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1、教学课件-贫血FactorsinfluencingHbconcentrationSexAgeAltitudeAlterationsinplasmavolume★ClassificationMorphologicclassificationTypeMCV(um)MCH(PG)MCHC(%)DiagnosisMacrocytic＞100＞3232-35MegaloblasticanemiaNormocytic80-10026-3232-35AA,HA,AcuteposthemorragicanemiaMicrocyt
2、ic＜80＜26＜32IDA,SideroblasticanemiaThalassemiasKineticclassification(Classifiedaccordingtoetiologyandpathogenesis)一、DecreasederythropoiesisProliferationanddifferentiationabnormalitiesofSCHSC:AA,Fanconisanemia,MDSErythrocyticprogenitors:Pureredcellaplasia,Anemi
3、ascausedbykidneyfailureandendocrinedisordersMarrowinfiltrationleukemias carcinoma multiplemyeloma myelofibrosis MalignanthistocytosisProductionandmaturationblockagesofdifferentiatingcellsDNAsynthesisblockage:VitB12,falicaciddifficiencies,嘌呤和嘧啶metabolicdefects
4、→MegaloblasticanemiaHbsynthesisblockage:Hemeproductiondefect:IDA Heptoglobinproductiondefect:Thalassemias4UnknownreasonorseveralmechanismsSideroblasticanemia Chronicdiseaseanemias(chronicinflummation,infections,尿毒症,Hepaticdisorders,neoplasm,connectivetissuedi
5、sease,endocrinedisorders)二、Accelerateddestructionofredcells1）Endogenous(intra-erythrocytedefects)1.Membranedefectsoferythrocytes:Hereditary:Hereditaryspherocytosis(HS) Hereditasyelliplocytosis(HE)Acquired:PNH2.EnzymedefectsGlucose--6--PhosphateDehydrogenase(G
6、6PD)deficiency Pyruvatekinasedeficiency3.Abnormalhaptogllbinsynthesis:Sicklecellanemia,Hemoglobinopathies Thalassemias2)ExtragenousImmuneHA:AIHA,neonatalHA,mismatchedtransfusion,drug-inducedHA2.Mechanical:marchhemoglobinuria,cardiacvalvesprostheses,microangio
7、pathichemolyticdisorders.3.Duetochemical,physicalormicrorganisms:Chemicaltoxin-anddrug-inducedhemolysis,largescaleburnedpatient(severeburnedpatient) Infection-induced,benzene,radiationmicrorganisms:Malaria,virus,etc.4.Increaseddamageofmonocyte-macrocytesystem
8、:Hypersplenism三.Bloodloss◆Acuteposthemorrageanemia◆Chronicbleeding→IDAClassifiedaccordindtotheproliferativesituationsofBMHyperplasticanemias(增生性贫血): HemolyticanemiaAnemiacausedbybloodloss
