
General urine examination
Urine analysis
Esraa Hammadi Fahad
M.Sc. MEDICAL PHYSIOLOGY
Background
ً‫ﺻﺎف وﺷﻔﺎف وﻟﮫ ﻋﺎدة‬
‫ اﻟﺒﻮل ﺳﺎﺋﻞ‬.‫اﻟﺒﻮل ھﻮ ﻧﻔﺎﯾﺎت ﺳﺎﺋﻠﺔ ﺗﻔﺮزھﺎ اﻟﻜﻠﻰ‬
ٍ
5 ‫ ﺳﺎﻋﺔ ﻣﺎ ﺑﯿﻦ‬24 ‫ ﯾﺒﻠﻎ ﻣﺘﻮﺳﻂ ﻛﻤﯿﺔ اﻟﺒﻮل اﻟﺘﻲ ﺗﻔﺮز ﺧﻼل‬.‫ﻟﻮن ﻛﮭﺮﻣﺎﻧﻲ‬
‫ اﻟﺒﻮل ھﻮ أﺳﺎﺳﺎ ﻣﺤﻠﻮل‬، ‫ ﻛﯿﻤﯿﺎﺋﯿﺎ‬.‫ أوﻧﺼﺔ‬60 ‫ إﻟﻰ‬40 ‫ أﻛﻮاب أو‬8 ‫إﻟﻰ‬
‫ﻣﺎﺋﻲ ﻣﻦ اﻟﻤﻠﺢ وﻣﻮاد ﺗﺴﻤﻰ اﻟﯿﻮرﯾﺎ وﺣﻤﺾ اﻟﺒﻮﻟﯿﻚ‬.
Urine is a liquid waste produced by the
kidneys. Urine is a clear, transparent fluid that
normally has an amber color. The average
amount of urine excreted in 24 hours is
between 5 to 8 cups or 40 and 60 ounces.
Chemically, urine is mainly a watery solution of
salt and substances called urea and uric acid.
Urinalysis
، ‫ اﻟﻤﻌﺮوف أﯾﻀًﺎ ﺑﺎﺳﻢ اﻟﻔﺤﺺ اﻟﺮوﺗﯿﻨﻲ واﻟﻤﺠﮭﺮي‬، ‫ﺗﺤﻠﯿﻞ اﻟﺒﻮل‬
‫ھﻮ ﻣﺠﻤﻮﻋﺔ ﻣﻦ اﻻﺧﺘﺒﺎرات اﻟﺘﻲ ﯾﺘﻢ إﺟﺮاؤھﺎ ﻋﻠﻰ اﻟﺒﻮل‬.
، ‫ﯾﻤﻜﻦ إﺟﺮاء ﺟﺰء ﻣﻦ ﺗﺤﻠﯿﻞ اﻟﺒﻮل ﺑﺎﺳﺘﺨﺪام ﺷﺮاﺋﻂ اﺧﺘﺒﺎر اﻟﺒﻮل‬
‫ طﺮﯾﻘﺔ أﺧﺮى ھﻲ‬.‫ﺣﯿﺚ ﯾﻤﻜﻦ ﻗﺮاءة ﻧﺘﺎﺋﺞ اﻻﺧﺘﺒﺎر ﻣﻊ ﺗﻐﯿﺮ اﻟﻠﻮن‬
‫اﻟﻔﺤﺺ اﻟﻤﺠﮭﺮي اﻟﻀﻮﺋﻲ ﻟﻌﯿﻨﺎت اﻟﺒﻮل‬.
A urinalysis (UA), also known as routine and
microscopy (R&M), is an array of tests performed on
urine.
A part of a urinalysis can be performed by using urine test
strips, in which the test results can be read as color
changes. Another method is light microscopy of urine
samples.
Macroscopic Urinalysis
‫ﺗﺤﻠﯿﻞ اﻟﺒﻮل اﻟﻌﯿﺎﻧﻲ‬
- ‫ ﯾﻜﻮن اﻟﺒﻮل اﻟﻄﺒﯿﻌﻲ واﻟﻄﺎزج ﺷﺎﺣﺒًﺎ إﻟﻰ أﺻﻔﺮ‬- .‫اﻟﺠﺰء اﻷول ﻣﻦ ﺗﺤﻠﯿﻞ اﻟﺒﻮل ھﻮ اﻟﻤﻼﺣﻈﺔ اﻟﺒﺼﺮﯾﺔ اﻟﻤﺒﺎﺷﺮة‬
‫ ﺳﺎﻋﺔ‬24 / ‫ ﻣﻞ‬2000 ‫ إﻟﻰ‬750 ‫ ﯾﺘﺮاوح ﺣﺠﻢ اﻟﺒﻮل اﻟﻄﺒﯿﻌﻲ ﻣﻦ‬- .‫وﺻﺎف‬
‫داﻛﻦ أو ﻛﮭﺮﻣﺎﻧﻲ اﻟﻠﻮن‬.
ٍ
- ‫ﻗﺪ ﯾﻜﻮن ﺳﺒﺐ اﻟﺘﻌﻜﺮ أو اﻟﺘﻌﻜﺮ ھﻮ زﯾﺎدة اﻟﻤﻮاد اﻟﺨﻠﻮﯾﺔ أو اﻟﺒﺮوﺗﯿﻦ ﻓﻲ اﻟﺒﻮل‬.
- ‫ﻗﺪ ﯾﻜﻮن اﻟﻠﻮن اﻷﺣﻤﺮ أو اﻟﺒﻨﻲ اﻷﺣﻤﺮ )ﻏﯿﺮ اﻟﻄﺒﯿﻌﻲ( ﻧﺎﺗﺠًﺎ ﻋﻦ ﺻﺒﻐﺔ طﻌﺎم أو دواء أو وﺟﻮد اﻟﮭﯿﻤﻮﺟﻠﻮﺑﯿﻦ‬.
- ‫ ﻓﺴﺘﻜﻮن ﻏﺎﺋﻤﺔ وﻛﺬﻟﻚ ﺣﻤﺮاء‬، ‫إذا اﺣﺘﻮت اﻟﻌﯿﻨﺔ ﻋﻠﻰ اﻟﻌﺪﯾﺪ ﻣﻦ ﺧﻼﯾﺎ اﻟﺪم اﻟﺤﻤﺮاء‬.
- The first part of a urinalysis is direct visual observation.
- Normal, fresh urine is pale to dark yellow or amber in color and clear.
- Normal urine volume is750 to 2000 ml/24hr.
- Turbidity or cloudiness may be caused by excessive cellular material or
protein in the urine.
- A red or red-brown (abnormal) color could be from a food dye, a drug, or the
presence of hemoglobin.
- If the sample contained many red blood cells, it would be cloudy as well as
red.
Urine Dipstick Chemical Analysis
1- Ph
‫ ﯾﺤﻠﻞ اﺧﺘﺒﺎر ﻣﺴﺘﻮى‬.8.0 ‫ إﻟﻰ‬4.5 ‫ﻗﺪ ﯾﺘﺮاوح اﻟﺮﻗﻢ اﻟﮭﯿﺪروﺟﯿﻨﻲ اﻟﺒﻮﻟﻲ ﻣﻦ‬
.‫ إﻧﮫ اﺧﺘﺒﺎر ﺑﺴﯿﻂ وﻏﯿﺮ ﻣﺆﻟﻢ‬.‫اﻟﺤﻤﻮﺿﺔ ﻓﻲ اﻟﺒﻮل ﺣﻤﻮﺿﺔ أو ﻗﻠﻮﯾﺔ ﻋﯿﻨﺔ اﻟﺒﻮل‬
‫ﯾﻤﻜﻦ أن ﺗﺆﺛﺮ اﻟﻌﺪﯾﺪ ﻣﻦ اﻷﻣﺮاض وﻧﻈﺎﻣﻚ اﻟﻐﺬاﺋﻲ واﻷدوﯾﺔ اﻟﺘﻲ ﺗﺘﻨﺎوﻟﮭﺎ ﻋﻠﻰ‬
‫ ﯾﻤﻜﻦ أن ﺗﺸﯿﺮ اﻟﻨﺘﺎﺋﺞ‬، ‫ ﻋﻠﻰ ﺳﺒﯿﻞ اﻟﻤﺜﺎل‬.(‫ﻣﺪى ﺣﻤﻀﯿﺔ اﻟﺒﻮل أو ﻗﺎﻋﺪﺗﮫ )ﻗﻠﻮﯾﺔ‬
‫اﻟﺘﻲ ﺗﻜﻮن ﻣﺮﺗﻔﻌﺔ ﺟﺪًا أو ﻣﻨﺨﻔﻀﺔ ﺟﺪًا إﻟﻰ اﺣﺘﻤﺎﻟﯿﺔ ﺗﻜﻮﯾﻦ اﻟﺠﺴﻢ ﻟﺤﺼﻮات‬
‫اﻟﻜﻠﻰ‬.
Urinary pH may range from as low as 4.5 to as high as 8.0.
A urine pH level test analyzes the acidity or alkalinity
of a urine sample. It’s a simple and painless test.
Many diseases, your diet, and the medications you
take can affect how acidic or basic (alkaline) your urine
is. For instance, results that are either too high or low
can indicate the likelihood that your body will form
kidney stones.
2- Specific Gravity (sp gr)
•
Specific gravity (which is directly proportional to urine
osmolality which measures solute concentration) measures
urine density, or the ability of the kidney to concentrate or
dilute the urine over that of plasma.
•
Specific gravity between 1.002 and 1.035 on
a random sample should be considered normal
if kidney function is normal.
Any measurement below this range indicates
hydration and any measurement above it indicates
relative dehydration
•
‫اﻟﺜﻘﻞ اﻟﻨﻮﻋﻲ )اﻟﺬي ﯾﺘﻨﺎﺳﺐ طﺮدﯾًﺎ ﻣﻊ اﻷﺳﻤﻮﻟﯿﺔ‬
‫ﻓﻲ اﻟﺒﻮل اﻟﺬي ﯾﻘﯿﺲ ﺗﺮﻛﯿﺰ اﻟﻤﺎدة اﻟﻤﺬاﺑﺔ( ﯾﻘﯿﺲ‬
‫ أو ﻗﺪرة اﻟﻜﻠﯿﺔ ﻋﻠﻰ ﺗﺮﻛﯿﺰ اﻟﺒﻮل أو‬، ‫ﻛﺜﺎﻓﺔ اﻟﺒﻮل‬
‫ﺗﺨﻔﯿﻔﮫ ﻋﻠﻰ ﺗﻠﻚ اﻟﻤﻮﺟﻮدة ﻓﻲ اﻟﺒﻼزﻣﺎ‬.
• ‫ و‬1.002 ‫ﯾﺠﺐ اﻋﺘﺒﺎر اﻟﺜﻘﻞ اﻟﻨﻮﻋﻲ ﺑﯿﻦ‬
‫ ﻋﻠﻰ ﻋﯿﻨﺔ ﻋﺸﻮاﺋﯿﺔ طﺒﯿﻌﯿًﺎ إذا ﻛﺎﻧﺖ‬1.035
‫وظﺎﺋﻒ اﻟﻜﻠﻰ طﺒﯿﻌﯿﺔ‬.
• ‫أي ﻗﯿﺎس أﻗﻞ ﻣﻦ ھﺬا اﻟﻨﻄﺎق ﯾﺸﯿﺮ إﻟﻰ‬
‫اﻟﺘﺮطﯿﺐ وأي ﻗﯿﺎس ﻓﻮﻗﮫ ﯾﺸﯿﺮ إﻟﻰ اﻟﺠﻔﺎف‬
‫اﻟﻨﺴﺒﻲ‬
‫ﯾﺘﻢ ﻓﺤﺺ اﻟﺒﺮوﺗﯿﻦ ﺑﺎﺳﺘﺨﺪام ﻣﻘﯿﺎس اﻟﻌﻤﻖ ﻓﻲ اﻟﺒﻮل‬
‫اﻟﻜﺎﻣﻞ‬.
‫ﯾﻤﻜﻦ اﻟﻌﺜﻮر ﻋﻠﻰ ﻛﻤﯿﺔ ﺻﻐﯿﺮة ﻣﻦ ﺑﺮوﺗﯿﻨﺎت اﻟﺒﻼزﻣﺎ‬
‫اﻟﻤﻔﻠﺘﺮة واﻟﺒﺮوﺗﯿﻦ اﻟﺬي ﯾﻔﺮزه اﻟﻨﯿﻔﺮون )اﻟﺒﺮوﺗﯿﻦ‬
‫اﻟﻤﺨﺎطﻲ( ﻓﻲ اﻟﺒﻮل اﻟﻄﺒﯿﻌﻲ‬.
150 ‫ﻻ ﯾﺘﺠﺎوز إﻓﺮاز اﻟﺒﺮوﺗﯿﻦ اﻟﻜﻠﻲ اﻟﻄﺒﯿﻌﻲ ﻋﺎدة‬
‫ ﻣﻞ ﻓﻲ أي ﻋﯿﻨﺔ‬100 / ‫ ﻣﺠﻢ‬10 ‫ ﺳﺎﻋﺔ )أو‬24 / ‫ﻣﺠﻢ‬
(‫ﻣﻔﺮدة‬.
.‫ ﯾﻮم ﻋﻠﻰ أﻧﮭﺎ ﺑﺮوﺗﯿﻨﯿﺔ‬/ ‫ ﻣﺠﻢ‬150 ‫ﯾﺘﻢ ﺗﻌﺮﯾﻒ أﻛﺜﺮ ﻣﻦ‬
‫ ﺳﺎﻋﺔ ﺷﺪﯾﺪة وﺗﻌﺮف‬24 / ‫ ﺟﻢ‬3.5 <‫اﻟﺒﯿﻠﺔ اﻟﺒﺮوﺗﯿﻨﯿﺔ‬
‫ﺑﺎﻟﻤﺘﻼزﻣﺔ اﻟﻜﻠﻮﯾﺔ‬.
3- Protein
Dipstick screening for protein is done on whole urine.
Asmall amount of filtered plasma proteins and protein secreted by the
nephron( mucoprotein) can be found in normal urine.
Normal total protein excretion does not usually exceed 150 mg/24 hours (or
10 mg/100 ml in any single specimen).
More than 150 mg/day is defined as proteinuria. Proteinuria > 3.5 gm/24
hours is severe and known as nephrotic syndrome.
‫ ﯾﺠﺐ أن ﺗﻘﻮم اﻟﻜﻠﻰ اﻟﺴﻠﯿﻤﺔ ﺑﺘﺮﺷﯿﺢ ﻛﻤﯿﺎت ﺻﻐﯿﺮة )أﺛﺮﯾﺔ( ﻓﻲ‬.‫اﻟﺒﺮوﺗﯿﻦ ﻣﻮﺟﻮد ﻓﻲ اﻟﺪم‬
‫ ﻟﯿﺲ ﻣﻦ‬.(‫اﻟﺒﻮل ﻷن ﻣﻌﻈﻢ ﺟﺰﯾﺌﺎت اﻟﺒﺮوﺗﯿﻦ ﻛﺒﯿﺮة ﺟﺪًا ﺑﺎﻟﻨﺴﺒﺔ إﻟﻰ اﻟﻤﺮﺷﺤﺎت )اﻟﻜﺒﯿﺒﺎت‬
‫ ﻋﻨﺪﻣﺎ ﯾﺤﺪث ھﺬا ﯾُﻌﺮف ﺑﺎﺳﻢ "اﻟﺒﯿﻠﺔ اﻟﺒﺮوﺗﯿﻨﯿﺔ‬.‫"اﻟﻤﻌﺘﺎد ﻓﻘﺪان اﻟﺒﺮوﺗﯿﻦ ﻓﻲ اﻟﺒﻮل‬.
 Protein
is present in the blood; healthy
kidneys should only filter tiny (trace)
amounts into the urine as most protein
molecules are too large for the filters
(glomeruli). It is not usual to lose protein in
the urine. When this does happen it is
known as 'Proteinuria'.
4- Glucose
Nearly all glucose filtered by the glomeruli is reabsorbed in the
proximal tubules and only undetectable amounts appear in urine in
healthy patients.
Above renal threshold (10 mmol/L) glucose will appear in urine.
Glycosuria (excess sugar in urine) generally means diabetes
‫ﺗﻘﺮﯾﺒﺎ ﻛﻞ اﻟﺠﻠﻮﻛﻮز اﻟﺬي ﺗﻤﺖ ﺗﺼﻔﯿﺘﮫ ﺑﻮاﺳﻄﺔ اﻟﻜﺒﯿﺒﺎت ﯾﻌﺎد‬
mellitus (DM).
‫اﻣﺘﺼﺎﺻﮫ ﻓﻲ اﻷﻧﺎﺑﯿﺐ اﻟﻘﺮﯾﺒﺔ وﺗﻈﮭﺮ ﻓﻘﻂ ﻛﻤﯿﺎت ﻏﯿﺮ ﻗﺎﺑﻠﺔ‬
‫ﻟﻠﻜﺸﻒ ﻓﻲ اﻟﺒﻮل ﻓﻲ اﻟﻤﺮﺿﻰ اﻷﺻﺤﺎء‬.
‫ ﻟﺘﺮ( ﻓﻲ‬/ ‫ ﻣﻠﯿﻤﻮل‬10) ‫ﺳﯿﻈﮭﺮ اﻟﺠﻠﻮﻛﻮز ﻓﻮق ﻋﺘﺒﺔ اﻟﻜﻠﻰ‬
‫اﻟﺒﻮل‬.
‫ﺑﯿﻠﺔ ﺳﻜﺮﯾﺔ )اﻟﺴﻜﺮ اﻟﺰاﺋﺪ ﻓﻲ اﻟﺒﻮل( ﺗﻌﻨﻲ ﺑﺸﻜﻞ ﻋﺎم داء‬
‫اﻟﺴﻜﺮي‬
5- Ketones
5- ‫اﻟﻜﯿﺘﻮﻧﺎت‬
‫ ﺣﻤﺾ ﺑﯿﺘﺎ ھﯿﺪروﻛﺴﻲ ﺑﯿﻮﺗﯿﺮﯾﻚ( اﻟﻨﺎﺗﺠﺔ إﻣﺎ ﻋﻦ‬، ‫ ﺣﻤﺾ اﻷﺳﯿﺘﻮ أﺳﯿﺘﯿﻚ‬، ‫اﻟﻜﯿﺘﻮﻧﺎت )اﻷﺳﯿﺘﻮن‬
‫اﻟﺤﻤﺎض اﻟﻜﯿﺘﻮﻧﻲ اﻟﺴﻜﺮي أو ﺑﻌﺾ أﺷﻜﺎل اﻟﺴﻌﺮات اﻟﺤﺮارﯾﺔ اﻷﺧﺮى‬
‫ ﯾﺘﻢ اﻛﺘﺸﺎﻓﮫ ﺑﺴﮭﻮﻟﺔ ﺑﺎﺳﺘﺨﺪام ﻋﺼﻲ اﻟﻐﻤﺲ أو أﻗﺮاص اﻻﺧﺘﺒﺎر اﻟﺘﻲ ﺗﺤﺘﻮي ﻋﻠﻰ‬، (‫اﻟﺤﺮﻣﺎن )اﻟﺘﺠﻮﯾﻊ‬
‫ﻧﯿﺘﺮوﺑﺮوﺳﯿﺪ اﻟﺼﻮدﯾﻮم‬.
Ketones (acetone, acetoacetic acid, beta-hydroxybutyric acid) resulting
from either diabetic ketoacidosis or some other form of caloric
deprivation (starvation), are easily detected using either dipsticks or test
tablets containing sodium nitroprusside.
6- Nitrite
6- ‫اﻟﻨﺘﺮﯾﺖ‬
‫ اﻟﻌﺪﯾﺪ ﻣﻦ‬.‫ واﻟﺘﻲ ﻻ ﺗﻮﺟﺪ ﻓﻲ اﻟﺒﻮل اﻟﻄﺒﯿﻌﻲ‬، ‫ﯾﻌﺘﻤﺪ ھﺬا اﻻﺧﺘﺒﺎر ﻋﻠﻰ ﺗﻜﺴﯿﺮ اﻟﻨﺘﺮات اﻟﺒﻮﻟﯿﺔ إﻟﻰ ﻧﺘﺮات‬
‫اﻟﺒﻜﺘﯿﺮﯾﺎ ﺳﺎﻟﺒﺔ اﻟﺠﺮام وﺑﻌﺾ اﻟﺒﻜﺘﺮﯾﺎ اﻟﻤﻮﺟﺒﺔ ﻟﻠﺠﺮام ﻗﺎدرة ﻋﻠﻰ إﻧﺘﺎج ھﺬا اﻟﺘﻔﺎﻋﻞ وإﯾﺠﺎﺑﻲ‬
‫ اﻟﻨﺘﯿﺠﺔ اﻟﺴﻠﺒﯿﺔ ﻻ ﺗﺴﺘﺒﻌﺪ‬.(‫ ﻟﻜﻞ ﻣﻞ‬10000 ‫ﯾﺸﯿﺮ اﻻﺧﺘﺒﺎر إﻟﻰ وﺟﻮدھﺎ ﺑﺄﻋﺪاد ﻛﺒﯿﺮة )أي أﻛﺜﺮ ﻣﻦ‬
‫اﻟﺘﮭﺎب اﻟﻤﺴﺎﻟﻚ اﻟﺒﻮﻟﯿﺔ‬.
This test relies on the breakdown of urinary nitrates to nitrites, which
are not found in normal urine. Many Gram-negative and some Grampositive bacteria are capable of producing this reaction and a positive
test suggests their presence in significant numbers (ie more than 10,000
per ml). A negative result does not rule out a UTI.
1- Red Blood Cells
Hematuria is the presence of abnormal numbers of red cells in urine due
to:
‫اﻟﺒﻮل اﻟﺪﻣﻮي ھﻮ وﺟﻮد أﻋﺪاد ﻏﯿﺮ طﺒﯿﻌﯿﺔ ﻣﻦ‬
•
glomerular damage.
‫ • ﺗﻠﻒ‬:‫ﺧﻼﯾﺎ اﻟﺪم اﻟﺤﻤﺮاء ﻓﻲ اﻟﺒﻮل ﺑﺴﺒﺐ‬
‫ • إﺻﺎﺑﺎت اﻟﻜﻠﻰ‬.‫اﻟﻜﺒﯿﺒﺎت‬. •
‫ﺣﺼﻮات اﻟﻤﺴﺎﻟﻚ اﻟﺒﻮﻟﯿﺔ‬.
•
kidney trauma.
• ‫اﻟﺘﮭﺎﺑﺎت اﻟﻤﺴﺎﻟﻚ اﻟﺒﻮﻟﯿﺔ اﻟﻌﻠﻮﯾﺔ واﻟﺴﻔﻠﯿﺔ‬. •
‫اﻟﺴﻤﻮم اﻟﻜﻠﻮﯾﺔ‬.
•
urinary tract stones.
• ‫ • ﻗﺪ ﺗﻠﻮث اﻟﺨﻼﯾﺎ اﻟﺤﻤﺮاء أﯾﻀًﺎ‬.‫اﻻﺟﮭﺎد اﻟﺒﺪﻧﻲ‬
‫ ﻻ‬، ‫ ﻧﻈﺮﯾًﺎ‬.‫اﻟﺒﻮل ﻣﻦ اﻟﻤﮭﺒﻞ ﻋﻨﺪ اﻟﺤﺎﺋﺾ‬
•
upper and lower urinary tract infections. ‫ﯾﻨﺒﻐﻲ‬
‫ ﻟﻜﻦ ﺑﻌﻀﮭﺎ ﯾﺠﺪ طﺮﯾﻘﮫ‬، ‫اﻟﻌﺜﻮر ﻋﻠﻰ ﺧﻼﯾﺎ ﺣﻤﺮاء‬
‫إﻟﻰ اﻟﺒﻮل ﺣﺘﻰ ﻓﻲ اﻷﺷﺨﺎص اﻷﺻﺤﺎء ﺟﺪًا‬.
•
nephrotoxins.
•
physical stress.
•
Red cells may also contaminate the urine from the vagina in
menstruating women.
Theoretically, no red cells should be found, but some find their way into
the urine even in very healthy individuals.
RBC's may appear normally shaped, swollen by dilute urine (in
fact, only cell ghosts and free hemoglobin may remain). Both
swollen, partly hemolyzed RBC's and are sometimes difficult to
distinguish from WBC's in the urine.
The presence of dysmorphic RBC's in urine suggests a glomerular
disease such as a glomerulonephritis.
Dysmorphic RBC's have odd shapes as a consequence of being
distorted via passage through the abnormal glomerular structure
‫ﻗﺪ ﺗﻈﮭﺮ ﻛﺮات اﻟﺪم اﻟﺤﻤﺮاء ﺑﺸﻜﻞ طﺒﯿﻌﻲ ‪ ،‬ﻣﻨﺘﻔﺨﺔ ﺑﺴﺒﺐ اﻟﺒﻮل‬
‫اﻟﻤﺨﻔﻒ )ﻓﻲ اﻟﻮاﻗﻊ ‪ ،‬ﻗﺪ ﺗﺒﻘﻰ أﺷﺒﺎح اﻟﺨﻼﯾﺎ واﻟﮭﯿﻤﻮﻏﻠﻮﺑﯿﻦ اﻟﺤﺮ‬
‫ﻓﻘﻂ(‪ .‬ﻛﻼ ﻣﻦ ﻛﺮات اﻟﺪم اﻟﺤﻤﺮاء اﻟﻤﻨﺘﻔﺨﺔ واﻟﻤﺘﺤﻠﻠﺔ ﺟﺰﺋﯿًﺎ وﯾﺼﻌﺐ‬
‫‪.‬أﺣﯿﺎﻧًﺎ ﺗﻤﯿﯿﺰھﺎ ﻋﻦ ﻛﺮات اﻟﺪم اﻟﺤﻤﺮاء ﻓﻲ اﻟﺒﻮل‬
‫ﯾﺸﯿﺮ وﺟﻮد ﻛﺮﯾﺎت اﻟﺪم اﻟﺤﻤﺮاء اﻟﻤﺸﻮھﺔ ﻓﻲ اﻟﺒﻮل إﻟﻰ وﺟﻮد‬
‫اﻟﻜﺒﯿﺒﺎت‬
‫ﻣﺮض ﻣﺜﻞ اﻟﺘﮭﺎب ﻛﺒﯿﺒﺎت اﻟﻜﻠﻰ‪ .‬ﺗﻤﺘﻠﻚ ﻛﺮات اﻟﺪم اﻟﺤﻤﺮاء اﻟﻤﺸﻮھﺔ‬
‫ً‬
‫أﺷﻜﺎﻻ ﻏﺮﯾﺒﺔ ﻧﺘﯿﺠﺔ ﻟﻠﻮﺟﻮد‬
‫ﻣﺸﻮھﺔ ﻋﻦ طﺮﯾﻖ اﻟﻤﺮور ﻣﻦ ﺧﻼل اﻟﮭﯿﻜﻞ اﻟﻜﺒﯿﺒﻲ ﻏﯿﺮ اﻟﻄﺒﯿﻌﻲ‬
2- White Blood Cells
•
Pyuria refers to the presence of abnormal numbers of leukocytes that
may appear with infection in either the upper or lower urinary tract
or with acute glomerulonephritis.
•
Usually, the WBC's are granulocytes. White cells from the vagina,
especially in the presence of vaginal and cervical infections.
•
If two or more leukocytes per each high power field appear in noncontaminated urine, the specimen is probably abnormal.
•
Leukocytes have lobed nuclei and granular cytoplasm.
‫‪• Pyuria‬‬
‫ﯾﺸﯿﺮ إﻟﻰ وﺟﻮد أﻋﺪاد ﻏﯿﺮ طﺒﯿﻌﯿﺔ ﻣﻦ اﻟﻜﺮﯾﺎت اﻟﺒﯿﺾ اﻟﺘﻲ ﻗﺪ‬
‫ﺗﻈﮭﺮ ﻣﺼﺎﺑﺔ ﺑﺎﻟﻌﺪوى إﻣﺎ ﻓﻲ اﻟﺠﺰء اﻟﻌﻠﻮي أو اﻟﺴﻔﻠﻲ ﻣﻦ‬
‫‪.‬اﻟﻤﺴﺎﻟﻚ اﻟﺒﻮﻟﯿﺔ أو ﻣﻊ اﻟﺘﮭﺎب ﻛﺒﯿﺒﺎت اﻟﻜﻠﻰ اﻟﺤﺎد‬
‫ﻋﺎدة ‪ ،‬ﺧﻼﯾﺎ اﻟﺪم اﻟﺒﯿﻀﺎء ھﻲ ﺣﺒﯿﺒﺎت‪ .‬ﺧﻼﯾﺎ ﺑﯿﻀﺎء ﻣﻦ اﻟﻤﮭﺒﻞ •‬
‫‪.‬ﺧﺎﺻﺔ ﻓﻲ وﺟﻮد اﻟﺘﮭﺎﺑﺎت اﻟﻤﮭﺒﻞ وﻋﻨﻖ اﻟﺮﺣﻢ‬
‫•‬
‫إذا ظﮭﺮت اﺛﻨﺘﺎن أو أﻛﺜﺮ ﻣﻦ اﻟﻜﺮﯾﺎت اﻟﺒﯿﺾ ﻟﻜﻞ ﺣﻘﻞ ﻋﺎﻟﻲ‬
‫اﻟﻘﺪرة ﻓﻲ اﻟﺒﻮل ﻏﯿﺮ اﻟﻤﻠﻮث ‪ ،‬ﻓﻤﻦ اﻟﻤﺤﺘﻤﻞ أن ﺗﻜﻮن اﻟﻌﯿﻨﺔ ﻏﯿﺮ‬
‫‪.‬طﺒﯿﻌﯿﺔ‬
‫‪.‬اﻟﻜﺮﯾﺎت اﻟﺒﯿﺾ ﻟﮭﺎ ﻧﻮى ﻣﻔﺼﺼﺔ وﺳﯿﺘﻮﺑﻼزم ﺣﺒﯿﺒﻲ •‬
3- Epithelial Cells
‫ وﻋﺎدة ﻣﺎ ﺗﻜﻮن أﻛﺒﺮ ﻣﻦ اﻟﺨﻼﯾﺎ اﻟﻤﺤﺒﺒﺔ‬، ‫ اﻟﺨﻼﯾﺎ اﻟﻄﻼﺋﯿﺔ اﻷﻧﺒﻮﺑﯿﺔ اﻟﻜﻠﻮﯾﺔ‬،
‫ﺗﺤﺘﻮي ﻋﻠﻰ ﻧﻮاة ﻣﺴﺘﺪﯾﺮة أو ﺑﯿﻀﺎوﯾﺔ ﻛﺒﯿﺮة وﻋﺎدة ﻣﺎ ﺗﺘﺴﺮب إﻟﻰ اﻟﺒﻮل ﺑﺄﻋﺪاد ﺻﻐﯿﺮة‬.
‫ ﯾﺰداد اﻟﻌﺪد‬، ‫ ﻣﻊ اﻟﻤﺘﻼزﻣﺔ اﻟﻜﻠﻮﯾﺔ وﻓﻲ اﻟﻈﺮوف اﻟﺘﻲ ﺗﺆدي إﻟﻰ اﻟﺘﻨﻜﺲ اﻷﻧﺒﻮﺑﻲ‬، ‫وﻣﻊ ذﻟﻚ‬
‫اﻟﻤﻘﺸﻮر‬.
Renal tubular epithelial cells, usually larger than granulocytes,
contain a large round or oval nucleus and normally slough into the
urine in small numbers.
However, with nephrotic syndrome and in conditions leading to
tubular degeneration, the number sloughed is increased.
4- Casts
•
•
•
•
•
•
They are solid and cylindrical structures formed by precipitation of
debris in the renal tubules.
Urinary casts are formed only in the distal convoluted tubule (DCT)
or the collecting duct (distal nephron). The proximal convoluted
tubule (PCT) and loop of Henle are not locations for cast formation.
Hyaline casts are composed primarily of a mucoprotein secreted by
tubule cells, hyalin cast are seen in healthy individuals.
RBCs casts are formed when RBCs stick together and in glomerular
disease.
WBCs casts are seen in acute pylonephritis and glomerulonephritis.
Granular and waxy casts are seen in nephrotic syndrome.
‫وھﻲ ھﯿﺎﻛﻞ ﺻﻠﺒﺔ واﺳﻄﻮاﻧﯿﺔ ﺗﺘﻜﻮن ﻣﻦ ﺗﺮﺳﯿﺐ اﻟﺤﻄﺎم‬
‫‪.‬ﻓﻲ اﻷﻧﺎﺑﯿﺐ اﻟﻜﻠﻮﯾﺔ‬
‫•‬
‫ﺗﺘﺸﻜﻞ اﻟﻘﻮاﻟﺐ اﻟﺒﻮﻟﯿﺔ ﻓﻘﻂ ﻓﻲ اﻟﻨﺒﯿﺐ اﻟﻤﻠﺘﻮي اﻟﺒﻌﯿﺪ أو‬
‫اﻟﻘﻨﺎة اﻟﺘﺠﻤﯿﻌﯿﺔ )اﻟﻨﯿﻔﺮون اﻟﺒﻌﯿﺪ(‪ .‬اﻟﻨﺒﯿﺐ اﻟﻤﻠﺘﻒ اﻟﻘﺮﯾﺐ‬
‫‪.‬وﺣﻠﻘﺔ ھﯿﻨﻠﻲ ﻟﯿﺴﺘﺎ ﻣﻮاﻗﻊ ﻟﺘﺸﻜﯿﻞ اﻟﺰھﺮ‬
‫ﺗﺘﻜﻮن ﻗﻮاﻟﺐ اﻟﮭﯿﺎﻟﯿﻦ ﺑﺸﻜﻞ أﺳﺎﺳﻲ ﻣﻦ ﺑﺮوﺗﯿﻦ ﻣﺨﺎطﻲ •‬
‫ﺗﻔﺮزه اﻟﺨﻼﯾﺎ اﻷﻧﺒﻮﺑﯿﺔ ‪ ،‬وﯾﻼﺣﻆ ﺻﺐ اﻟﮭﯿﺎﻟﯿﻦ ﻓﻲ اﻷﻓﺮاد‬
‫‪.‬اﻷﺻﺤﺎء‬
‫ﺗﺘﻜﻮن ﻗﻮاﻟﺐ ﻛﺮات اﻟﺪم اﻟﺤﻤﺮاء ﻋﻨﺪﻣﺎ ﺗﻠﺘﺼﻖ ﻛﺮات •‬
‫‪.‬اﻟﺪم اﻟﺤﻤﺮاء ﺑﺒﻌﻀﮭﺎ اﻟﺒﻌﺾ وﻓﻲ ﻣﺮض اﻟﻜﺒﯿﺒﺎت‬
‫ﺗﻈﮭﺮ اﻟﻘﻮاﻟﺐ ﻟﺨﻼﯾﺎ اﻟﺪم اﻟﺒﯿﻀﺎء ﻓﻲ اﻟﺘﮭﺎب اﻟﺼﻮاﻣﻊ •‬
‫• ‪.‬اﻟﺤﺎد واﻟﺘﮭﺎب ﻛﺒﯿﺒﺎت اﻟﻜﻠﻰ‬
‫‪.‬ﺗﻈﮭﺮ اﻟﻘﻮاﻟﺐ اﻟﺤﺒﯿﺒﯿﺔ واﻟﺸﻤﻌﯿﺔ ﻓﻲ اﻟﻤﺘﻼزﻣﺔ اﻟﻜﻠﻮﯾﺔ‬
5- Bacteria
 If
‫إذا ﻧﻤﺖ اﻟﺒﻜﺘﯿﺮﯾﺎ ﻓﻲ اﺧﺘﺒﺎر ﻣﺰرﻋﺔ اﻟﺒﻮل وﻛﺎﻧﺖ ﻟﺪﯾﻚ أﻋﺮاض ﻋﺪوى أو ﺗﮭﯿﺞ‬
‫ ھﺬه اﻟﻨﺘﯿﺠﺔ ھﻲ ﻧﺘﯿﺠﺔ‬.‫ ﻓﮭﺬا ﯾﻌﻨﻲ أﻧﻚ ﻣﺼﺎب ﺑﺎﻟﺘﮭﺎب اﻟﻤﺴﺎﻟﻚ اﻟﺒﻮﻟﯿﺔ‬، ‫ﻓﻲ اﻟﻤﺜﺎﻧﺔ‬
‫ ﯾﺠﺮي اﻟﻤﻌﻤﻞ اﺧﺘﺒﺎر‬.‫اﺧﺘﺒﺎر ﻣﺰرﻋﺔ ﺑﻮل إﯾﺠﺎﺑﯿﺔ أو ﻧﺘﯿﺠﺔ اﺧﺘﺒﺎر ﻏﯿﺮ طﺒﯿﻌﯿﺔ‬
‫ﺣﺴﺎﺳﯿﺔ ﻟﻠﻤﻀﺎدات اﻟﺤﯿﻮﯾﺔ ﻋﻠﻰ اﻟﺒﻜﺘﯿﺮﯾﺎ اﻟﻤﻮﺟﻮدة ﻓﻲ اﻟﻌﯿﻨﺔ اﻟﻤﺰروﻋﺔ‬.
bacteria grow in the urine culture test and
you have symptoms of an infection or
bladder irritation, it means you have a UTI.
This result is a positive urine culture test or
abnormal test result. The lab conducts an
antibiotic sensitivity test on the bacteria in
the cultured sample.
6- Yeast
‫ ﻏﺎﻟﺒًﺎ ﻣﺎ ﯾﻜﻮن‬.‫ﻗﺪ ﺗﻜﻮن ﺧﻼﯾﺎ اﻟﺨﻤﯿﺮة ﻣﻠﻮﺛﺔ أو ﺗﻤﺜﻞ ﻋﺪوى ﻓﻄﺮﯾﺔ ﺣﻘﯿﻘﯿﺔ‬
‫ﻣﻦ اﻟﺼﻌﺐ ﺗﻤﯿﯿﺰھﺎ ﻋﻦ اﻟﺨﻼﯾﺎ اﻟﺤﻤﺮاء واﻟﺒﻠﻮرات ﻏﯿﺮ اﻟﻤﺘﺒﻠﻮرة وﻟﻜﻨﮭﺎ‬
‫ اﻟﺘﻲ ﻗﺪ ﺗﺴﺘﻌﻤﺮ اﻟﻤﺜﺎﻧﺔ‬، ‫ ﻏﺎﻟﺒًﺎ ﻣﺎ ﺗﻜﻮن اﻟﻤﺒﯿﻀﺎت‬.‫ﺗﺘﻤﯿﺰ ﺑﻤﯿﻠﮭﺎ إﻟﻰ اﻟﺘﺒﺮﻋﻢ‬
‫أو اﻹﺣﻠﯿﻞ أو اﻟﻤﮭﺒﻞ‬.
Yeast cells may be contaminants or represent a true yeast infection.
They are often difficult to distinguish from red cells and
amorphous crystals but are distinguished by their tendency to bud.
Most often they are Candida, which may colonize bladder, urethra,
or vagina .
7- Crystals
‫ﺗﺸﻤﻞ اﻟﺒﻠﻮرات اﻟﺸﺎﺋﻌﺔ ﺣﺘﻰ ﻓﻲ اﻟﻤﺮﺿﻰ اﻷﺻﺤﺎء أﻛﺴﺎﻻت اﻟﻜﺎﻟﺴﯿﻮم وﺑﻠﻮرات اﻟﻔﻮﺳﻔﺎت اﻟﺜﻼﺛﯿﺔ واﻟﻔﻮﺳﻔﺎت ﻏﯿﺮ اﻟﻤﺘﺒﻠﻮر‬.
Common crystals seen even in healthy patients include calcium
oxalate, triple phosphate crystals and amorphous phosphates.
calcium oxalate