Clinical Enzymology-ar PDF

ENZYMES IN CLINICAL DIAGNOSIS ‫‪ENZYMES IN CLINICAL DIAGNOSIS‬‬ ‫اﻹﻧﺰﯾﻤﺎت ﻓﻲ اﻟﺘﺸﺨﯿﺺ اﻟﺴﺮﯾﺮي‬ ‫ﺻﻔﺤﺔ )‪ | (1‬ﺗُﺮﺟﻤﺖ ﺑﻮاﺳﻄﺔ ‪@xFxBot‬‬ Plasma enzymes can be classified into two major groups. First, a relativel...

ENZYMES IN CLINICAL DIAGNOSIS ‫‪ENZYMES IN CLINICAL DIAGNOSIS‬‬ ‫اﻹﻧﺰﯾﻤﺎت ﻓﻲ اﻟﺘﺸﺨﯿﺺ اﻟﺴﺮﯾﺮي‬ ‫ﺻﻔﺤﺔ )‪ | (1‬ﺗُﺮﺟﻤﺖ ﺑﻮاﺳﻄﺔ ‪@xFxBot‬‬ Plasma enzymes can be classified into two major groups. First, a relatively small group of enzymes are actively secreted into the blood by certain cell types. For example, the liver secretes zymogens (inactive precursors) of the enzymes involved in blood coagulation. Second, a large number of enzyme species are released from cells during normal cell turnover. These enzymes almost always function intracellularly, and have no physiologic use in the plasma. In healthy individuals, the levels of these enzymes are fairly constant, and represent a steady state in which the rate of release from damaged cells into the plasma is balanced by an equal rate of removal of the enzyme protein from the plasma. Increased plasma levels of these enzyme may indicate tissue damage Plasma enzymes can be classified into two major groups..‫ﯾﻤﻜﻦ ﺗﺼﻨﯿﻒ إﻧﺰﯾﻤﺎت اﻟﺒﻼزﻣﺎ إﻟﻰ ﻣﺠﻤﻮﻋﺘﯿﻦ رﺋﯿﺴﯿﺘﯿﻦ‬ First, a relatively small group of enzymes are actively secreted into the blood by certain cell types. ً.‫ ﯾﺘﻢ إﻓﺮاز ﻣﺠﻤﻮﻋﺔ ﺻﻐﯿﺮة ﻧﺴﺒ ًﯿﺎ ﻣﻦ اﻹﻧﺰﯾﻤﺎت ﺑﺸﻜﻞ ﻧﺸﻂ ﻓﻲ اﻟﺪم ﺑﻮاﺳﻄﺔ أﻧﻮاع ﻣﻌﯿﻨﺔ ﻣﻦ اﻟﺨﻼﯾﺎ‬،‫أوﻻ‬ For example, the liver secretes zymogens (inactive precursors) of the enzymes involved in blood coagulation..‫ ﯾﻔﺮز اﻟﻜﺒﺪ ﻣﻮﻟﺪات اﻹﻧﺰﯾﻢ )اﻟﺴﻼﺋﻒ ﻏﯿﺮ اﻟﻨﺸﻄﺔ( ﻟﻺﻧﺰﯾﻤﺎت اﻟﻤﺸﺎرﻛﺔ ﻓﻲ ﺗﺨﺜﺮ اﻟﺪم‬،‫ﻋﻠﻰ ﺳﺒﯿﻞ اﻟﻤﺜﺎل‬ Second, a large number of enzyme species are released from cells during normal cell turnover..‫ ﯾﺘﻢ إﻃﻼق ﻋﺪد ﻛﺒﯿﺮ ﻣﻦ أﻧﻮاع اﻹﻧﺰﯾﻤﺎت ﻣﻦ اﻟﺨﻼﯾﺎ أﺛﻨﺎء دوران اﻟﺨﻼﯾﺎ اﻟﻄﺒﯿﻌﻲ‬،‫ﺛﺎﻧ ًﯿﺎ‬ These enzymes almost always function intracellularly, and have no physiologic use in the plasma..‫ وﻟﯿﺲ ﻟﻬﺎ أي اﺳﺘﺨﺪام ﻓﺴﯿﻮﻟﻮﺟﻲ ﻓﻲ اﻟﺒﻼزﻣﺎ‬،‫ﺗﻌﻤﻞ ﻫﺬه اﻹﻧﺰﯾﻤﺎت داﺋ ًﻤﺎ ﺗﻘﺮﯾ ًﺒﺎ داﺧﻞ اﻟﺨﻼﯾﺎ‬ @xFxBot ‫( | ﺗُﺮﺟﻤﺖ ﺑﻮاﺳﻄﺔ‬2) ‫ﺻﻔﺤﺔ‬ In healthy individuals, the levels of these enzymes are fairly constant, and represent a steady state in which the rate of release from damaged cells into the plasma is balanced by an equal rate of removal of the enzyme protein from the plasma. ‫ وﺗﻤﺜﻞ ﺣﺎﻟﺔ ﺛﺎﺑﺘﺔ ﯾﺘﻢ ﻓﯿﻬﺎ ﻣﻮازﻧﺔ ﻣﻌﺪل اﻹﻃﻼق ﻣﻦ‬،‫ ﺗﻜﻮن ﻣﺴﺘﻮﯾﺎت ﻫﺬه اﻹﻧﺰﯾﻤﺎت ﺛﺎﺑﺘﺔ إﻟﻰ ﺣﺪ ﻣﺎ‬،‫ﻓﻲ اﻷﻓﺮاد اﻷﺻﺤﺎء‬.‫اﻟﺨﻼﯾﺎ اﻟﺘﺎﻟﻔﺔ إﻟﻰ اﻟﺒﻼزﻣﺎ ﺑﻤﻌﺪل ﻣﺘﺴﺎو ﻹزاﻟﺔ ﺑﺮوﺗﯿﻦ اﻹﻧﺰﯾﻢ ﻣﻦ اﻟﺒﻼزﻣﺎ‬ Increased plasma levels of these enzyme may indicate tissue damage ‫ﻗﺪ ﺗﺸﯿﺮ زﯾﺎدة ﻣﺴﺘﻮﯾﺎت ﻫﺬه اﻹﻧﺰﯾﻤﺎت ﻓﻲ اﻟﺒﻼزﻣﺎ إﻟﻰ ﺗﻠﻒ اﻷﻧﺴﺠﺔ‬ @xFxBot ‫( | ﺗُﺮﺟﻤﺖ ﺑﻮاﺳﻄﺔ‬2) ‫ﺻﻔﺤﺔ‬ A. Alteration of plasma enzyme levels in disease states Many diseases that cause tissue damage result in an increased release of intracellular enzymes into the plasma. The activities of many of these enzymes are routinely determined for diagnostic purposes in diseases of the heart, liver, skeletal muscle, and other tissues. The level of specific enzyme activity in the plasma frequently correlates with the extent of tissue damage. Thus, determining the degree of elevation of a particular enzyme activity in the plasma is often useful in evaluating the prognosis for the patient A. Alteration of plasma enzyme levels in disease states Many diseases that cause tissue damage result in an increased release of intracellular enzymes into the plasma. ‫ ﺗﻐﯿﯿﺮ ﻣﺴﺘﻮﯾﺎت إﻧﺰﯾﻤﺎت اﻟﺒﻼزﻣﺎ ﻓﻲ اﻟﺤﺎﻻت اﻟﻤﺮﺿﯿﺔ اﻟﻌﺪﯾﺪ ﻣﻦ اﻷﻣﺮاض اﻟﺘﻲ ﺗﺴﺒﺐ ﺗﻠﻒ اﻷﻧﺴﺠﺔ ﺗﺆدي إﻟﻰ زﯾﺎدة‬.‫أ‬.‫إﻃﻼق اﻹﻧﺰﯾﻤﺎت داﺧﻞ اﻟﺨﻼﯾﺎ ﻓﻲ اﻟﺒﻼزﻣﺎ‬ The activities of many of these enzymes are routinely determined for diagnostic purposes in diseases of the heart, liver, skeletal muscle, and other tissues. ‫ﯾﺘﻢ ﺗﺤﺪﯾﺪ أﻧﺸﻄﺔ اﻟﻌﺪﯾﺪ ﻣﻦ ﻫﺬه اﻹﻧﺰﯾﻤﺎت ﺑﺸﻜﻞ روﺗﯿﻨﻲ ﻷﻏﺮاض اﻟﺘﺸﺨﯿﺺ ﻓﻲ أﻣﺮاض اﻟﻘﻠﺐ واﻟﻜﺒﺪ واﻟﻌﻀﻼت اﻟﻬﯿﻜﻠﯿﺔ‬.‫واﻷﻧﺴﺠﺔ اﻷﺧﺮى‬ The level of specific enzyme activity in the plasma frequently correlates with the extent of tissue damage..‫ﯾﺮﺗﺒﻂ ﻣﺴﺘﻮى ﻧﺸﺎط اﻹﻧﺰﯾﻢ اﻟﻤﺤﺪد ﻓﻲ اﻟﺒﻼزﻣﺎ ﻓﻲ ﻛﺜﯿﺮ ﻣﻦ اﻷﺣﯿﺎن ﺑﻤﺪى ﺗﻠﻒ اﻷﻧﺴﺠﺔ‬ Thus, determining the degree of elevation of a particular enzyme activity in the plasma is often useful in evaluating the prognosis for the patient.‫ ﻓﺈن ﺗﺤﺪﯾﺪ درﺟﺔ ارﺗﻔﺎع ﻧﺸﺎط إﻧﺰﯾﻢ ﻣﻌﯿﻦ ﻓﻲ اﻟﺒﻼزﻣﺎ ﻏﺎﻟ ًﺒﺎ ﻣﺎ ﯾﻜﻮن ﻣﻔﯿﺪًا ﻓﻲ ﺗﻘﯿﯿﻢ ﺗﺸﺨﯿﺺ اﻟﻤﺮﯾﺾ‬،‫وﺑﺎﻟﺘﺎﻟﻲ‬ @xFxBot ‫( | ﺗُﺮﺟﻤﺖ ﺑﻮاﺳﻄﺔ‬3) ‫ﺻﻔﺤﺔ‬ B. Plasma enzymes as diagnostic tools Some enzymes show relatively high activity in only one or a few tissues. The presence of increased levels of these enzymes in plasma thus reflects damage to the corresponding tissue. For example, the enzyme alanine aminotransferase (ALT) is abundant in the liver. The appearance of elevated levels of ALT in plasma signals possible damage to hepatic tissue. [Note: Measurement of ALT is part of the liver function test panel.] Increases in plasma levels of enzymes with a wide tissue distribution provide a less specific indication of the site of cellular injury and limits their diagnostic value. B..‫ب‬ Plasma enzymes as diagnostic tools Some enzymes show relatively high activity in only one or a few tissues. ً ‫إﻧﺰﯾﻤﺎت اﻟﺒﻼزﻣﺎ ﻛﺄدوات ﺗﺸﺨﯿﺼﯿﺔ ُﺗﻈﻬﺮ ﺑﻌﺾ اﻹﻧﺰﯾﻤﺎت‬ ‫ﻧﺸﺎﻃﺎ ﻣﺮﺗﻔ ًﻌﺎ ﻧﺴﺒ ًﯿﺎ ﻓﻲ ﻧﺴﯿﺞ واﺣﺪ ﻓﻘﻂ أو ﻋﺪد ﻗﻠﯿﻞ ﻣﻦ‬.‫اﻷﻧﺴﺠﺔ‬ The presence of increased levels of these enzymes in plasma thus reflects damage to the corresponding tissue..‫وﺑﺎﻟﺘﺎﻟﻲ ﻓﺈن وﺟﻮد ﻣﺴﺘﻮﯾﺎت ﻣﺘﺰاﯾﺪة ﻣﻦ ﻫﺬه اﻹﻧﺰﯾﻤﺎت ﻓﻲ اﻟﺒﻼزﻣﺎ ﯾﻌﻜﺲ ﺗﻠﻒ اﻷﻧﺴﺠﺔ اﻟﻤﻘﺎﺑﻠﺔ‬ For example, the enzyme alanine aminotransferase (ALT) is abundant in the liver..‫( ﺑﻜﺜﺮة ﻓﻲ اﻟﻜﺒﺪ‬ALT) ‫ ﯾﻮﺟﺪ إﻧﺰﯾﻢ أﻻﻧﯿﻦ أﻣﯿﻨﻮﺗﺮاﻧﺴﻔﯿﺮاز‬،‫ﻋﻠﻰ ﺳﺒﯿﻞ اﻟﻤﺜﺎل‬ The appearance of elevated levels of ALT in plasma signals possible damage to hepatic tissue..‫ ﻓﻲ اﻟﺒﻼزﻣﺎ إﻟﻰ ﺗﻠﻒ ﻣﺤﺘﻤﻞ ﻓﻲ أﻧﺴﺠﺔ اﻟﻜﺒﺪ‬ALT ‫ﯾﺸﯿﺮ ﻇﻬﻮر ﻣﺴﺘﻮﯾﺎت ﻣﺮﺗﻔﻌﺔ ﻣﻦ‬ @xFxBot ‫( | ﺗُﺮﺟﻤﺖ ﺑﻮاﺳﻄﺔ‬4) ‫ﺻﻔﺤﺔ‬ [Note: Measurement of ALT is part of the liver function test panel.] [.‫ ﻫﻮ ﺟﺰء ﻣﻦ ﻟﻮﺣﺔ اﺧﺘﺒﺎر وﻇﺎﺋﻒ اﻟﻜﺒﺪ‬ALT ‫ ﻗﯿﺎس‬:‫]ﻣﻼﺣﻈﺔ‬ Increases in plasma levels of enzymes with a wide tissue distribution provide a less specific indication of the site of cellular injury and limits their diagnostic value. ‫ﻣﺆﺷﺮا أﻗﻞ ﺗﺤﺪﯾﺪًا ﻟﻤﻮﻗﻊ اﻹﺻﺎﺑﺔ اﻟﺨﻠﻮﯾﺔ‬ ً ‫ﺗﻮﻓﺮ اﻟﺰﯾﺎدات ﻓﻲ ﻣﺴﺘﻮﯾﺎت اﻹﻧﺰﯾﻤﺎت ﻓﻲ اﻟﺒﻼزﻣﺎ ﻣﻊ ﺗﻮزﯾﻊ اﻷﻧﺴﺠﺔ اﻟﻮاﺳﻊ‬.‫وﺗﺤﺪ ﻣﻦ ﻗﯿﻤﺘﻬﺎ اﻟﺘﺸﺨﯿﺼﯿﺔ‬ @xFxBot ‫( | ﺗُﺮﺟﻤﺖ ﺑﻮاﺳﻄﺔ‬4) ‫ﺻﻔﺤﺔ‬