贫血及贫血性心脏病-夜.ppt

该【贫血及贫血性心脏病-夜 】是由【wxq362】上传分享，文档一共【28】页，该文档可以免费在线阅读，需要了解更多关于【贫血及贫血性心脏病-夜 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。AnemiaANDAnemiaHeartDisease
本文档由医学百事通高端医生网专家制作
在线咨询医生
第1页,共28页。
Definition
AnemiaisdefinedasadecreaseinthecirculatingRBC,hemoglobinorthehematocrit,andacorrespondingdecreaseintheoxygen-carryingcapacityoftheblood.
Normalvaluesofthehemogram(Insealevel):
TESTWOMENMEN
HCT(%)37-4840-50
Hb(g/L)110-150120-160
RBCCount(1012
PS:TheHBofNewbornis170-200g/L.
*
ChestHospital
第2页,共28页。
Diagnosis
WOMENMENPREGNANT
Hb(g/L)<110<120<100
WOMEN
■Anemiaisn’tadiagnosis,
itisasignofthepresenceofdisease.
■Correctdiagnosis:includeunderlyingcauseoftheanemia
■Theycanbealteredbytheplasmaticvolumes.
■Themeannormalvaluedependson:altitudeofresidence,
ageandgender.
■Differencebetweenwomenandmenvalues
areduetoandrogenhormones.
*
ChestHospital
第3页,共28页。
Diagnosis
Firststep:
detectionofthepresenceofanemia,andtheseverity.
Secondstep:
laboratoryinvestigationofthemorphologicalclassification.
Thirdstep:
investigationofthepathogenesisofanemia.
*
ChestHospital
第4页,共28页。
Diagnosis
Mild
120/110
Moderate
90
Severe
60
VerySevere
30
Classificationaccordingtoseverity
Firststep:
*
ChestHospital
第5页,共28页。
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.
*
ChestHospital
第6页,共28页。
Diagnosis
Thirdstep:accordingtoetiology/pathogenesis
--acutehemorrhage
chronichemorrhage

--hemolyticanemia(HA)
ThechronichemorrhageoftencombinewithIDA,
causedbyITP,bronchiectasis,tuberculosis,tumor,etc.
*
ChestHospital
第7页,共28页。
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)
*
ChestHospital
第8页,共28页。
Diagnosis

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

*
ChestHospital
第9页,共28页。
Diagnosis
Completediagnosis




*
ChestHospital
第10页,共28页。