贫血及贫血性心脏病-夜

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1、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网址:http://www.12320bst.comDefinitionAnemiaisdefinedasadecreaseinthecirculatingRBC,hemoglobinorthehematocrit,andacorrespondingdecreaseintheoxygen-carryingcapacityoftheblood.Normalvaluesofthehemogram(Insealevel):TESTWO

2、MENMENHCT(%)37-4840-50Hb(g/L)110-150120-160RBCCount(1012/L)3.5-5.04.0-5.5PS:TheHBofNewbornis170-200g/L.2ChestHospitalDiagnosisWOMENMENPREGNANTHb(g/L)＜110＜120＜100WOMEN■Anemiaisn’tadiagnosis,itisasignofthepresenceofdisease.■Correctdiagnosis:includeunderlyingcauseofthea

3、nemia■Theycanbealteredbytheplasmaticvolumes.■Themeannormalvaluedependson:altitudeofresidence,ageandgender.■Differencebetweenwomenandmenvaluesareduetoandrogenhormones.3ChestHospitalDiagnosisFirststep:detectionofthepresenceofanemia,andtheseverity.Secondstep:laboratoryi

4、nvestigationofthemorphologicalclassification.Thirdstep:investigationofthepathogenesisofanemia.4ChestHospitalDiagnosisMild120/110Moderate90Severe60VerySevere30ClassificationaccordingtoseverityFirststep:5ChestHospitalDiagnosiscellmorphologicaltypeMCV（fl）MCH(pg)MCHC(%)M

5、acrocyticanemia>100>3432～36Normocyticanemia80～10027～3432～36MicrocytichypochromicanemiaSimplemicrocyticanemia(80-100)(32-36)(27-34)<80<27<32<80<2732～36Secondstep:cellmorphologicalclassificationPS:AccordingtoBonemarrowproliferativedegreeandperipheralRBCmorphology.6Ches

6、tHospitalDiagnosisThirdstep:accordingtoetiology/pathogenesis1.Bloodloss--acutehemorrhagechronichemorrhage2.IncreasedRBCdestruction--hemolyticanemia(HA)ThechronichemorrhageoftencombinewithIDA,causedbyITP,bronchiectasis,tuberculosis,tumor,etc.7ChestHospitalDiagnosisRBC

7、internaldefect(1)RBCmembranedefectacquired:PNHhereditary:hereditaryspherocytosis(2)enzymedeficiency:G6PDdeficiency(3)Hbabnormality:hemoglobinopathy,Thalassemia(4)porphyrinmetabolism:porphyrinopathyExopathicimmunologic(AIHA),chemical,biological,orphisicalfactorsUsuall

8、y<6.5mdiameterMicrospherocytes:<4mdiameterLacksareaofcentralpallor.Additionalcauses:ImmunologicreactionPhysicaltrauma(dacryocyte)