟــ
C.B.C ﻣﻦ ﺍﻧﺴﺪﺍﺩ ﻣﺠﺎﺭﻱ ﺍﻟﺠﻬﺎﺯ ﻓﻲ ﺣﺎﻟﺔ ﻣﺮﻭﺭ ﻛﺘﻞ ﻣﺘﺠﻠﻄﺔ ﻣﻦ
ﻣﻜﻮﻧﺎﺕ ﺍﻟﺪﻡ .
ﻭﻳﻌﻤﻞ ﺟﻬﺎﺯ ﺍﻟــــ coulter ﺍﻟﺨﺎﺹ ﺑﻌﻤﻠﻴﺔ ﺍﻟـــ C.B.C ﻋﻠﻰ ﻋﺪ
ﺍﻟﺨﻼﻳﺎ ﺍﻟﺪﻣﻮﻳﺔ ﺍﻟﺒﻴﻀﺎﺀ ﻭﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﺍﻟﺼﻔﺎﺋﺢ ﺍﻟﺪﻣﻮﻳﺔ
( ﺍﻟﻤﻜﻮﻧﺎﺕ ﺍﻟﺪﻣﻮﻳﺔ ) .
ﻭﺍﻟﻔﻜﺮﺓ ﺍﻟﻌﻠﻤﻴﺔ ﻓﻲ ﻃﺮﻳﻘﺔ ﻋﺪ ﻣﻜﻮﻧﺎﺕ ﺍﻟﺪﻡ ﻫﻲ ﺍﺣﺘﻮﺍﺀ ﺍﻟﺠﻬﺎﺯ ﻋﻠﻰ
ﺣﺠﺮﺗﻴﻦ ﺍﻷﻭﻟﻰ ﻳﻘﺎﺱ ﻓﻴﻬﺎ ﺧﻼﻳﺎ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ ﻭﻳﺘﻢ ﻗﻴﺎﺱ
ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﺑﻮﺍﺳﻄﺔ ﺗﺤﻠﻴﻞ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﺑﻮﺍﺳﻄﺔ ﻣﺎﺩﺓ ﺗﻮﺩﻱ
ﻟﺘﻜﺴﻴﺮ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﺧﺮﻭﺝ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﺍﻟﺬﻱ ﻳﺘﻢ ﻗﻴﺎﺳﻪ
ﺑﻮﺍﺳﻄﺔ ﺟﻬﺎﺯ ﺍﻟﻘﻴﺎﺱ ﺍﻟﻀﻮﺋﻲ spectrophotometers .
ﺃﻣﺎ ﺍﻟﺤﺠﺮﺓ ﺍﻟﺜﺎﻧﻴﺔ ﺗﻘﺎﺱ ﻓﻴﻬﺎ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﺍﻟﺼﻔﺎﺋﺢ ﺍﻟﺪﻣﻮﻳﺔ .
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ﻧﻈﺮﺓ ﻋﺎﻣﺔ ﻋﻠﻰ ﺟﻬﺎﺯ ( CBC ):
ﺇﻥ ﺟﻬﺎﺯ ﺍﻝ ( CBC ) ﻳﺘﻜﻮﻥ ﻣﻦ ﺛﻼﺙ ﺃﻧﻈﻤﺔ ﺭﺋﻴﺴﻴﺔ , ﻧﻈﺎﻡ ﻫﻴﺪﺭﻭﻟﻴﻜﻲ
( Hydraulic system ) ﻭﻧﻈﺎﻡ ﻛﻬﺮﺑﺎﺋﻲ ( Electrical system )
ﻭﻧﻈﺎﻡ ﺿﻐﻂ ﻫﻮﺍﺋﻲ ( Pneumatic system ) . ﺃﻣﺎ ﺍﻧﻈﺎﻡ
ﺍﻟﻬﻴﺪﺭﻭﻟﻴﻜﻲ ﻓﻴﺘﻢ ﺃﺧﺬ ﻋﻴﻨﺔ ﺍﻟﺪﻡ ﻭﺧﻠﻄﻬﺎ ﻣﻊ ﺑﻌﺾ ﺍﻟﻤﻮﺍﺩ ﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ
ﻭﻳﺤﻠﻠﻬﺎ ﺇﻟﻰ ﻣﺮﻛﺒﺎﺗﻬﺎ ﺍﻷﺳﺎﺳﻴﺔ ﻣﻦ ﻛﺮﻳﺎﺕ ﺩﻡ ﺣﻤﺮﺍﺀ ﻭﺑﻴﻀﺎﺀ ﻭﺻﻔﺎﺋﺢ
ﻣﻦ ﺃﺟﻞ ﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ . ﺃﻣﺎ ﺍﻟﻨﻈﺎﻡ ﺍﻟﻜﻬﺮﺑﺎﺋﻲ ﻓﻴﻘﻮﻡ ﺑﻌﻤﻠﻴﺔ ﺗﺤﻠﻴﻞ
ﻭﺣﺴﺎﺏ ﺍﻹﺷﺎﺭﺍﺕ ﺍﻟﻨﺎﺗﺠﺔ ﻣﻦ ﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ . ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺫﻟﻚ ﻭﺟﻮﺩ
ﻧﻈﺎﻡ ﺿﻐﻂ ﻫﻮﺍﺋﻲ ﺣﻴﺚ ﻳﻮﺟﺪ ﻓﻲ ﺍﻟﺠﻬﺎﺯ ﻣﻀﺨﺔ ﻫﻮﺍﺀ ﺫﺍﺕ ﻣﻌﺪﻝ
ﺿﻐﻂ ﺛﺎﺑﺖ . ﺍﻟﻨﺘﻴﺠﺔ ﻟﻬﺬﺍ ﺍﻟﻔﺤﺺ ﻳﺘﻢ ﻃﺒﺎﻋﺘﻬﺎ ﻣﻦ ﺧﻼﻝ ﻃﺎﺑﻌﺔ ﻣﺤﺘﻮﻳﺎ
ﺟﺪﺍﻭﻝ ﻭﺭﺳﻮﻣﺎﺕ ﺑﻴﺎﻧﻴﺔ ﻟﻠﻨﺘﺎﺋﺞ .
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ﻧﻈﺎﻡ ﺍﻟﻜﻮﺍﺷﻒ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻬﺬﻩ ﺍﻟﻔﺤﻮﺻﺎﺕ:
ﻳﺤﺘﻮﻱ ﻫﺬﺍ ﻻﺟﻬﺎﺯ ﻋﻠﻰ ﻣﺠﻤﻮﻋﺔ ﻣﻦ ﺍﻟﻤﺤﺎﻟﻴﻞ ﻭﺍﻟﻜﻮﺍﺷﻒ ﺍﻟﺘﻲ ﺗﻠﺰﻡ
ﻟﻌﻤﻞ ﺍﻟﻔﺤﻮﺻﺎﺕ ﻭﻫﻲ ﺍﻟﻤﺤﻠﻮﻝ ﺍﻟﻤﺨﻔﻒ ( Diluent) , ﻭﺍﻟﻜﺎﺷﻒ
ﺍﻟﻤﺤﻠﻞ , ﻭ ﺍﻟﻜﺸﻒ ﺍﻟﻤﻨﻈﻒ ( Detergent Reagent ) , ﻭ ﻣﺤﺎﻟﻴﻞ
ﺍﻟﻤﻌﺎﻳﺮﺓ ( Calibration solution ) , ﻭﻣﺤﺎﻟﻴﻞ ﺍﻟﺘﺒﻴﻴﺾ ( Bleach) .
• ﺍﻟﻤﺨﻔﻒ ( Diluent) :ﻳﺴﺘﺤﺴﻦ ﻓﻲ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ ﺍﺳﺘﺨﺪﺍﻡ ﻣﺤﻠﻮﻝ
ﻣﺨﻔﻒ ﻳﺴﻤﻰ ( azide- free isotonic diluent ) ﻟﺘﺨﻔﻴﻒ ﻋﻴﻨﺔ
ﺍﻟﺪﻡ ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺗﺤﻮﻳﻠﻪ ﺇﻟﻰ ﻣﺤﻠﻮﻝ ﻣﻮﺻﻞ ﻣﻦ ﺃﺟﻞ ﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ
ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺫﻟﻚ ﻳﻌﻤﻞ ﻛﻤﺤﻠﻮﻝ ﻣﻨﻈﻒ ﻟﻠﺠﻬﺎﺯ .
• ﺍﻟﻜﺎﺷﻒ ﺍﻟﻤﺤﻠﻞ (Lytic ) : ﻭﻳﺴﺘﺤﺴﻦ ﻓﻲ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ ﺇﺳﺘﺨﺪﺍﻡ
ﻛﺎﺷﻒ ﻣﺤﻠﻞ ﻳﺴﻤﻰ ( azide-free isotonic lytic ) ﻷﻧﻪ ﻳﻘﻮﻡ
ﺑﺘﺤﻠﻴﻞ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﺑﺸﻜﻞ ﺳﺮﻳﻊ ﻭﻳﻘﻮﻡ ﺑﺘﺤﺮﻳﺮ ﺍﻟﻬﻴﻤﺠﻠﻮﺑﻴﻦ
ﺑﺸﻜﻞ ﺳﺮﻳﻊ ﺃﻳﻀﺎ ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺃﻧﻪ ﻳﻘﻠﻞ ﺑﻘﺎﻳﺎ ﻋﻤﻠﻴﺔ ﺗﺤﻠﻴﻞ ﺍﻟﺨﻼﻳﺎ
( Cellular debris ) ﻟﻤﺴﺘﻮﻯ ﻣﻌﻴﻦ ﻣﻦ ﺍﻟﺤﺠﻢ ﺣﺘﻰ ﻟﺘﺪﺧﻞ ﻫﺬﻩ
ﺍﻟﺒﻘﺎﻳﺎ ﻓﻲ ﻋﻤﻠﻴﺔ ﻋﺪ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ , ﻭﻳﻘﻮﻡ ﺃﻳﻀﺎ ﺑﻌﻤﻠﻴﺔ ﺻﺒﻎ
ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﻟﻴﺼﺒﺢ ﺳﻴﺎﻧﻴﺪ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ .
• ﺍﻟﻜﺎﺷﻒ ﺍﻟﻤﻨﻈﻒ ( Detergent Reagent ) ﻓﻲ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ
ﻳﺴﺘﺨﺪﻡ ﻛﺎﺷﻒ ﻣﻨﻈﻒ ﻳﺴﻤﻰ ( azide-free isotonic
detergent ) ﻭﺍﻟﺬﻱ ﻳﺘﻢ ﺧﻠﻄﻪ ﺑﺎﻟﻤﺤﻠﻮﻝ ﺍﻟﻤﺨﻔﻒ ﻭﺍﻟﺬﻱ ﻳﻘﻮﻡ
ﺑﺎﻟﺘﺨﻠﺺ ﻣﻦ ﺑﻘﺎﻳﺎ ﺍﻟﺪﻡ ﺍﻟﻤﻮﺟﻮﺩﺓ ﻓﻲ ﺍﻟﺠﻬﺎﺯ ﻭﺑﺎﻷﺧﺺ ﻓﻲ ﺍﻷﻧﺎﺑﻴﺐ .
• ﻣﺤﻠﻮﻝ ﺍﻟﻤﻌﺎﻳﺮﺓ )) Calibration solution ﺗﺴﺘﺨﺮﺝ ﻫﺬﻩ ﺍﻟﻤﺤﺎﻟﻴﻞ
ﻣﻦ ﺍﻟﺪﻡ ﺍﻟﺒﺸﺮﻱ ﻭﺗﺴﺘﺨﺪﻡ ﻣﻦ ﺃﺟﻞ ﻣﻌﺎﻳﺮﺓ ﻭﺿﺒﻂ ﺍﻟﺠﻬﺎﺯ ﻋﻠﻰ ﻗﻴﻢ
ﺻﺤﻴﺔ ﻣﺴﺘﻤﺪﺓ ﻣﻦ ﺩﻡ ﺇﻧﺴﺎﻥ ﺳﻠﻴﻢ .
• ﻣﺤﻠﻮﻝ ﺍﻟﺘﺒﻴﻴﺾ ( Bleach ) : ﻳﺴﺘﺨﺪﻡ ﻫﺬﺍ ﺍﻟﻤﺤﻠﻮﻝ ﻓﻲ ﻋﻤﻠﻴﺔ
ﺗﻨﻈﻴﻒ ﻓﻮﻫﺔ ﺍﻟﻌﺪ ( Aperture ) ﺣﺘﻰ ﺗﺘﻢ ﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ ﺑﺸﻜﻞ ﺻﺤﻴﺢ
ﻭﺧﺎﻟﻴﺔ ﻣﻦ ﺍﻷﺧﻄﺎﺀ .
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ﻧﻈﺮﻳﺔ ﺍﻟﻌﺪ ( Electric resistance detection ) :
ﺗﺘﻢ ﻋﻤﻠﻴﺔ ﻋﺪ ﻭﺗﺤﺪﻳﺪ ﺣﺠﻢ ﺍﻟﺨﻼﻳﺎ ﻓﻲ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ ﺑﺎﺇﻋﺘﻤﺎﺩ ﻋﻠﻰ ﻧﻈﺎﻡ
( Electric resistance detection ) ﺣﻴﺚ ﻳﻘﻮﻡ ﺍﻟﺠﻬﺎﺯ ﺑﺴﺤﺐ
ﺍﻟﻌﻴﻨﺔ ﻭﺗﻤﻴﺮﻫﺎ ﻓﻲ ﻣﺮﺣﻠﺔ ﻣﺎ ﻋﺒﺮ ﻣﺠﺲ ﺧﺎﺹ ﻣﻦ ﺧﻼﻝ ﻓﻮﻫﺔ ﺗﺴﻤﻰ
( Aperture -transducer detection )
ﻧﺪ ﻣﺮﻭﺭ ﺍﻟﺨﻠﻴﺔ ﻋﺒﺮ ﻫﺬﻩ ﺍﻟﻔﺘﺤﺔ ﺑﻮﺟﻮﺩ ﺩﺍﺋﺮﺓ ﺗﻴﺎﺭ ﻛﻬﺮﺑﺎﺋﻲ ﺛﺎﺑﺖ ( DC )
ﺑﺤﻴﺚ ﻳﺘﺪﻓﻖ ﺍﻟﺘﻴﺎﺭ ﺍﻟﻜﻬﺮﺑﺎﺋﻲ ﺑﻴﻦ ﺇﻟﻜﺘﺮﻭﺩﻳﻦ ﺧﺎﺭﺟﻲ ( ﺧﺎﺭﺝ ﻣﺤﻠﻮﻝ
ﺍﻟﺪﻡ ) ﻭﺩﺍﺧﻠﻲ (ﺩﺍﺧﻞ ﻣﺤﻠﻮﻝ ﺍﻟﺪﻡ ) ﺑﻬﺪﻑ ﺇﻛﻤﺎﻝ ﺍﻟﺪﺍﺭﺓ ﺍﻟﻜﻬﺮﺑﺎﺋﻴﺔ ,
ﻓﺈﻧﻪ ﻳﺘﻮﻟﺪ ﺗﻐﻴﺮ ﻓﻲ ﻣﻘﺪﺍﺭ ﻣﻘﺎﻭﻣﺔ ﺍﻟﻤﺤﻠﻮﻝ ﻣﻤﺎ ﻳﺆﺩﻱ ﺇﻟﻰ ﺯﻳﺎﺩﺓ ﻓﻲ
ﻗﻴﻤﺔ ﺍﻟﺠﻬﺪ ﺑﻴﻦ ﻃﺮﻓﻲ ﺍﻹﻟﻜﺘﺮﻭﺩ , ﻭﻗﻴﻤﺔ ﺍﻟﺠﻬﺪ ﺗﺘﻨﺎﺳﺐ ﺗﻨﺎﺳﺒﺎ ﻃﺮﺩﻳﺎ
ﻣﻊ ﺣﺠﻢ ﺍﻟﺨﻠﻴﺔ ﺍﻟﻤﺎﺭﺓ ﺑﻴﻦ ﻃﺮﻓﻲ ﺍﻹﻟﻜﺘﺮﻭﺩ ﻭﻫﺬﺍ ﺍﻟﺘﻐﻴﺮ ﻳﻤﺮ ﻋﺒﺮ ﺩﻭﺍﺋﺮ
ﺗﻜﺒﻴﺮ ﻭﻓﻠﺘﺮﺓ (Amplifier ) ﻟﺘﺤﻮﻝ ﺑﻌﺪ ﺫﻟﻚ ﺇﻟﻰ ﺇﺷﺎﺭﺓ ﻣﻘﺮﻭﺃﺓ
ﻭﺑﻌﺪﻫﺎ ﺗﺤﻮﻝ ﺇﻟﻰ ﺇﺷﺎﺭﺓ ﺭﻗﻤﻴﺔ ﻋﺒﺮ ﺩﺍﺋﺮﺓ ﺗﺤﻮﻳﻞ ﻣﻦ ﺇﺷﺎﺭﺓ ﺟﻴﺒﻴﺔ ﺇﻟﻰ
ﺇﺷﺎﺭﺓ ﺭﻗﻤﻲ ( ADC ) ﺛﻢ ﺗﺮﺳﻞ ﻫﺬﻩ ﺍﻹﺷﺎﺭﺍﺕ ﺇﻟﻰ ﺩﺍﺭﺓ ﺗﻌﺪﺍﺩﻳﺔ ﻟﺘﻘﻮﻡ
ﺑﻌﺪ ﺍﻟﺨﻼﻳﺎ ﺑﺎﻹﻋﺘﻤﺎﺩ ﻋﻠﻰ ﻋﺪﺩ ﺍﻹﺷﺎﺭﺍﺕ ﺍﻟﺮﻗﻤﻴﺔ ﺍﻟﻨﻐﺘﺠﺔ ( Pulses).
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ﻣﺒﺪﺃﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ ﻭﺗﺤﺪﻳﺪ ﺣﺠﻢ ﺍﻟﺨﻠﻴﺔ :
ﺇﻥ ﺧﻼﻳﺎ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﺍﻟﺒﻴﻀﺎﺀ ﺑﺎﺇﺿﺎﻓﺔ ﺇﻟﻰ ﺍﻟﺼﻔﺎﺋﺢ ﺍﻟﺪﻣﻮﻳﺔ ﻳﺘﻢ
ﻋﺪﻫﺎ ﻭﻗﻴﺎﺱ ﺣﺠﻤﻬﺎ ﻋﻦ ﻃﻠﺮﻳﻖ ﺗﺤﺪﻳﺪ ﺍﻟﻔﺮﻕ ﻓﻲ ﺍﻟﻤﻮﺻﻠﻴﺔ ﺑﻴﻨﻬﺎ
ﻭﺑﻴﻦ ﺍﻟﻤﺤﻠﻮﻝ ﺍﻟﻜﻬﺮﻟﻲ , ﻭﺑﺎﺍﺗﺎﻟﻲ ﻓﺈﻥ ﺍﻟﻔﺮﻕ ﺍﻟﻜﺒﻴﺮ ﻓﻲ ﺍﻟﻤﻮﺻﻠﻴﺔ ﺑﻴﻦ
ﺍﻟﺨﻼﻳﺎ ﻭﺍﻟﻤﺤﻠﻮﻝ ﻳﻌﺒﺮ ﻋﻨﻬﺎ ﺑﻨﺒﻀﺔ ﻛﻬﺮﺑﺎﺋﻴﺔ ﺃﻭ ﺇﺷﺎﺭﺓ ﺭﻗﻤﻴﺔ (Pulse )
ﻳﺘﻢ ﻗﻴﺎﺳﻬﺎ ﻭﻣﻘﺎﺭﻧﺘﻬﺎ ﻣﻊ ﺍﻟﻨﺒﻀﺎﺕ ﺍﻷﺧﺮﻯ ﻟﺘﺘﻢ ﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ ﻭﺗﺤﺪﻳﺪ
ﺍﻟﺤﺠﻢ .
ﻭﻫﻨﺎ ﻧﻮﺿﺢ ﺍﻟﺨﻄﻮﺍﺕ ﺍﻟﺘﻲ ﺗﻤﺮ ﺑﻬﺎ ﺍﻟﻌﻤﻠﻴﺔ :
• ﻳﺘﻢ ﺳﺤﺐ ﺍﻟﻌﻴﻨﺔ ﻭﺑﺎﻟﺘﻠﻲ ﺗﻤﻠﺮ ﺍﻟﺨﻠﻴﺔ ﻋﺒﺮ ﻓﻮﻫﺔ ﺍﻟﻌﺪ ﺑﻮﺟﻮﺩ ﺍﻟﺘﻴﺎﺭ
ﺍﻟﺜﺎﺑﺖ ﺍﻟﻤﺘﺪﻓﻖ ﻣﻦ ﺍﻹﻟﻜﺘﺮﻭﺩ ﺍﻟﺨﺎﺭﺟﻲ ﺇﻟﻰ ﺍﻟﺪﺍﺧﻠﻲ .
• ﻋﻨﺪ ﻣﺮﻭﺭ ﺍﻟﺨﻠﻴﺔ ﺧﻼﻝ ﺍﻟﺜﻘﺐ ﻓﺈﻥ ﺍﻟﻤﻘﺎﻭﻣﺔ ﺍﻟﻜﻬﺮﺑﺎﺋﻴﺔ ﺑﻴﻦ ﺍﻹﻟﻜﺘﺮﻭﺩﻳﻦ
ﺳﻮﻑ ﺗﺰﺩﺍﺩ ﻣﻤﺎ ﻳﻮﻟﺪ ﺯﻳﺎﺩﺓ ﺟﻬﺪ ﻃﺮﻓﻲ ﺍﻹﻟﻜﺘﺮﻭﺩ ﻭﺍﻟﺬﻱ ﻳﺘﻨﺎﺳﺐ
ﺗﻨﺎﺳﺐ ﻃﺮﺩﻱ ﻣﻊ ﺍﻟﻤﻘﺎﻭﻣﺔ . ﻫﺬﺍ ﺍﻟﺘﻐﻴﺮ ﻓﻲ ﺍﻟﺠﻬﺪ ﻳﺘﻨﺎﺳﺐ ﺗﻨﺎﺳﺐ
ﻃﺮﺩﻱ ﻣﻊ ﺣﺠﻢ ﺍﻟﺨﻠﻴﺔ ﺍﻟﻤﺎﺭﺓ ﻋﺒﺮ ﻓﻮﻫﺔ ﺍﻟﻌﺪ
ﻣﻘﺪﺍﺭ ﻓﺮﻕ ﺍﻟﺠﻬﺪ ﺍﻟﺼﻐﻴﺮ (ﻛﻘﻴﻤﺔ ) ﻳﺘﻢ ﺗﻜﺒﻴﺮﻩ ﻋﺒﺮ ﺩﺍﺋﺮﺓ ﺗﻜﺒﻴﺮ
, ﻭﻳﺘﻀﻤﻦ ﺫﻟﻚ ﻭﺟﻮﺩ ﺇﺷﺎﺭﺍﺕ ﺗﺸﻮﻳﺶ ﻏﻴﺮ ﻣﻨﻄﻘﻴﺔ ﻧﺎﺗﺠﺔ ﻋﻦ ﻭﺟﻮﺩ
ﻓﻘﺎﻗﻴﻊ ﻣﻦ ﺍﻟﻬﻮﺍﺀ ( Air bubbles ) ﻳﺘﻢ ﺍﻟﺨﻠﺺ ﻣﻨﻬﺎ ﻣﻦ ﺧﻼﻝ ﺩﻭﺍﺋﺮ
ﺍﻟﻔﻠﺘﺮﺓ ﻛﻤﺎ ﻭﺿﺤﻨﺎﻫﺎ ﺳﺎﺑﻘﺎ .
• ﻳﻌﺘﻤﺪ ﺗﻐﻴﺮ ﻣﻮﺻﻠﻴﺔ ﺍﻟﻤﺤﻠﻮﻝ ﺍﻟﻜﻬﺮﻟﻲ ( ﺍﻟﻤﺘﺠﺎﻧﺲ ﻣﻊ ﺍﻟﺪﻡ ) ﻋﻠﻰ
ﺍﻟﺘﻐﻴﺮ ﻓﻲ ﺩﺭﺟﺔ ﺍﻟﺤﺮﺍﺭﺓﻭﺍﻟﻀﻐﻂ ﺍﻹﺳﻤﺰﻱ , ﻭﻟﻜﻦ ﻫﺬﺍ ﺍﻟﻤﺤﻠﻮﻝ
ﺍﻟﻜﻬﺮﻟﻲ ﻳﺼﻨﻊ ﻋﻠﻰ ﺃﻥ ﻳﻜﻮﻥ ﺫﺍﺕ ﺿﻐﻂ ﺇﺳﻤﺰﻱ ﺛﺎﺑﺖ , ﻭﻟﻜﻦ
ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺘﻐﻴﺮ ﻓﻲ ﺩﺭﺟﺔ ﺣﺮﺍﺭﺓ ﺍﻟﻤﺤﻠﻮﻝ ﻓﻬﻨﺎﻟﻚ ﻣﺮﺍﻗﺒﺔ ﻟﺪﺭﺟﺔ ﺣﺮﺍﺭﺓ
ﺍﻟﻤﺤﻠﻮﻝ ﻋﻦ ﻃﺮﻳﻖ ﻣﺠﺲ ﺣﺮﺍﺭﻱ ﻣﻮﺿﻮﻉ ﻋﻨﺪ ﻓﻮﻫﺔ ﺍﻟﻌﺪ
( Aperture ) ﻭﻣﻦ ﺍﻟﻤﻼﺣﻆ ﺃﻧﻪ ﻋﻨﺪ ﺯﻳﺎﺩﺓ ﺩﺭﺟﺔ ﺣﺮﺍﺭﺓ ﺍﻟﻤﺤﻠﻮﻝ ﺳﻮﻑ
ﺗﺰﺩﺍﺩ ﻣﻮﺻﻠﻴﺘﻪ ﻭﺑﺎﻟﺘﺎﻟﻲ ﻳﺆﺩﻱ ﺇﻟﻰ ﺇﻧﺸﺎﺀ ﺇﺷﺎﺭﺓ ﺻﻐﻴﺮﺓ ﺍﻟﻘﻴﻤﺔ .
• ﻛﻞ ﺍﻟﻨﺒﻀﺎﺕ ﺍﻟﻨﺎﺗﺠﺔ ﻣﻦ ﺍﻟﻜﺮﻳﺎﺕ ﻭﻏﻴﺮﻫﺎ ﻣﺨﺘﻠﻔﺔ ﺍﻟﺤﺠﻢ ﻟﻨﻔﺲ ﺍﻟﻨﻮﻉ
ﻣﻦ ﻛﺮﻳﺎﺕ ﺩﻡ ﺣﻤﺮﺍﺀ ﺃﻭ ﺑﻴﻀﺎﺀ ﺃﻭ ﺻﻔﺎﺋﺢ ﺩﻣﻮﻳﺔ , ﻭﺑﺎﻟﺘﺎﻟﻲ ﺳﻮﻑ ﻳﻌﺪ
ﺍﻟﻜﺮﻳﺎﺕ ﻣﻦ ﻧﻔﺲ ﺍﻟﻨﻮﻉ ﺍﻟﻮﺍﻗﻌﺔ ﻓﻲ ﻣﺠﺎﻝ ﻣﻌﻴﻦ ﻭﻣﺤﺪﺩ ﻣﻦ ﻗﺒﻞ
ﺍﻟﻤﺒﺮﻣﺞ ﻭﻳﻬﻤﻞ ﺍﻟﺒﻘﻴﺔ ﺍﻟﻐﻴﺮ ﻭﺍﻗﻌﺔ ﻓﻲ ﻫﺬﺍ ﺍﻟﻤﺠﺎﻝ .
• (ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ ﺍﻟﻤﺤﻠﻠﺔ ) : ﻳﺘﻢ ﺳﺤﺐ µL 12 ﻣﻦ ﻋﻴﻨﺔ ﺍﻟﺪﻡ
ﺍﻟﻜﻠﻴﺔ ﻭﺗﺨﻔﻒ ﺑﻨﺴﺒﺔ 1:250 ﻣﺴﺘﺨﺪﻣﺎ ﻣﺤﻠﻞ ﺧﺎﺹ ﻳﻘﻮﻡ ﺑﺘﺤﻠﻴﻞ ﻛﺮﻳﺎﺕ
ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﻏﺸﺎﺀ ﻛﺮﻳﺔ ﺍﻟﺪﻡ ﺍﻟﺒﻀﺎﺀ ﻣﺒﻘﻴﺎ ﻋﻠﻰ ﺃﻧﻮﻳﺔ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ
ﺍﻟﺒﻴﻀﺎﺀ ﻟﻴﺘﻢ ﻋﺪﻫﺎ . ﺇﻥ ﻋﻤﻠﻴﺔ ﺣﺴﺎﺏ ﻋﺪﺩ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ ﺗﺘﻢ ﺑﻌﺪ
ﺃﻧﻮﻳﺔ ﻛﺮﻳﺎﺕ ﺍﺩﻡ ﺍﻟﺒﻴﻀﺎﺀ ﻭﺍﻟﺘﻲ ﺗﻜﻮﻥ ﺿﻤﻦ ﺍﻟﻤﺠﺎﻝ ﺍﻟﻤﺤﺪﺩ ﺃﻱ ﺃﻧﻪ
ﻋﻨﺪﻣﺎ ﺗﻜﻮﻥ ﺣﺠﻢ ﺍﻟﻨﻮﺍﺓ ﺃﻛﺒﺮ ﻣﻦ FL 36 ﺗﻌﺪ ﻛﺮﻳﺔ ﺑﻴﻀﺎﺀ ﻭﺍﺣﺪﺓﻭﺇﺫﺍ ﺃﻗﻞ
ﻣﻨﻬﺬﻩ ﺍﻟﻘﻴﻤﺔ ﻓﺈﻧﻬﺎ ﺗﻬﻤﻞ , ﻭﺑﺎﻟﺘﺎﻟﻲ ﻓﺈﻥ ﺍﻟﻘﺮﻳﺮ ﺍﻟﻨﻬﺎﺋﻲ ﺳﻮﻑ ﻳﻈﻬﺮ
ﺣﻴﺚ ﺗﺪﻝ n ﻋﻠﻰ ﻋﺪﺩ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ ﻟﻜﻞ ﻓﻲ ﺍﻟﺪﻡ .
"ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﺍﻟﻤﺤﻠﻠﺔ ﻭﺻﻔﺎﺋﺢ ﺍﻟﺪﻡ :" ﻳﺘﻢ ﺳﺤﺐ µL 4 ﻣﻦ
ﻋﻴﻨﺔ ﺍﻟﺪﻡ ﺍﻟﻜﻠﻴﺔ ﻭﺗﺨﻔﻒ ﺑﻨﺴﺒﺔ 0001:250 , ﻳﺘﻢ ﺗﺤﺪﻳﺪ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ
ﺍﻟﺤﻤﺮﺍﺀ ﺍﻟﻘﺒﻠﺔ ﻟﻠﻌﺪ ﺑﺎﺳﺘﺨﺪﺍﻡ ﻣﻘﺎﺭﻥ ﺑﺤﻴﺚ ﻳﺤﺪﺩ ﺃﻗﻞ ﻭﺃﻋﻠﻰ ﻗﻴﻤﺔ
ﻟﺤﺠﻢ ﻛﺮﻳﺔ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﻫﻲ ﻛﺎﻟﺘﺎﻟﻲ ﺣﻴﺚ ﺃﻧﻪ ﻳﺠﺐ ﺃﻥ ﻳﻘﻊ ﺣﺠﻢ
ﺍﻟﻜﺮﻳﺔﻓﻲ ﻫﺬﺍ ﺍﻟﻤﺠﺎﻝ ﻓﺈﻥ ﻟﻢ ﺗﻘﻊ ﻓﺈﻧﻪ ﻳﺘﻢ ﺇﻫﻤﺎﻟﻬﺎ , ﻭﺑﺎﻟﻨﻬﺎﻳﺔ ﻳﻈﻬﺮ
ﺑﺎﻟﺘﻘﺮﻳﺮ ﻭﻫﺬﺍ ﻳﻌﻨﻲ ﻭﺟﻮﺩ n ﻣﻦ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻓﻲ ﻛﻞ ﻣﻦ ﺍﻟﺪﻡ .
ﺃﻣﺎ ﻓﻲ ﻋﻤﻠﻴﺔ ﻋﺪ ﺍﻟﺼﻔﺎﺋﺢ ﻓﺈﻧﻪ ﻳﺤﺘﺎﺝ ﺇﻟﻰ ﺩﻗﺔ ﻣﺘﻨﺎﻫﻴﺔ ﻓﻲ ﻋﻤﻠﻴﺔ
ﺍﻟﻌﺪ ﺑﺤﻴﺚ ﺃﻧﻪ ﻳﺘﻢ ﺗﺤﺪﻳﺪ ﻣﺠﺎﻝ ﺣﺠﻢ ﺍﻟﺼﻔﻴﺤﺔ ﺍﻟﻘﺎﺑﻠﺔ ﻟﻠﻌﺪ ﺃﺗﻮﻣﺎﺗﻴﻜﻴﺎ
ﺑﺤﻴﺚ ﺃﻥ ﺗﺘﺮﺍﻭﺡ ﺃﻗﻞ ﻗﻴﻤﺔ ﺑﻴﻦ ﻭﺃﻋﻠﻰ ﻗﻴﻤﺔ ﻣﺎﺑﻴﻦ ﻭﺑﺎﻟﻨﻬﺎﻳﺔ ﻳﻈﻬﺮ
ﺗﻘﺮﻳﺮ ﺣﻴﺚ n ﺗﻤﺜﻞ ﻋﺪﺩ ﺍﻟﺼﻔﺎﺋﺢ ﻟﻜﻞ µL1 ﻓﻲ ﺍﻟﺪﻡ .
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ﻋﻤﻠﻴﺔ ﺣﺴﺎﺏ HCT ﻧﺴﺒﺔ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻓﻲ ﺍﻟﺪﻡ :
ﻳﺘﻢ ﺣﺴﺎﺑﻪ ﻛﻬﺮﺑﺌﻴﺎ ﺃﻥ ﺃﻋﻠﻰ ﻧﺒﻀﺔ ﻛﻬﺮﺑﺎﺋﻴﺔ ﻧﺎﺗﺠﺔ ﻣﻦ ﻣﺮﻭﺭ ﺧﻠﻴﺔ ﺩﻡ
ﺧﻼﻝ ﻓﻮﻫﺔ ﺍﻟﻌﺪ ﻭﺍﻟﺘﻲ ﺗﺘﻨﺎﺳﺐ ﺗﻨﺎﺳﺒﺎ ﻃﺮﺩﻳﺎ ﻣﻊ ﺣﺠﻢ ﺗﻠﻚ ﺍﻟﺨﻠﻴﺔ
ﻭﺑﺎﻟﺘﺎﻟﻲ ﻓﺈﻥ ﻣﺠﻤﻮﻉ ﺍﻟﻨﺒﻀﺎﺕ ﺍﻟﻨﺎﺗﺠﺔ ﻳﻤﺜﻞ ﻋﺪﺩ ﺍﻟﺨﻼﻳﺎ ﻓﻲ ﻋﻴﻨﺔ ﺍﻟﺪﻡ
ﻭﺑﺎﻟﺘﺎﻟﻲ ﻧﻌﺮﻑ ﻣﻦ ﺧﻼﻟﻬﺎ ﻣﺠﻤﻮﻉ ﺣﺠﻢ ﺧﻼﻳﺎ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻓﻲ ﺍﻟﻌﻴﻨﺔ ,
ﻭﻣﻨﻬﺎ ﻧﺴﺘﻄﻴﻊ ﺣﺴﺎﺏ HCT
ﻋﻤﻠﻴﺔ ﺣﺴﺎﺏ ﻧﺴﺒﺔ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﻓﻲ ﺍﻟﺪﻡ ( Hgb ):
ﺑﻌﺪ ﺇﺿﺎﻓﺔ ﺍﻟﻜﺎﺷﻒ ﺍﻟﻤﺤﻞ ﺇﻟﻰ ﻋﻴﻨﺔ ﺍﻟﺪﻡ ﻓﺈﻧﻪ ﻳﺘﻢ ﺗﺤﻠﻞ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ
ﺍﻟﺤﻤﺮﺍﺀ ﻭ ﻣﺒﻘﻴﺎ ﻋﻠﻰ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﻭﻋﻨﺪﻫﺎ ﻳﺘﺤﻮﻝ ﻋﻨﺼﺮ ﺍﻟﺤﺪﻳﺪ ﻓﻲ
ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﻣﻦ ( Ferrous ) ﺇﻟﻰ ( Ferric ) ﻟﻴﻨﺘﺞ ﺳﻴﺎﻧﻴﺪ
ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ (HicN ) .
ﻳﺘﻢ ﺗﻌﺮﻳﺾ ﺍﻟﻤﺮﻛﺐ ﻟﺤﺰﻣﺔ ﺿﻮﺋﻴﺔ ﻣﻔﻠﺘﺮﺓ ﺑﻮﺍﺳﻄﺔ ﺯﺟﺎﺝ ﻣﻔﻠﺘﺮ ﺫﺍﺕ
ﻃﻮﻝ ﻣﻮﺟﻲ 510nm ﻣﺼﺪﺭﻩ ﻣﺼﺒﺎﺡ ﺗﻨﺠﺴﺘﻮﻥ , ﺛﻢ ﻳﺘﻢ ﺗﺤﻮﻳﻞ ﺍﻟﻀﻮﺀ
ﺍﻟﻤﻨﻌﻜﺲ ﻋﻦ ﺳﻴﺎﻧﻴﺪ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﺇﻟﻰ ﺇﺷﺎﺭﺓ ﻛﻬﺮﺑﺎﺋﻴﺔ ﺑﻮﺍﺳﻄﺔ
ﻣﺎﻳﺴﻤﻰ ( Photo detector ) ﺣﻴﺚ ﺃﻥ ﺍﻹﺷﺎﺭﺓ ﺍﻟﻨﺎﺗﺠﺔ ﺗﺘﻨﺎﺳﺐ
ﺗﻨﺎﺳﺐ ﻃﺮﺩﻱ ﻣﻊ ﻛﺜﺎﻓﺔ ﺍﻟﻀﻮﺀ ﺍﻟﻤﻨﻌﻜﺲ ﻓﻲ ﻧﻔﺲ ﺍﻟﻮﻗﺖ ﻳﺘﻢ ﺇﺳﻘﺎﻁ
ﺣﺰﻣﺔ ﺿﻮﺋﻴﺔ ﺃﺧﺮﻯ ﻋﻠﻰ ﻣﺎﻳﺴﻤﻰ ( Blank Reagent ) ﻭﺍﻟﺘﻲ ﺗﻌﺘﺒﺮ
ﻗﻴﻤﺔ ﻣﺮﺟﻌﻴﺔ ﻟﻘﻴﻤﺔ ﺍﻟﺤﺰﻣﺔ ﺍﻟﻤﻤﺘﺼﺔ ﻣﻦ ﻗﺒﻞ ﺍﻟﻌﻴﻨﺔ ﻭﺍﻟﻠﺘﺎﻥ ﻳﺘﻢ
ﻣﻘﺎﺭﻧﺘﻬﻤﺎ ﻋﻦ ﻃﺮﻳﻖ ﺩﺍﺋﺮﺓ ﻣﻘﺎﺭﻥ , ﻭﻓﻖ ﺍﻟﻤﻌﺎﺩﻟﺔ ﺍﻟﺘﺎﻟﻴﺔ:
Sample Absorbance – Blank Absorbance =Hgb
.Absorbance
ﺃﻣﺎ ﺍﻟﻮﺣﺪﺓ ﺍﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻬﻲ g/dL .
ﻣﻼﺣﻈﺔ : ﻛﻞ ﻫﺬﻩ ﺍﻟﻌﻤﻠﻴﺔ ﺗﺘﻢ ﻓﻲ ﺣﺠﺮﺓ ﺗﺴﻤﻰ ( Hgb flow cell).
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ﻣﻌﺎﺩﻻﺕ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ:
• ﻣﻌﺪﻝ ﺍﻟﺤﺠﻢ ﺍﻟﺠﺴﻴﻤﻲ (MCV ) :
ﻭﻳﺘﻢ ﺣﺴﺎﺑﻪ ﺑﺤﺴﺎﺏ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﻧﺴﺒﺔ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ
ﻓﻲ ﺍﻟﺪﻡ (HCT ) -:
• ﺍﻟﻤﻌﺪﻝ ﺍﻟﺠﺴﻴﻤﻲ ﻟﻠﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ( MCH ):
ﻭﻳﺘﻢ ﺣﺴﺎﺑﻬﺎ ﺑﺤﺴﺎﺏ ﻗﻴﻤﺔ ﻋﺪﺩ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ .
• ﻣﻌﺪﻝ ﺗﺮﻛﻴﺰ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﻓﻲ ﺍﻟﺪﻡ (MCHC ):
ﻭﻳﺘﻢ ﺣﺴﺎﺑﻬﺎ ﻣﻦ ﻧﺴﺒﺔ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻓﻲ ﺍﻟﺪﻡ ﻭﻧﺴﺒﺔ
ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ
-2 ﻗﺴﻢ ﺍﻟﻤﺨﺘﺒﺮﺍﺕ ﺍﻟﻄﺒﻴﺔ ﻭﺑﻨﻚ ﺍﻟﺪﻡ . Department of
Medical Laboratory and Blood Bank :
ﺟﻬﺎﺯ ﺗﻌﺪﺍﺩ ﺍﻟﺪﻡ ﺍﻟﻜﺎﻣﻞ - ( CBC) . Complete Blood Count
:device
ﺍﻟﻔﺤﻮﺻﺎﺕ ﺍﻟﺘﻲ ﻳﻘﻮﻡ ﺑﻬﺎ ﺍﻟﺠﻬﺎﺯ :
ﺇﻥ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ ﻋﺒﺎﺭﺓ ﻋﻦ ﺟﻬﺎﺯ ﺍﺧﺘﺒﺎﺭ ﻭﺗﺤﻠﻴﻞ ﺍﻟﺪﻡ ﺍﻷﻭﺗﻮﻣﺎﺗﻴﻜﻲ
ﻟﺤﺎﻻﺗﺎﻟﺘﺸﺨﻴﺺ ﺍﻟﺨﺎﺭﺟﻲ ﻟﻺﻧﺴﺎﻥ ( Invitro ) ﻭﺍﻟﺬﻱ ﻳﺴﺘﺨﺪﻡ ﻓﻲ
ﺍﻟﻤﺨﺘﺒﺮﺍﺕ ﺍﻟﻄﺒﻴﺔ ﻭﻳﺘﻢ ﻣﻦ ﺧﻼﻟﻪ ﺇﺟﺮﺍﺀ ﺍﻟﻔﺤﻮﺻﺎﺕ ﺍﻟﺘﺎﻟﻴﺔ:
ﻋﺪﺩ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ ( WBC ) .
ﻋﺪﺩ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ)) .RBC
ﻋﺪﺩ ﺍﻟﺼﻔﺎﺋﺢ ﺍﻟﻤﻮﻳﺔ ﻓﻲ ﺍﻟﺪﻡ (PLT ) .
ﺗﺮﻛﻴﺰ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ( Hgb ) .
ﺍﻟﺤﺠﻢ ﺍﻟﺠﺴﻴﻤﻲ ﻟﻜﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ( MVC ) .
ﻧﺴﺒﺔ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻓﻲ ﺍﻟﺪﻡ ( HCT).
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ﻳﺴﺘﺨﺪﻡ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ ﻹﻋﻄﺎﺀ ﺻﻮﺭﺓ ﻛﺎﻣﻠﺔ ﻟﻤﻜﻮﻧﺎﺕ ﺍﻟﺪﻡ ﻭﻳﺘﻢ ﺍﺳﺘﺨﺪﺍﻡ
ﺃﻧﺎﺑﻴﺐ ﺍﻟﺪﻡ ﺍﻟﻤﺤﺘﻮﻳﺔ ﻋﻠﻰ ﻣﺎﻧﻊ ﺍﻟﺘﺠﻠﻂ EDTA ﻛﺄﻓﻀﻞ ﻣﺎﻧﻊ ﺗﺠﻠﻂ
ﻟﻘﺴﻢ ﻋﻠﻢ ﺍﻟﺪﻡ , ﺣﻴﺚ ﻳﻤﻨﻊ ﺗﺮﺍﺹ ﻛﺮﺍﺕ ﺍﻟﺪﻡ ﻭﺍﻟﻤﻜﻮﻧﺎﺕ ﺍﻷﺧﺮﻯ ﻋﻠﻰ
ﺑﻌﻀﻬﺎ ﻣﻤﺎ ﻳﺴﺎﻋﺪ ﻋﻠﻰ ﺇﻋﻄﺎﺀ ﻧﺘﺎﺋﺞ ﺻﺤﻴﺤﺔ , ﻭﺿﻤﺎﻥ ﺳﻼﻣﺔ ﺟﻬﺎﺯ ﺍﻟــ
C.B.C ﻣﻦ ﺍﻧﺴﺪﺍﺩ ﻣﺠﺎﺭﻱ ﺍﻟﺠﻬﺎﺯ ﻓﻲ ﺣﺎﻟﺔ ﻣﺮﻭﺭ ﻛﺘﻞ ﻣﺘﺠﻠﻄﺔ ﻣﻦ
ﻣﻜﻮﻧﺎﺕ ﺍﻟﺪﻡ .
ﻭﻳﻌﻤﻞ ﺟﻬﺎﺯ ﺍﻟــــ coulter ﺍﻟﺨﺎﺹ ﺑﻌﻤﻠﻴﺔ ﺍﻟـــ C.B.C ﻋﻠﻰ ﻋﺪ
ﺍﻟﺨﻼﻳﺎ ﺍﻟﺪﻣﻮﻳﺔ ﺍﻟﺒﻴﻀﺎﺀ ﻭﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﺍﻟﺼﻔﺎﺋﺢ ﺍﻟﺪﻣﻮﻳﺔ
( ﺍﻟﻤﻜﻮﻧﺎﺕ ﺍﻟﺪﻣﻮﻳﺔ ) .
ﻭﺍﻟﻔﻜﺮﺓ ﺍﻟﻌﻠﻤﻴﺔ ﻓﻲ ﻃﺮﻳﻘﺔ ﻋﺪ ﻣﻜﻮﻧﺎﺕ ﺍﻟﺪﻡ ﻫﻲ ﺍﺣﺘﻮﺍﺀ ﺍﻟﺠﻬﺎﺯ ﻋﻠﻰ
ﺣﺠﺮﺗﻴﻦ ﺍﻷﻭﻟﻰ ﻳﻘﺎﺱ ﻓﻴﻬﺎ ﺧﻼﻳﺎ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ ﻭﻳﺘﻢ ﻗﻴﺎﺱ
ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﺑﻮﺍﺳﻄﺔ ﺗﺤﻠﻴﻞ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﺑﻮﺍﺳﻄﺔ ﻣﺎﺩﺓ ﺗﻮﺩﻱ
ﻟﺘﻜﺴﻴﺮ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﺧﺮﻭﺝ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﺍﻟﺬﻱ ﻳﺘﻢ ﻗﻴﺎﺳﻪ
ﺑﻮﺍﺳﻄﺔ ﺟﻬﺎﺯ ﺍﻟﻘﻴﺎﺱ ﺍﻟﻀﻮﺋﻲ spectrophotometers .
ﺃﻣﺎ ﺍﻟﺤﺠﺮﺓ ﺍﻟﺜﺎﻧﻴﺔ ﺗﻘﺎﺱ ﻓﻴﻬﺎ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﺍﻟﺼﻔﺎﺋﺢ ﺍﻟﺪﻣﻮﻳﺔ .
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ﻧﻈﺮﺓ ﻋﺎﻣﺔ ﻋﻠﻰ ﺟﻬﺎﺯ ( CBC ):
ﺇﻥ ﺟﻬﺎﺯ ﺍﻝ ( CBC ) ﻳﺘﻜﻮﻥ ﻣﻦ ﺛﻼﺙ ﺃﻧﻈﻤﺔ ﺭﺋﻴﺴﻴﺔ , ﻧﻈﺎﻡ ﻫﻴﺪﺭﻭﻟﻴﻜﻲ
( Hydraulic system ) ﻭﻧﻈﺎﻡ ﻛﻬﺮﺑﺎﺋﻲ ( Electrical system )
ﻭﻧﻈﺎﻡ ﺿﻐﻂ ﻫﻮﺍﺋﻲ ( Pneumatic system ) . ﺃﻣﺎ ﺍﻧﻈﺎﻡ
ﺍﻟﻬﻴﺪﺭﻭﻟﻴﻜﻲ ﻓﻴﺘﻢ ﺃﺧﺬ ﻋﻴﻨﺔ ﺍﻟﺪﻡ ﻭﺧﻠﻄﻬﺎ ﻣﻊ ﺑﻌﺾ ﺍﻟﻤﻮﺍﺩ ﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ
ﻭﻳﺤﻠﻠﻬﺎ ﺇﻟﻰ ﻣﺮﻛﺒﺎﺗﻬﺎ ﺍﻷﺳﺎﺳﻴﺔ ﻣﻦ ﻛﺮﻳﺎﺕ ﺩﻡ ﺣﻤﺮﺍﺀ ﻭﺑﻴﻀﺎﺀ ﻭﺻﻔﺎﺋﺢ
ﻣﻦ ﺃﺟﻞ ﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ . ﺃﻣﺎ ﺍﻟﻨﻈﺎﻡ ﺍﻟﻜﻬﺮﺑﺎﺋﻲ ﻓﻴﻘﻮﻡ ﺑﻌﻤﻠﻴﺔ ﺗﺤﻠﻴﻞ
ﻭﺣﺴﺎﺏ ﺍﻹﺷﺎﺭﺍﺕ ﺍﻟﻨﺎﺗﺠﺔ ﻣﻦ ﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ . ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺫﻟﻚ ﻭﺟﻮﺩ
ﻧﻈﺎﻡ ﺿﻐﻂ ﻫﻮﺍﺋﻲ ﺣﻴﺚ ﻳﻮﺟﺪ ﻓﻲ ﺍﻟﺠﻬﺎﺯ ﻣﻀﺨﺔ ﻫﻮﺍﺀ ﺫﺍﺕ ﻣﻌﺪﻝ
ﺿﻐﻂ ﺛﺎﺑﺖ . ﺍﻟﻨﺘﻴﺠﺔ ﻟﻬﺬﺍ ﺍﻟﻔﺤﺺ ﻳﺘﻢ ﻃﺒﺎﻋﺘﻬﺎ ﻣﻦ ﺧﻼﻝ ﻃﺎﺑﻌﺔ ﻣﺤﺘﻮﻳﺎ
ﺟﺪﺍﻭﻝ ﻭﺭﺳﻮﻣﺎﺕ ﺑﻴﺎﻧﻴﺔ ﻟﻠﻨﺘﺎﺋﺞ .
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ﻧﻈﺎﻡ ﺍﻟﻜﻮﺍﺷﻒ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻬﺬﻩ ﺍﻟﻔﺤﻮﺻﺎﺕ:
ﻳﺤﺘﻮﻱ ﻫﺬﺍ ﻻﺟﻬﺎﺯ ﻋﻠﻰ ﻣﺠﻤﻮﻋﺔ ﻣﻦ ﺍﻟﻤﺤﺎﻟﻴﻞ ﻭﺍﻟﻜﻮﺍﺷﻒ ﺍﻟﺘﻲ ﺗﻠﺰﻡ
ﻟﻌﻤﻞ ﺍﻟﻔﺤﻮﺻﺎﺕ ﻭﻫﻲ ﺍﻟﻤﺤﻠﻮﻝ ﺍﻟﻤﺨﻔﻒ ( Diluent) , ﻭﺍﻟﻜﺎﺷﻒ
ﺍﻟﻤﺤﻠﻞ , ﻭ ﺍﻟﻜﺸﻒ ﺍﻟﻤﻨﻈﻒ ( Detergent Reagent ) , ﻭ ﻣﺤﺎﻟﻴﻞ
ﺍﻟﻤﻌﺎﻳﺮﺓ ( Calibration solution ) , ﻭﻣﺤﺎﻟﻴﻞ ﺍﻟﺘﺒﻴﻴﺾ ( Bleach) .
• ﺍﻟﻤﺨﻔﻒ ( Diluent) :ﻳﺴﺘﺤﺴﻦ ﻓﻲ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ ﺍﺳﺘﺨﺪﺍﻡ ﻣﺤﻠﻮﻝ
ﻣﺨﻔﻒ ﻳﺴﻤﻰ ( azide- free isotonic diluent ) ﻟﺘﺨﻔﻴﻒ ﻋﻴﻨﺔ
ﺍﻟﺪﻡ ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺗﺤﻮﻳﻠﻪ ﺇﻟﻰ ﻣﺤﻠﻮﻝ ﻣﻮﺻﻞ ﻣﻦ ﺃﺟﻞ ﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ
ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺫﻟﻚ ﻳﻌﻤﻞ ﻛﻤﺤﻠﻮﻝ ﻣﻨﻈﻒ ﻟﻠﺠﻬﺎﺯ .
• ﺍﻟﻜﺎﺷﻒ ﺍﻟﻤﺤﻠﻞ (Lytic ) : ﻭﻳﺴﺘﺤﺴﻦ ﻓﻲ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ ﺇﺳﺘﺨﺪﺍﻡ
ﻛﺎﺷﻒ ﻣﺤﻠﻞ ﻳﺴﻤﻰ ( azide-free isotonic lytic ) ﻷﻧﻪ ﻳﻘﻮﻡ
ﺑﺘﺤﻠﻴﻞ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﺑﺸﻜﻞ ﺳﺮﻳﻊ ﻭﻳﻘﻮﻡ ﺑﺘﺤﺮﻳﺮ ﺍﻟﻬﻴﻤﺠﻠﻮﺑﻴﻦ
ﺑﺸﻜﻞ ﺳﺮﻳﻊ ﺃﻳﻀﺎ ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺃﻧﻪ ﻳﻘﻠﻞ ﺑﻘﺎﻳﺎ ﻋﻤﻠﻴﺔ ﺗﺤﻠﻴﻞ ﺍﻟﺨﻼﻳﺎ
( Cellular debris ) ﻟﻤﺴﺘﻮﻯ ﻣﻌﻴﻦ ﻣﻦ ﺍﻟﺤﺠﻢ ﺣﺘﻰ ﻟﺘﺪﺧﻞ ﻫﺬﻩ
ﺍﻟﺒﻘﺎﻳﺎ ﻓﻲ ﻋﻤﻠﻴﺔ ﻋﺪ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ , ﻭﻳﻘﻮﻡ ﺃﻳﻀﺎ ﺑﻌﻤﻠﻴﺔ ﺻﺒﻎ
ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﻟﻴﺼﺒﺢ ﺳﻴﺎﻧﻴﺪ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ .
• ﺍﻟﻜﺎﺷﻒ ﺍﻟﻤﻨﻈﻒ ( Detergent Reagent ) ﻓﻲ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ
ﻳﺴﺘﺨﺪﻡ ﻛﺎﺷﻒ ﻣﻨﻈﻒ ﻳﺴﻤﻰ ( azide-free isotonic
detergent ) ﻭﺍﻟﺬﻱ ﻳﺘﻢ ﺧﻠﻄﻪ ﺑﺎﻟﻤﺤﻠﻮﻝ ﺍﻟﻤﺨﻔﻒ ﻭﺍﻟﺬﻱ ﻳﻘﻮﻡ
ﺑﺎﻟﺘﺨﻠﺺ ﻣﻦ ﺑﻘﺎﻳﺎ ﺍﻟﺪﻡ ﺍﻟﻤﻮﺟﻮﺩﺓ ﻓﻲ ﺍﻟﺠﻬﺎﺯ ﻭﺑﺎﻷﺧﺺ ﻓﻲ ﺍﻷﻧﺎﺑﻴﺐ .
• ﻣﺤﻠﻮﻝ ﺍﻟﻤﻌﺎﻳﺮﺓ )) Calibration solution ﺗﺴﺘﺨﺮﺝ ﻫﺬﻩ ﺍﻟﻤﺤﺎﻟﻴﻞ
ﻣﻦ ﺍﻟﺪﻡ ﺍﻟﺒﺸﺮﻱ ﻭﺗﺴﺘﺨﺪﻡ ﻣﻦ ﺃﺟﻞ ﻣﻌﺎﻳﺮﺓ ﻭﺿﺒﻂ ﺍﻟﺠﻬﺎﺯ ﻋﻠﻰ ﻗﻴﻢ
ﺻﺤﻴﺔ ﻣﺴﺘﻤﺪﺓ ﻣﻦ ﺩﻡ ﺇﻧﺴﺎﻥ ﺳﻠﻴﻢ .
• ﻣﺤﻠﻮﻝ ﺍﻟﺘﺒﻴﻴﺾ ( Bleach ) : ﻳﺴﺘﺨﺪﻡ ﻫﺬﺍ ﺍﻟﻤﺤﻠﻮﻝ ﻓﻲ ﻋﻤﻠﻴﺔ
ﺗﻨﻈﻴﻒ ﻓﻮﻫﺔ ﺍﻟﻌﺪ ( Aperture ) ﺣﺘﻰ ﺗﺘﻢ ﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ ﺑﺸﻜﻞ ﺻﺤﻴﺢ
ﻭﺧﺎﻟﻴﺔ ﻣﻦ ﺍﻷﺧﻄﺎﺀ .
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ﻧﻈﺮﻳﺔ ﺍﻟﻌﺪ ( Electric resistance detection ) :
ﺗﺘﻢ ﻋﻤﻠﻴﺔ ﻋﺪ ﻭﺗﺤﺪﻳﺪ ﺣﺠﻢ ﺍﻟﺨﻼﻳﺎ ﻓﻲ ﻫﺬﺍ ﺍﻟﺠﻬﺎﺯ ﺑﺎﺇﻋﺘﻤﺎﺩ ﻋﻠﻰ ﻧﻈﺎﻡ
( Electric resistance detection ) ﺣﻴﺚ ﻳﻘﻮﻡ ﺍﻟﺠﻬﺎﺯ ﺑﺴﺤﺐ
ﺍﻟﻌﻴﻨﺔ ﻭﺗﻤﻴﺮﻫﺎ ﻓﻲ ﻣﺮﺣﻠﺔ ﻣﺎ ﻋﺒﺮ ﻣﺠﺲ ﺧﺎﺹ ﻣﻦ ﺧﻼﻝ ﻓﻮﻫﺔ ﺗﺴﻤﻰ
( Aperture -transducer detection )
ﻧﺪ ﻣﺮﻭﺭ ﺍﻟﺨﻠﻴﺔ ﻋﺒﺮ ﻫﺬﻩ ﺍﻟﻔﺘﺤﺔ ﺑﻮﺟﻮﺩ ﺩﺍﺋﺮﺓ ﺗﻴﺎﺭ ﻛﻬﺮﺑﺎﺋﻲ ﺛﺎﺑﺖ ( DC )
ﺑﺤﻴﺚ ﻳﺘﺪﻓﻖ ﺍﻟﺘﻴﺎﺭ ﺍﻟﻜﻬﺮﺑﺎﺋﻲ ﺑﻴﻦ ﺇﻟﻜﺘﺮﻭﺩﻳﻦ ﺧﺎﺭﺟﻲ ( ﺧﺎﺭﺝ ﻣﺤﻠﻮﻝ
ﺍﻟﺪﻡ ) ﻭﺩﺍﺧﻠﻲ (ﺩﺍﺧﻞ ﻣﺤﻠﻮﻝ ﺍﻟﺪﻡ ) ﺑﻬﺪﻑ ﺇﻛﻤﺎﻝ ﺍﻟﺪﺍﺭﺓ ﺍﻟﻜﻬﺮﺑﺎﺋﻴﺔ ,
ﻓﺈﻧﻪ ﻳﺘﻮﻟﺪ ﺗﻐﻴﺮ ﻓﻲ ﻣﻘﺪﺍﺭ ﻣﻘﺎﻭﻣﺔ ﺍﻟﻤﺤﻠﻮﻝ ﻣﻤﺎ ﻳﺆﺩﻱ ﺇﻟﻰ ﺯﻳﺎﺩﺓ ﻓﻲ
ﻗﻴﻤﺔ ﺍﻟﺠﻬﺪ ﺑﻴﻦ ﻃﺮﻓﻲ ﺍﻹﻟﻜﺘﺮﻭﺩ , ﻭﻗﻴﻤﺔ ﺍﻟﺠﻬﺪ ﺗﺘﻨﺎﺳﺐ ﺗﻨﺎﺳﺒﺎ ﻃﺮﺩﻳﺎ
ﻣﻊ ﺣﺠﻢ ﺍﻟﺨﻠﻴﺔ ﺍﻟﻤﺎﺭﺓ ﺑﻴﻦ ﻃﺮﻓﻲ ﺍﻹﻟﻜﺘﺮﻭﺩ ﻭﻫﺬﺍ ﺍﻟﺘﻐﻴﺮ ﻳﻤﺮ ﻋﺒﺮ ﺩﻭﺍﺋﺮ
ﺗﻜﺒﻴﺮ ﻭﻓﻠﺘﺮﺓ (Amplifier ) ﻟﺘﺤﻮﻝ ﺑﻌﺪ ﺫﻟﻚ ﺇﻟﻰ ﺇﺷﺎﺭﺓ ﻣﻘﺮﻭﺃﺓ
ﻭﺑﻌﺪﻫﺎ ﺗﺤﻮﻝ ﺇﻟﻰ ﺇﺷﺎﺭﺓ ﺭﻗﻤﻴﺔ ﻋﺒﺮ ﺩﺍﺋﺮﺓ ﺗﺤﻮﻳﻞ ﻣﻦ ﺇﺷﺎﺭﺓ ﺟﻴﺒﻴﺔ ﺇﻟﻰ
ﺇﺷﺎﺭﺓ ﺭﻗﻤﻲ ( ADC ) ﺛﻢ ﺗﺮﺳﻞ ﻫﺬﻩ ﺍﻹﺷﺎﺭﺍﺕ ﺇﻟﻰ ﺩﺍﺭﺓ ﺗﻌﺪﺍﺩﻳﺔ ﻟﺘﻘﻮﻡ
ﺑﻌﺪ ﺍﻟﺨﻼﻳﺎ ﺑﺎﻹﻋﺘﻤﺎﺩ ﻋﻠﻰ ﻋﺪﺩ ﺍﻹﺷﺎﺭﺍﺕ ﺍﻟﺮﻗﻤﻴﺔ ﺍﻟﻨﻐﺘﺠﺔ ( Pulses).
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ﻣﺒﺪﺃﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ ﻭﺗﺤﺪﻳﺪ ﺣﺠﻢ ﺍﻟﺨﻠﻴﺔ :
ﺇﻥ ﺧﻼﻳﺎ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﺍﻟﺒﻴﻀﺎﺀ ﺑﺎﺇﺿﺎﻓﺔ ﺇﻟﻰ ﺍﻟﺼﻔﺎﺋﺢ ﺍﻟﺪﻣﻮﻳﺔ ﻳﺘﻢ
ﻋﺪﻫﺎ ﻭﻗﻴﺎﺱ ﺣﺠﻤﻬﺎ ﻋﻦ ﻃﻠﺮﻳﻖ ﺗﺤﺪﻳﺪ ﺍﻟﻔﺮﻕ ﻓﻲ ﺍﻟﻤﻮﺻﻠﻴﺔ ﺑﻴﻨﻬﺎ
ﻭﺑﻴﻦ ﺍﻟﻤﺤﻠﻮﻝ ﺍﻟﻜﻬﺮﻟﻲ , ﻭﺑﺎﺍﺗﺎﻟﻲ ﻓﺈﻥ ﺍﻟﻔﺮﻕ ﺍﻟﻜﺒﻴﺮ ﻓﻲ ﺍﻟﻤﻮﺻﻠﻴﺔ ﺑﻴﻦ
ﺍﻟﺨﻼﻳﺎ ﻭﺍﻟﻤﺤﻠﻮﻝ ﻳﻌﺒﺮ ﻋﻨﻬﺎ ﺑﻨﺒﻀﺔ ﻛﻬﺮﺑﺎﺋﻴﺔ ﺃﻭ ﺇﺷﺎﺭﺓ ﺭﻗﻤﻴﺔ (Pulse )
ﻳﺘﻢ ﻗﻴﺎﺳﻬﺎ ﻭﻣﻘﺎﺭﻧﺘﻬﺎ ﻣﻊ ﺍﻟﻨﺒﻀﺎﺕ ﺍﻷﺧﺮﻯ ﻟﺘﺘﻢ ﻋﻤﻠﻴﺔ ﺍﻟﻌﺪ ﻭﺗﺤﺪﻳﺪ
ﺍﻟﺤﺠﻢ .
ﻭﻫﻨﺎ ﻧﻮﺿﺢ ﺍﻟﺨﻄﻮﺍﺕ ﺍﻟﺘﻲ ﺗﻤﺮ ﺑﻬﺎ ﺍﻟﻌﻤﻠﻴﺔ :
• ﻳﺘﻢ ﺳﺤﺐ ﺍﻟﻌﻴﻨﺔ ﻭﺑﺎﻟﺘﻠﻲ ﺗﻤﻠﺮ ﺍﻟﺨﻠﻴﺔ ﻋﺒﺮ ﻓﻮﻫﺔ ﺍﻟﻌﺪ ﺑﻮﺟﻮﺩ ﺍﻟﺘﻴﺎﺭ
ﺍﻟﺜﺎﺑﺖ ﺍﻟﻤﺘﺪﻓﻖ ﻣﻦ ﺍﻹﻟﻜﺘﺮﻭﺩ ﺍﻟﺨﺎﺭﺟﻲ ﺇﻟﻰ ﺍﻟﺪﺍﺧﻠﻲ .
• ﻋﻨﺪ ﻣﺮﻭﺭ ﺍﻟﺨﻠﻴﺔ ﺧﻼﻝ ﺍﻟﺜﻘﺐ ﻓﺈﻥ ﺍﻟﻤﻘﺎﻭﻣﺔ ﺍﻟﻜﻬﺮﺑﺎﺋﻴﺔ ﺑﻴﻦ ﺍﻹﻟﻜﺘﺮﻭﺩﻳﻦ
ﺳﻮﻑ ﺗﺰﺩﺍﺩ ﻣﻤﺎ ﻳﻮﻟﺪ ﺯﻳﺎﺩﺓ ﺟﻬﺪ ﻃﺮﻓﻲ ﺍﻹﻟﻜﺘﺮﻭﺩ ﻭﺍﻟﺬﻱ ﻳﺘﻨﺎﺳﺐ
ﺗﻨﺎﺳﺐ ﻃﺮﺩﻱ ﻣﻊ ﺍﻟﻤﻘﺎﻭﻣﺔ . ﻫﺬﺍ ﺍﻟﺘﻐﻴﺮ ﻓﻲ ﺍﻟﺠﻬﺪ ﻳﺘﻨﺎﺳﺐ ﺗﻨﺎﺳﺐ
ﻃﺮﺩﻱ ﻣﻊ ﺣﺠﻢ ﺍﻟﺨﻠﻴﺔ ﺍﻟﻤﺎﺭﺓ ﻋﺒﺮ ﻓﻮﻫﺔ ﺍﻟﻌﺪ
ﻣﻘﺪﺍﺭ ﻓﺮﻕ ﺍﻟﺠﻬﺪ ﺍﻟﺼﻐﻴﺮ (ﻛﻘﻴﻤﺔ ) ﻳﺘﻢ ﺗﻜﺒﻴﺮﻩ ﻋﺒﺮ ﺩﺍﺋﺮﺓ ﺗﻜﺒﻴﺮ
, ﻭﻳﺘﻀﻤﻦ ﺫﻟﻚ ﻭﺟﻮﺩ ﺇﺷﺎﺭﺍﺕ ﺗﺸﻮﻳﺶ ﻏﻴﺮ ﻣﻨﻄﻘﻴﺔ ﻧﺎﺗﺠﺔ ﻋﻦ ﻭﺟﻮﺩ
ﻓﻘﺎﻗﻴﻊ ﻣﻦ ﺍﻟﻬﻮﺍﺀ ( Air bubbles ) ﻳﺘﻢ ﺍﻟﺨﻠﺺ ﻣﻨﻬﺎ ﻣﻦ ﺧﻼﻝ ﺩﻭﺍﺋﺮ
ﺍﻟﻔﻠﺘﺮﺓ ﻛﻤﺎ ﻭﺿﺤﻨﺎﻫﺎ ﺳﺎﺑﻘﺎ .
• ﻳﻌﺘﻤﺪ ﺗﻐﻴﺮ ﻣﻮﺻﻠﻴﺔ ﺍﻟﻤﺤﻠﻮﻝ ﺍﻟﻜﻬﺮﻟﻲ ( ﺍﻟﻤﺘﺠﺎﻧﺲ ﻣﻊ ﺍﻟﺪﻡ ) ﻋﻠﻰ
ﺍﻟﺘﻐﻴﺮ ﻓﻲ ﺩﺭﺟﺔ ﺍﻟﺤﺮﺍﺭﺓﻭﺍﻟﻀﻐﻂ ﺍﻹﺳﻤﺰﻱ , ﻭﻟﻜﻦ ﻫﺬﺍ ﺍﻟﻤﺤﻠﻮﻝ
ﺍﻟﻜﻬﺮﻟﻲ ﻳﺼﻨﻊ ﻋﻠﻰ ﺃﻥ ﻳﻜﻮﻥ ﺫﺍﺕ ﺿﻐﻂ ﺇﺳﻤﺰﻱ ﺛﺎﺑﺖ , ﻭﻟﻜﻦ
ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺘﻐﻴﺮ ﻓﻲ ﺩﺭﺟﺔ ﺣﺮﺍﺭﺓ ﺍﻟﻤﺤﻠﻮﻝ ﻓﻬﻨﺎﻟﻚ ﻣﺮﺍﻗﺒﺔ ﻟﺪﺭﺟﺔ ﺣﺮﺍﺭﺓ
ﺍﻟﻤﺤﻠﻮﻝ ﻋﻦ ﻃﺮﻳﻖ ﻣﺠﺲ ﺣﺮﺍﺭﻱ ﻣﻮﺿﻮﻉ ﻋﻨﺪ ﻓﻮﻫﺔ ﺍﻟﻌﺪ
( Aperture ) ﻭﻣﻦ ﺍﻟﻤﻼﺣﻆ ﺃﻧﻪ ﻋﻨﺪ ﺯﻳﺎﺩﺓ ﺩﺭﺟﺔ ﺣﺮﺍﺭﺓ ﺍﻟﻤﺤﻠﻮﻝ ﺳﻮﻑ
ﺗﺰﺩﺍﺩ ﻣﻮﺻﻠﻴﺘﻪ ﻭﺑﺎﻟﺘﺎﻟﻲ ﻳﺆﺩﻱ ﺇﻟﻰ ﺇﻧﺸﺎﺀ ﺇﺷﺎﺭﺓ ﺻﻐﻴﺮﺓ ﺍﻟﻘﻴﻤﺔ .
• ﻛﻞ ﺍﻟﻨﺒﻀﺎﺕ ﺍﻟﻨﺎﺗﺠﺔ ﻣﻦ ﺍﻟﻜﺮﻳﺎﺕ ﻭﻏﻴﺮﻫﺎ ﻣﺨﺘﻠﻔﺔ ﺍﻟﺤﺠﻢ ﻟﻨﻔﺲ ﺍﻟﻨﻮﻉ
ﻣﻦ ﻛﺮﻳﺎﺕ ﺩﻡ ﺣﻤﺮﺍﺀ ﺃﻭ ﺑﻴﻀﺎﺀ ﺃﻭ ﺻﻔﺎﺋﺢ ﺩﻣﻮﻳﺔ , ﻭﺑﺎﻟﺘﺎﻟﻲ ﺳﻮﻑ ﻳﻌﺪ
ﺍﻟﻜﺮﻳﺎﺕ ﻣﻦ ﻧﻔﺲ ﺍﻟﻨﻮﻉ ﺍﻟﻮﺍﻗﻌﺔ ﻓﻲ ﻣﺠﺎﻝ ﻣﻌﻴﻦ ﻭﻣﺤﺪﺩ ﻣﻦ ﻗﺒﻞ
ﺍﻟﻤﺒﺮﻣﺞ ﻭﻳﻬﻤﻞ ﺍﻟﺒﻘﻴﺔ ﺍﻟﻐﻴﺮ ﻭﺍﻗﻌﺔ ﻓﻲ ﻫﺬﺍ ﺍﻟﻤﺠﺎﻝ .
• (ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ ﺍﻟﻤﺤﻠﻠﺔ ) : ﻳﺘﻢ ﺳﺤﺐ µL 12 ﻣﻦ ﻋﻴﻨﺔ ﺍﻟﺪﻡ
ﺍﻟﻜﻠﻴﺔ ﻭﺗﺨﻔﻒ ﺑﻨﺴﺒﺔ 1:250 ﻣﺴﺘﺨﺪﻣﺎ ﻣﺤﻠﻞ ﺧﺎﺹ ﻳﻘﻮﻡ ﺑﺘﺤﻠﻴﻞ ﻛﺮﻳﺎﺕ
ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﻏﺸﺎﺀ ﻛﺮﻳﺔ ﺍﻟﺪﻡ ﺍﻟﺒﻀﺎﺀ ﻣﺒﻘﻴﺎ ﻋﻠﻰ ﺃﻧﻮﻳﺔ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ
ﺍﻟﺒﻴﻀﺎﺀ ﻟﻴﺘﻢ ﻋﺪﻫﺎ . ﺇﻥ ﻋﻤﻠﻴﺔ ﺣﺴﺎﺏ ﻋﺪﺩ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ ﺗﺘﻢ ﺑﻌﺪ
ﺃﻧﻮﻳﺔ ﻛﺮﻳﺎﺕ ﺍﺩﻡ ﺍﻟﺒﻴﻀﺎﺀ ﻭﺍﻟﺘﻲ ﺗﻜﻮﻥ ﺿﻤﻦ ﺍﻟﻤﺠﺎﻝ ﺍﻟﻤﺤﺪﺩ ﺃﻱ ﺃﻧﻪ
ﻋﻨﺪﻣﺎ ﺗﻜﻮﻥ ﺣﺠﻢ ﺍﻟﻨﻮﺍﺓ ﺃﻛﺒﺮ ﻣﻦ FL 36 ﺗﻌﺪ ﻛﺮﻳﺔ ﺑﻴﻀﺎﺀ ﻭﺍﺣﺪﺓﻭﺇﺫﺍ ﺃﻗﻞ
ﻣﻨﻬﺬﻩ ﺍﻟﻘﻴﻤﺔ ﻓﺈﻧﻬﺎ ﺗﻬﻤﻞ , ﻭﺑﺎﻟﺘﺎﻟﻲ ﻓﺈﻥ ﺍﻟﻘﺮﻳﺮ ﺍﻟﻨﻬﺎﺋﻲ ﺳﻮﻑ ﻳﻈﻬﺮ
ﺣﻴﺚ ﺗﺪﻝ n ﻋﻠﻰ ﻋﺪﺩ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎﺀ ﻟﻜﻞ ﻓﻲ ﺍﻟﺪﻡ .
"ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﺍﻟﻤﺤﻠﻠﺔ ﻭﺻﻔﺎﺋﺢ ﺍﻟﺪﻡ :" ﻳﺘﻢ ﺳﺤﺐ µL 4 ﻣﻦ
ﻋﻴﻨﺔ ﺍﻟﺪﻡ ﺍﻟﻜﻠﻴﺔ ﻭﺗﺨﻔﻒ ﺑﻨﺴﺒﺔ 0001:250 , ﻳﺘﻢ ﺗﺤﺪﻳﺪ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ
ﺍﻟﺤﻤﺮﺍﺀ ﺍﻟﻘﺒﻠﺔ ﻟﻠﻌﺪ ﺑﺎﺳﺘﺨﺪﺍﻡ ﻣﻘﺎﺭﻥ ﺑﺤﻴﺚ ﻳﺤﺪﺩ ﺃﻗﻞ ﻭﺃﻋﻠﻰ ﻗﻴﻤﺔ
ﻟﺤﺠﻢ ﻛﺮﻳﺔ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﻫﻲ ﻛﺎﻟﺘﺎﻟﻲ ﺣﻴﺚ ﺃﻧﻪ ﻳﺠﺐ ﺃﻥ ﻳﻘﻊ ﺣﺠﻢ
ﺍﻟﻜﺮﻳﺔﻓﻲ ﻫﺬﺍ ﺍﻟﻤﺠﺎﻝ ﻓﺈﻥ ﻟﻢ ﺗﻘﻊ ﻓﺈﻧﻪ ﻳﺘﻢ ﺇﻫﻤﺎﻟﻬﺎ , ﻭﺑﺎﻟﻨﻬﺎﻳﺔ ﻳﻈﻬﺮ
ﺑﺎﻟﺘﻘﺮﻳﺮ ﻭﻫﺬﺍ ﻳﻌﻨﻲ ﻭﺟﻮﺩ n ﻣﻦ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻓﻲ ﻛﻞ ﻣﻦ ﺍﻟﺪﻡ .
ﺃﻣﺎ ﻓﻲ ﻋﻤﻠﻴﺔ ﻋﺪ ﺍﻟﺼﻔﺎﺋﺢ ﻓﺈﻧﻪ ﻳﺤﺘﺎﺝ ﺇﻟﻰ ﺩﻗﺔ ﻣﺘﻨﺎﻫﻴﺔ ﻓﻲ ﻋﻤﻠﻴﺔ
ﺍﻟﻌﺪ ﺑﺤﻴﺚ ﺃﻧﻪ ﻳﺘﻢ ﺗﺤﺪﻳﺪ ﻣﺠﺎﻝ ﺣﺠﻢ ﺍﻟﺼﻔﻴﺤﺔ ﺍﻟﻘﺎﺑﻠﺔ ﻟﻠﻌﺪ ﺃﺗﻮﻣﺎﺗﻴﻜﻴﺎ
ﺑﺤﻴﺚ ﺃﻥ ﺗﺘﺮﺍﻭﺡ ﺃﻗﻞ ﻗﻴﻤﺔ ﺑﻴﻦ ﻭﺃﻋﻠﻰ ﻗﻴﻤﺔ ﻣﺎﺑﻴﻦ ﻭﺑﺎﻟﻨﻬﺎﻳﺔ ﻳﻈﻬﺮ
ﺗﻘﺮﻳﺮ ﺣﻴﺚ n ﺗﻤﺜﻞ ﻋﺪﺩ ﺍﻟﺼﻔﺎﺋﺢ ﻟﻜﻞ µL1 ﻓﻲ ﺍﻟﺪﻡ .
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ﻋﻤﻠﻴﺔ ﺣﺴﺎﺏ HCT ﻧﺴﺒﺔ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻓﻲ ﺍﻟﺪﻡ :
ﻳﺘﻢ ﺣﺴﺎﺑﻪ ﻛﻬﺮﺑﺌﻴﺎ ﺃﻥ ﺃﻋﻠﻰ ﻧﺒﻀﺔ ﻛﻬﺮﺑﺎﺋﻴﺔ ﻧﺎﺗﺠﺔ ﻣﻦ ﻣﺮﻭﺭ ﺧﻠﻴﺔ ﺩﻡ
ﺧﻼﻝ ﻓﻮﻫﺔ ﺍﻟﻌﺪ ﻭﺍﻟﺘﻲ ﺗﺘﻨﺎﺳﺐ ﺗﻨﺎﺳﺒﺎ ﻃﺮﺩﻳﺎ ﻣﻊ ﺣﺠﻢ ﺗﻠﻚ ﺍﻟﺨﻠﻴﺔ
ﻭﺑﺎﻟﺘﺎﻟﻲ ﻓﺈﻥ ﻣﺠﻤﻮﻉ ﺍﻟﻨﺒﻀﺎﺕ ﺍﻟﻨﺎﺗﺠﺔ ﻳﻤﺜﻞ ﻋﺪﺩ ﺍﻟﺨﻼﻳﺎ ﻓﻲ ﻋﻴﻨﺔ ﺍﻟﺪﻡ
ﻭﺑﺎﻟﺘﺎﻟﻲ ﻧﻌﺮﻑ ﻣﻦ ﺧﻼﻟﻬﺎ ﻣﺠﻤﻮﻉ ﺣﺠﻢ ﺧﻼﻳﺎ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻓﻲ ﺍﻟﻌﻴﻨﺔ ,
ﻭﻣﻨﻬﺎ ﻧﺴﺘﻄﻴﻊ ﺣﺴﺎﺏ HCT
ﻋﻤﻠﻴﺔ ﺣﺴﺎﺏ ﻧﺴﺒﺔ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﻓﻲ ﺍﻟﺪﻡ ( Hgb ):
ﺑﻌﺪ ﺇﺿﺎﻓﺔ ﺍﻟﻜﺎﺷﻒ ﺍﻟﻤﺤﻞ ﺇﻟﻰ ﻋﻴﻨﺔ ﺍﻟﺪﻡ ﻓﺈﻧﻪ ﻳﺘﻢ ﺗﺤﻠﻞ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ
ﺍﻟﺤﻤﺮﺍﺀ ﻭ ﻣﺒﻘﻴﺎ ﻋﻠﻰ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﻭﻋﻨﺪﻫﺎ ﻳﺘﺤﻮﻝ ﻋﻨﺼﺮ ﺍﻟﺤﺪﻳﺪ ﻓﻲ
ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﻣﻦ ( Ferrous ) ﺇﻟﻰ ( Ferric ) ﻟﻴﻨﺘﺞ ﺳﻴﺎﻧﻴﺪ
ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ (HicN ) .
ﻳﺘﻢ ﺗﻌﺮﻳﺾ ﺍﻟﻤﺮﻛﺐ ﻟﺤﺰﻣﺔ ﺿﻮﺋﻴﺔ ﻣﻔﻠﺘﺮﺓ ﺑﻮﺍﺳﻄﺔ ﺯﺟﺎﺝ ﻣﻔﻠﺘﺮ ﺫﺍﺕ
ﻃﻮﻝ ﻣﻮﺟﻲ 510nm ﻣﺼﺪﺭﻩ ﻣﺼﺒﺎﺡ ﺗﻨﺠﺴﺘﻮﻥ , ﺛﻢ ﻳﺘﻢ ﺗﺤﻮﻳﻞ ﺍﻟﻀﻮﺀ
ﺍﻟﻤﻨﻌﻜﺲ ﻋﻦ ﺳﻴﺎﻧﻴﺪ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﺇﻟﻰ ﺇﺷﺎﺭﺓ ﻛﻬﺮﺑﺎﺋﻴﺔ ﺑﻮﺍﺳﻄﺔ
ﻣﺎﻳﺴﻤﻰ ( Photo detector ) ﺣﻴﺚ ﺃﻥ ﺍﻹﺷﺎﺭﺓ ﺍﻟﻨﺎﺗﺠﺔ ﺗﺘﻨﺎﺳﺐ
ﺗﻨﺎﺳﺐ ﻃﺮﺩﻱ ﻣﻊ ﻛﺜﺎﻓﺔ ﺍﻟﻀﻮﺀ ﺍﻟﻤﻨﻌﻜﺲ ﻓﻲ ﻧﻔﺲ ﺍﻟﻮﻗﺖ ﻳﺘﻢ ﺇﺳﻘﺎﻁ
ﺣﺰﻣﺔ ﺿﻮﺋﻴﺔ ﺃﺧﺮﻯ ﻋﻠﻰ ﻣﺎﻳﺴﻤﻰ ( Blank Reagent ) ﻭﺍﻟﺘﻲ ﺗﻌﺘﺒﺮ
ﻗﻴﻤﺔ ﻣﺮﺟﻌﻴﺔ ﻟﻘﻴﻤﺔ ﺍﻟﺤﺰﻣﺔ ﺍﻟﻤﻤﺘﺼﺔ ﻣﻦ ﻗﺒﻞ ﺍﻟﻌﻴﻨﺔ ﻭﺍﻟﻠﺘﺎﻥ ﻳﺘﻢ
ﻣﻘﺎﺭﻧﺘﻬﻤﺎ ﻋﻦ ﻃﺮﻳﻖ ﺩﺍﺋﺮﺓ ﻣﻘﺎﺭﻥ , ﻭﻓﻖ ﺍﻟﻤﻌﺎﺩﻟﺔ ﺍﻟﺘﺎﻟﻴﺔ:
Sample Absorbance – Blank Absorbance =Hgb
.Absorbance
ﺃﻣﺎ ﺍﻟﻮﺣﺪﺓ ﺍﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻬﻲ g/dL .
ﻣﻼﺣﻈﺔ : ﻛﻞ ﻫﺬﻩ ﺍﻟﻌﻤﻠﻴﺔ ﺗﺘﻢ ﻓﻲ ﺣﺠﺮﺓ ﺗﺴﻤﻰ ( Hgb flow cell).
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ﻣﻌﺎﺩﻻﺕ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ:
• ﻣﻌﺪﻝ ﺍﻟﺤﺠﻢ ﺍﻟﺠﺴﻴﻤﻲ (MCV ) :
ﻭﻳﺘﻢ ﺣﺴﺎﺑﻪ ﺑﺤﺴﺎﺏ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﻧﺴﺒﺔ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ
ﻓﻲ ﺍﻟﺪﻡ (HCT ) -:
• ﺍﻟﻤﻌﺪﻝ ﺍﻟﺠﺴﻴﻤﻲ ﻟﻠﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ( MCH ):
ﻭﻳﺘﻢ ﺣﺴﺎﺑﻬﺎ ﺑﺤﺴﺎﺏ ﻗﻴﻤﺔ ﻋﺪﺩ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻭﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ .
• ﻣﻌﺪﻝ ﺗﺮﻛﻴﺰ ﺍﻟﻬﻴﻤﻮﺟﻠﻮﺑﻴﻦ ﻓﻲ ﺍﻟﺪﻡ (MCHC ):
ﻭﻳﺘﻢ ﺣﺴﺎﺑﻬﺎ ﻣﻦ ﻧﺴﺒﺔ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺤﻤﺮﺍﺀ ﻓﻲ ﺍﻟﺪﻡ ﻭﻧﺴﺒﺔ
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