文档介绍：ANEMIA
Hematology Department,Huashan
Hospital,Fudan University,Shanghai
XieYan-Hui
DIAGNOSIS AND CLASSIFICATION Anemia is an absolute decrease in hematocrit , hemoglobin concentration, or the RBC count. Anemia is not a diagnosis, but a sign of underlying disease..
Hemoglobin(Hb): male(adult)<120g/L
female(adult)<110g/L
female(gestation)<100g/L
Red cell count male< /L
female< /L
Hemocrit(HCT) male<
female<
female(gestation)<
Determination of the cause: A. History 1. Drug administration. 2. Exposure to toxic chemicals 3. Family occurrence. 4. Recent transfusions (woman) (child) disease 8. Age at onset.
B. Physical findings plaints a. Pale mucous membranes and skins b. Weakness, loss of stamina, and exercise intolerance,Hypersensitivity to cold ,fever.
c. Tachycardia and polypnea,Heart murmur.
anemia associated cardiac disease:
Hb<30g/L more than 2 months
heart enlargement
ST depression
d. headache,dizziness ,nauxea,abdominal fullness diarria or constipation, Icterus. disorder or amenorrea hemoglobinuria g. Shock if >1/ 2blood volume lost in short period.
C. Laboratory findings 1. The Hct is the easiest, most accurate method for detecting anemia. Its result should be interpreted with knowledge of the hydration status and any alteration caused by splenic contraction.
2. Hb and RBC may be used to further classify the anemia.
II. Classification A. Size (MCV) and Hb Concentration (MCHC) 1. Normocytic, macrocytic, microcytic. 2. Normochromic, hypochromic. (Hyperchromia does not occur)
Type MCV(fl) MCHC(%) MCH(pg) disorder
Macro >100 >32 32-35 megaloblastic anemia
MDS
Normo 80-100 26-32 32-35 aplastic anemia,blood
lost, hemolytic anemia
Micro <80 <26 <32 iron deficiency anemia
sideroblastic anemia
thalassemia