※各項檢驗數據為參考值，需配合臨床症狀，才能做正確診斷。 1 血液常規檢查 2 肝膽功能檢查 3 腎功能 4 痛風篩檢 5 組織發炎篩檢 6 血脂肪 7 糖尿病篩檢 8 甲狀腺功能 9 胰臟功能 10 心臟功能 11 肝炎檢查 12 電解質 13 糞便常規檢查 14 尿液常規檢查 15 梅毒檢查 16 愛滋病檢查 17 癌症篩檢 18 常見遺傳學檢查 19 特殊血液檢查 血液常規檢查 Blood routine 白血球(WBC)- 偏高：可能是急性感染、組織壞死、急性出血、白血病、劇烈運動...等原因。- 偏低：可能是感冒、病毒感染、骨髓抑制、自體免疫疾病、做化學治療。 紅血球(RBC) - 偏高：可能只是相對的增多，例如發燒或失水過多；也可能是真性的多血病，或是因帶氧量不足而紅血球增加，例如住在高山或是心肺有問題...等。- 偏低：會造成貧血，可能是急性或慢性的失血，或者缺乏原料，例如缺鐵或維他命B12...等，或是骨髓製造有問題，或是紅血球有不正常的破壞...等。 血紅素(Hgb)- 偏高：可能是紅血球增生症、脫水或肺部氣體交換不良...等。- 偏低：可能有貧血、失血、紅白球減少或營養不良...等。 血球容積比(Hct) - 偏高：可能是紅血球增生、脫水...等。- 偏低：可能有貧血現象。 平均紅血球體積(MCV) - 偏高：可能是胃腸吸收差、巨芽球性貧血(大紅血球性貧血)。- 偏低：可能是慢性的貧血、缺鐵性貧血、地中海型貧血...等。 平均紅血球血色素(MCH)- 偏高：可能是遺傳性球狀血球症。- 偏低：大部分的續發性貧血、MCH均可能偏低。 平均紅血球血色素濃度(MCHC) - 偏高：遺傳性球狀紅血球症、巨芽球性貧血(大紅血球性貧血)。- 偏低：在一些小球性的貧血，MCHC會偏低。 血小板(Platelet，PLT) - 偏高：有紅血球過多症，骨髓性白血病，脾臟切除等症狀。- 偏低：表示凝血機制不良，出血傾向。 白血球分類(Differential count，DC) - 表示白血球狀態 「嗜中性球 Neutrophil」- 偏高：表示傳染性炎症感染，如：肺炎、闌尾炎、扁桃腺炎。- 偏低：表示重症感染、流行性感冒、再生不良性貧血。 「淋巴球 Lymphocyte 」- 偏高：表示病毒性感染，是為白血病、細菌性、過敏性炎症。- 偏低：表示免疫不良症狀疾病可能。 「混合型 MXD」- 偏高：表示可能為過敏、感染或血液疾病等。 肝膽功能檢查 Liver function 總膽紅素(T - Bilirubin，T-Bil) - 偏高值時有肝炎、溶血、膽道阻塞、長期禁食或先天高膽紅素體質...等的可能性。 直接膽紅素(D - Bilirubin，D-Bil)- 通常伴隨總膽紅素(T-Bil)昇高，用以區分黃疸種類及肝病，為膽道阻塞及膽結石徵兆。 總蛋白(Total-protein，T-P) - 檢查營養狀態，為血中所有蛋白質。 偏高：慢性發炎、細菌感染、骨髓瘤(由於骨髓內大量製造紅血球)。 偏低：營養不良、肝病、腎病、大量出血、慢性疾病。 白蛋白(Albumin，Alb) - 肝臟以外的器官不會製造白蛋白，因此肝臟障礙時，血液中的白蛋白會明顯減少。- 白蛋白用以維持血液中滲透壓；在肝、腎功能不好，下痢、營養不良、水腫...等情形時會降低。 球蛋白(Globulin，Glo)- 蛋白質的一種，在免疫疾病發生時會昇高。 白蛋白/球蛋白比值(A/G ratio) - 判斷體內體液的滲透壓狀態，可用於診斷肝硬化疾病的嚴重性。- 肝功能異常(偏高)需注意： (1)禁酒、熬夜。 (2)適當運動、多休息、多食用綠色蔬菜。 (3)每六個月定期追蹤。 鹼性磷酸酵素(Alkaline phosphatase，Alk-P) - 兒童或發育期青少年，其值往往高達正常人的3-4倍。- 成人偏高時為下列疾病徵兆：急性肝炎、肝癌、肝硬化、閉塞性黃疸...等。 血清麩胺酸苯醋酸轉氨基脢(SGOT，AST，GOT) - 存在心臟、肝臟及骨骼肌其他組織中酵素，昇高表示該部位發炎或受損，在診斷肝臟障礙、心肌梗塞、溶血方面，GOT是很重要的線索，肝炎急性期可高達數百至1000以上，作為肝臟疾病治療的指標。 血清麩胺酸丙酮酸轉氨基脢(SGPT，ALT，GPT) - 主要為肝臟中酵素昇高表示肝炎或肝受損，肝炎急性期可高達數百至1000以上，作為肝臟疾病治療的指標。 麩胺轉酸酶(r-GT) - 存在於肝臟、膽道等位置的酵素。- 偏高時代表下列疾病徵兆：膽汁阻塞、肝炎、肝硬化、酒精性肝炎、藥物性肝炎。 腎功能 Renal function 尿素氮(Blood Urea Nitrogen，BUN) - 蛋白質代謝後產物，會經由腎臟排出。若腎功能不良，數值會增加。主要疾病有腎臟病、腎功能不全、腎衰竭、尿毒症、腸胃道出血、脫水、中暑...等問題，需配合臨床診斷。 肌酸酐(Creatinine，Cr) - 肌酸酐是肌肉代謝物，其排泄是藉由腎絲球的過濾以及腎小管的分泌作用，所以肌酸酐廓清率，可視為測量腎絲球過濾率。 痛風篩檢 Gout 尿酸(Uric acid，UA) - 身體中每天都有新的細胞被製造出來，同時舊的細胞也不斷地破壞，細胞核原形質的核酸代謝後，代謝所產生的物質就是「尿酸」。不論激烈運動或食用高普林食品都會產生尿酸。- 尿酸是普林(Purine)最終的代謝產物，主要由肝臟形成，亦由腎臟排出。腎功能不良時與BUN、Cr共同升高。單獨升高時為高尿酸血症，可能引發痛風。經由食物攝取過量會升高，應少食豆類、內臟、海鮮等食物。- 尿酸升高飽和狀態時，會產生針狀的尿酸鹽結晶，留存腳趾跟部或膝蓋關節，引發炎症，並伴隨激烈疼痛。 組織發炎篩檢 Inflammation 類風濕因子(Rheumatic factor，RA)- 為自體產生的一種抗體，類風濕關節炎的病人，有75%的人會出現，亦可能為紅斑性狼瘡、肝炎、肝癌...等疾病。 C反應性蛋白試驗(High sensitive C-Reactive protein，hs-CRP) - 這是一種高敏感度的分析方法，所以可以用來預測心臟血管疾病的危險性。急性發炎期時，肝臟產生異常醣蛋白CRP，當發炎舒解時立刻下降，可視為感染、組織傷害敏感的指標。 血脂肪 Lipid 總膽固醇(Cholesterol，CHOL) - 血液中主要的脂質，經由食物攝取後留在血液中供細胞攝取。- 偏高：易引起動脈硬化及腦中風。可能為下列疾病徵兆：高血脂症、糖尿病、甲狀腺功能低下、肥胖症、腎疾病、高血壓、肝膽疾病、口服避孕藥。 三酸甘油脂(Triglyceride，TG) - 大多來自醣類及碳水化合物。- 偏高：易有動脈硬化、心肌梗塞等血管疾病，糖尿病患者亦經常合併有高三酸甘油脂的問題。 高密度脂蛋白 - 膽固醇(High density lipoprotein cholesterol，HDL-C) - 為「好」的膽固醇的一種，含量高低與心血管疾病有重大關聯。HDL-C高，則危險性較低；HDL-C低，則危險性高。- 多配合膽固醇及LDL-C一起判讀。偏低時易造成動脈硬化、心肌缺氧、高血脂症、肥胖、糖尿病。 低密度脂蛋白 - 膽固醇(Low density lipoprotein cholesterol，LDL-C) - 身體內的膽固醇主要由LDL-C運送至全身各部位，若過多將對人體不利，因而被稱為「壞」的膽固醇，是造成冠狀動脈硬化和心臟疾病的危險因子。 血管硬化指數(Risk Factor，CHOL/HDL-C) - 若血中好的膽固醇(HDL-C)多了，相對膽固醇總量也會昇高，因此膽固醇總量高時，不見得不好，必須參考HDL-C的因素，也就是動脈硬化指數來評估。 五個主要危險因子- 1.吸煙。- 2.高血壓 >= 140/90 mmHg 或高血壓病史。- 3.HDL-C < 40 mm/dL。- 4.一等親(男性55歲或女生65歲前)發生冠動脈心臟疾病。- 5.男性 > 45歲或女性 > 55歲。 糖尿病篩檢 D.M. Screening 飯前血糖(Blood sugar AC，AC) - 糖尿病的成因與胰島素的分泌有密切關係，胰島素可維持血糖濃度。血糖值110-126mg/dL可視為糖尿病的先兆，若大於126mg/dL時為糖尿病。若未能飲食控制或治療，嚴重時併發症相當多。 飯後2小時血糖(Blood sugar PC，PC) - 飯後2小時血糖若高於200mg/dL，則可視為糖尿病，須進一步治療。 醣化血色素(HbA1c) - 可瞭解糖尿病患者最近三個月血糖控制的情形及治療的效果。 甲狀腺功能 Thyroid function 甲狀腺刺激素(Thyroid Stimulating Hormone，TSH) - TSH是由腦下垂體前葉所分泌之荷爾蒙，可刺激甲狀腺分泌甲狀腺素(T3及T4)。甲狀腺機能減低時會昇高，甲狀腺機能亢進時會降低。 游離三碘甲狀腺素(Free Triiodothyronine，Free T3) - 高值：為甲狀腺機能亢進，或用thyroxine治療甲狀腺機能低下者。- 低值：為甲狀腺機能低下者。 游離四碘甲狀腺素(Free Thyroxine，Free T4) - Free T4為四碘甲狀腺素(T4)的游離狀態，在診斷輕微甲狀腺機能亢進或低下時，準確性高於T4。- 高值：甲狀腺機能亢進或甲狀腺炎。- 低值：甲狀腺機能低下，須配合TSH一起判讀。 三碘甲狀腺素(Triiodothyronine，T3) - 高值：甲狀腺功能亢進。- 低值：甲狀腺功能低下。 四碘甲狀腺素(Thyroxine，T4) - T4為甲狀腺激素，最好與TSH一起判讀。- 高值：可能為急性甲狀腺炎、甲狀腺功能亢進。- 低值：甲狀腺功能低下。 胰臟功能 Pancreatic function 澱粉酶(Amylase) - 主要存在於胰臟的酵素，在急慢性胰臟炎、胰臟癌的情況會昇高。 心臟功能 Cardiac function 乳酸脫氫酶(Lactate Dehydrogenase，LDH) - 肌肉組織，如心肌、骨骼肌及血球內都有。高值時有心肌梗塞、惡性腫瘤、血液疾病、肝臟疾病、肌肉損傷...等疾病的可能，須與其他檢驗結果共同判讀。 肌酸磷化酶(Creatine kinase，CPK) - 主要存在橫紋肌、腦部、心臟等位置。高值時多發生在急性心肌梗塞、肌肉萎縮、腦部組織受損等症狀，激烈運動後亦會昇高。 C反應性蛋白試驗(High sensitive C-Reactive protein，hs-CRP) - 這是一種高敏感度的分析方法，所以可以用來預測心臟血管疾病的危險性。急性發炎期時，肝臟產生異常醣蛋白CRP，當發炎舒解時立刻下降，可視為感染、組織傷害敏感的指標。 肝炎檢查 Hepatitis A型肝炎(Hepatitis A)- 經由A型肝炎病毒所造成的肝炎稱之。係經由飲食感染，若到衛生環境較差的地方旅遊時，行前最好接受疫苗接種。 B型肝炎(Hepatitis B) C型肝炎(Hepatitis C)- C型肝炎抗體 Anti-HCV：當C型肝炎抗體產生(+)，表示該病人正處於感染階段，這是C型與B型肝炎的差異性；B型肝炎表面抗體(Anti-HBs)產生之時，病人已經有免疫力，而C型則是正在感染，須密切注意肝功能是否正常。 電解質 Electrolyte 鈉(Sodium，Na) - 增加表示脫水、腎上腺功能亢進，減少表示水腫、嘔吐、腹瀉、腎臟病等情形。 鉀(Potassium，K) - 升高為尿毒症、燒燙傷等情形，減少為代謝性鹼中毒、營養不良及腹瀉...等狀況。 氯(Chloride，CI) - 升高表示脫水、尿路阻塞等情形，減少時與鈉相同。 鈣(Calcium，Ca) - 血鈣增加時，見於惡性腫瘤、副甲狀腺機能亢進等症，降低時見於軟骨症、維生素D缺乏、副甲狀腺機能低下時，應與磷同時判讀。 磷(Phosphorus，P) - 與鈣值共同判讀。- 鈣上升，磷下降，表示副甲狀腺機能亢進，維生素D過盛等。- 鈣下降，磷也下降，表軟骨症、維生素D缺乏。- 鈣下降，磷昇高，表副甲狀腺機能低下或慢性腎功能不全等。 糞便常規檢查 Stool routine 外觀(Appearance)- 上腸胃道出血，為柏油狀(Tarry Stool)。下腸胃出血、痔瘡，為鮮血。灰白色糞便表阻塞性黃疸。水狀便可能為腸胃炎。 潛血(Occult blood)- 潛血反應陽性時表示確實有出血，多半為腸胃道疾病，但若飲食中有豬血、肉類食物過多時，亦有「偽陽性」發生。 鏡檢(Microscopy)- 顯微鏡檢查可看寄生蟲、脂肪球、原蟲、紅白血球等物，對異常疾病極有幫助。 尿液常規檢查 Urine routine 外觀(Appearance) - 正常尿液呈黃色或淡黃色，太深或太淺均不好，正常尿液無雜質，若有白濁現象表示有問題。 酸鹼度(PH) - 新鮮尿液為弱酸性，過酸或過鹼都不理想，吃素的人偏鹼性，肉類吃多的人尿液偏酸。 尿蛋白(Urine Protein) - 蛋白尿主要發生於腎臟炎、腎病症候群、發燒、妊娠毒血症等情形。例外狀況：健康人在運動後或脫水下，也會出現尿蛋白現象。 尿糖(Urine Sugar) - 正常情形下均為陰性。若有陽性反應，可能有糖尿病，須再連續追蹤檢查。亦有可能是腎小管疾病，或腎絲球過濾率減少。 膽紅素(Urine Bilirubin) - 為紅血球代謝產物，正常尿液為陰性，膽道阻塞或肝功能不良時呈陽性。 尿膽素原(Urine Urobilinogen) - 正常尿液中有0.1-1 u/dL，其前身為膽紅素。若升高表示急性肝炎、肝硬化，完全沒有時表示膽道阻塞。 潛血(Occult blood) - 正常情形為陰性，陽性表示尿液中有紅血球或血紅素，如結石、腎炎等，婦女生理期驗本項沒有意義。例外狀況：健康人在激烈運動後，亦可能發生輕微血尿。 酮體(Ketone Body) - 酮體為脂肪代謝不完全的產物，常見於糖尿病患者，減肥或長時間禁食、飢餓、大量嘔吐、嚴重腹瀉時亦會出現此種產物。 亞硝酸(Nitrite) - 亞硝酸由細菌代謝產生，陽性表示泌尿道細菌感染。 比重(Specific Gravity) - 低比重：尿崩症、水分攝取過多、利尿劑等。- 高比重：糖尿病、脫水、嘔吐等情形。- 尿比重是測量尿的濃度，內含物多則重，少則輕，此與受檢者喝水習慣有關。 鏡檢(Microscopy)- 檢查尿液沈渣，正常時，尿液中只有一些泌尿道剝落的上皮細胞和少數血，有腎病或泌尿道疾病會出現程度不等的血球或細菌。 紅血球(RBC)- 尿液中有紅血球時表示結石、腎臟疾病或泌尿道發炎。 白血球(WBC) - 尿液中有白血球時表示有發炎現象，急慢性泌尿道發炎。 上皮細胞(Epi cell) - 通常女性上皮細胞較多，若出現卵圓細胞，則須進一步檢查。 圓柱體(Cast)- 腎臟病時尿液中沈積物。 結晶體(Crystal)- 可能為結石、腎臟病及其他病理性疾病、部分用藥造成。 滴蟲(Trichomonas)- 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