文档介绍：贫血及贫血性心脏病-夜
Definition
Anemia is defined as a decrease in the circulating RBC, hemoglobin or the hematocrit ,and a cding to etiology/pathogenesis
loss--acute hemorrhage
chronic hemorrhage
2. Increased RBC destruction
--hemolytic anemia(HA)
The chronic hemorrhage often combine with IDA,
caused by ITP,bronchiectasis,tuberculosis,tumor,etc.
7
Chest Hospital
Diagnosis
RBC internal defect
(1)RBC membrane defect
acquired: PNH
hereditary : hereditary spherocytosis
(2) enzyme deficiency: G6PD deficiency
(3) Hb abnormality: hemoglobinopathy, Thalassemia
(4) porphyrin metabolism : porphyrinopathy
Exopathic immunologic (AIHA), chemical,
biological, or phisical factors
Usually < m diameter
Microspherocytes: <4 m diameter Lacks area of central pallor.
Additional causes:
Immunologic reaction
Physical trauma
(dacryocyte)
(spherocyte)
(elliptocyte)
(stomatocyte)
8
Chest Hospital
Diagnosis
3. Decresed RBC production
BM stem cells abnormality AA
BM injured by abnormal tissues/cells Leukemia
Cell dysmaturity(deficiency of essential substances )
(1). DNA dyssynthesis Megaloblastic anemias
(2). Hb dyssynthesis IDA
4. Abnormality in haematopoiesis modulation AA
9
Chest Hospital
Laboratory investigation
Hematologic---blood RT, platelet count, hematocrit(HCT), MCV, MCH, MCHC, RBC morphological change, bone marrow, reticulocyte count ,etc.
reticulocyte count lower than normal—aplastic anemia
reticulocyte count higher than normal—hemolytic anemia
Blood smear—easy, quickly, useful for much information Bone marrow—show all hemocytic changes
Hypochromia, Microcytosis—iron difiencey
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