贫血及贫血性心脏病夜.pptx

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2
Definition
AnemiaisdefinedasadecreaseinthecirculatingRBC,hemoglobinorthehematocrit,andacorrespondingdecreaseintheoxygen-carryingcapacityoftheblood.
Normalvaluesofthehemogram(Insealevel):
TESTWOMENMEN
HCT(%)37-4840-50
Hb(g/L)110-150120-160
RBCCount(1012
PS:TheHBofNewbornis170-200g/L.
3
Diagnosis
WOMENMENPREGNANT
Hb(g/L)<110<120<100
WOMEN
■Anemiaisn’tadiagnosis,
itisasignofthepresenceofdisease.
■Correctdiagnosis:includeunderlyingcauseoftheanemia
■Theycanbealteredbytheplasmaticvolumes.
■Themeannormalvaluedependson:altitudeofresidence,
ageandgender.
■Differencebetweenwomenandmenvalues
areduetoandrogenhormones.
4
Diagnosis
Firststep:
detectionofthepresenceofanemia,andtheseverity.
Secondstep:
laboratoryinvestigationofthemorphologicalclassification.
Thirdstep:
investigationofthepathogenesisofanemia.
5
Diagnosis
Mild
120/110
Moderate
90
Severe
60
VerySevere
30
Classificationaccordingtoseverity
Firststep:
6
Diagnosis
cellmorphologicaltypeMCV(fl)MCH(pg)MCHC(%)
Macrocyticanemia>100>3432~36
Normocyticanemia80~10027~3432~36
Microcytichypochromic
anemia
Simplemicrocytic
anemia
(80-100)
(32-36)
(27-34)
<80<27<32
<80<2732~36
Secondstep:
cellmorphologicalclassification
PS:AccordingtoBonemarrowproliferativedegreeand
peripheralRBCmorphology.
7
Diagnosis
Thirdstep:accordingtoetiology/pathogenesis
--acutehemorrhage
chronichemorrhage

--hemolyticanemia(HA)
ThechronichemorrhageoftencombinewithIDA,
causedbyITP,bronchiectasis,tuberculosis,tumor,etc.
8
Diagnosis
RBCinternaldefect
(1)RBCmembranedefect
acquired:PNH
hereditary:hereditaryspherocytosis
(2)enzymedeficiency:G6PDdeficiency
(3)Hbabnormality:hemoglobinopathy,Thalassemia
(4)porphyrinmetabolism:porphyrinopathy
Exopathicimmunologic(AIHA),chemical,
biological,orphisicalfactors
Usually<mdiameter
Microspherocytes:<4mdiameterLacksareaofcentralpallor.
Additionalcauses:
Immunologicreaction
Physicaltrauma
(dacryocyte)
(spherocyte)
(elliptocyte)
(stomatocyte)
9
Diagnosis

BMstemcellsabnormalityAA
BMinjuredbyabnormaltissues/cellsLeukemia
Celldysmaturity(deficiencyofessentialsubstances)
(1).DNAdyssynthesisMegaloblasticanemias
(2).HbdyssynthesisIDA

10
Diagnosis
Completediagnosis