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1、AnemiaANDAnemiaHeartDisease本文檔由醫(yī)學(xué)百事通高端醫(yī)生網(wǎng)專家制作在線咨詢醫(yī)生網(wǎng)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)
