General Aspect of Anemia09[1][1].ppt

1、General Aspects of Anemia,Hematology Department Tianjin medical university general hospital Rong Fu,Background knowledge,Blood system (1) The composition of blood system (2) The differentiation of blood cells The types of blood diseases,The classification of blood diseases,1. Erythrocytic diseases 2

2、. Leukocytic diseases 3. Hemorrhagic diseases 4. Thrombotic diseases,Anemia is a kind of syndrome rather than disease,Anemia,Definition Classifications Manifestations Diagnosis Therapy,Definition,The term anemia, as it generally is used in clinical medicine, refers to a reduction below normal in the

3、 concentration of hemoglobin or red cells in the blood,Normal range of RBC, Hb, Ht,WHO Criteria for anemia,Hemoglobin concentration adult men : 130g/L adult women: 120g/L 6 months old to 6 years old children: 110g/L 6 to 14 years old children : 120 g/L pregnant women: 110g/L,Classification,progressi

4、ve rate of anemia,acute,chronic,morphologic characteristic of red cells,macrocytic,normocytic,microcytic,severity of anemia,mild,severe,moderate,very severe,cellularity of BM,Hyper-cellular,Hypo-cellular,etiology of anemia,Impaired erythrocyte production,More destruction of erythrocyte,Loss of blood

5、,Classification,According to the morphologic characteristic of red cells, mainly according to MCV and MCHC,Macrocytic Anemia,MCV100um3 Folic acid deficiency anemia VitaminB12 deficiency anemia,Microcytic hypochromic anemia,MCV80um3 MCHC 32%, Iron-deficiency anemia Sideroblastic anemia Thalassemia,No

6、rmocytic anemia,MCV=80100um3 Aplastic anemia The majority of hemolytic anemia Anemia with chronic disorders(ACD) Chronic inflammation Infection Hepatic diseases Connective diseases Malignancy,业务 流程,Chinese folk arts,Failure of hemopoietic function,Insufficiency of Hemopoietic materials,1.Impaired Er

7、ythrocyte production,Classification According to the etiology and pathogen of anemia,Iron-deficiency anemia Megaloblastic anemia,Aplastic anemia Anemia with chronic disorders Sideroblastic anemia,业务 流程,Chinese folk arts,Traditional Festival,Extrinsic-defect of erythrocyte,Intrinsic-defect of erythro

8、cyte,2.More destruction of erythrocyte,Hereditary: Hereditary spherocytosis Enzyme deficiency anemia Thalassemia Acquired: PNH,Immunohemolytic anemia Mechanical trauma: microangiopathic hemolytic anemia Hemolytic anemia resulted from physical, chemical or biological factors,Chinese folk arts,3.Loss

9、of blood,Manifestations,The clinical manifestations of anemia depend on 5 factors: The reduction in the oxygen-carrying capacity of blood. The degree of change in total blood volume. The rate of which the previous two factors developed. The capacity of the cardiovascular and pulmonary systems to com

10、pensate for the anemia. The associated manifestations of the underlying disorders that resulted in the development of anemia,Manifestations,The symptoms, signs of anemia can involve all of the systems, as follows,The symptoms of anemia affect multiple body systems,CNS Debilitating fatigue Headache,

11、Dizziness Depression Impaired cognitive function vertigo, restlessness,Immune system Impaired T cell and macrophage function,Cardiorespiratory system Exertional dyspnoea Tachycardia, palpitations Cardiac enlargement, hypertrophy Increased pulse pressure, systolic ejection murmur Risk of life-threate

12、ning cardiac failure Electrocardiographic changes ST junction depressed,Gastro-intestinal system Anorexia Nausea constipation,Genitourinary systems slight proteinuria Menstrual problems Loss of libido,Vascular system Low skin temperature Pallor of skin, mucous membranes and conjunctivae,Other signs

13、Fever Hemoglobinemia hemoglobinuria,Diagnostic,Pathological classification,Existence of anemia,Tentative treatment to definite the cause of anemia (If necessary,Clinical and morphologic classification,Summary of the clinical and laboratory characteristics,Anemia,Steps,Diagnosis,Diagnostic Clues: His

14、tory. Physical examination. Adjuvant laboratory tests,Diagnosis,History The initial time, duration and manifestations of anemia Dietary habit, gastrointestinal conditions, nutritional conditions Acute and chronic hemorrhagic diseases Other chronic diseases Menstruation and pregnancy history Exposure

15、 to chemical, toxic substances and radiation Parasitic diseases Congenital diseases and family history,Diagnosis -Physical Examinations,malnutrional deficieny of hematopoietic materials,hemolysis,malignancy,bone marrow failure,Signs of,function deficiency of various organs,Diagnosis-Laboratory tests,Blood Regular Test Hemoglobin and RBC -The most reliable index for diagnosing anemia MCV、MCHC、MCH Reticulocyte -A very important index for diagnosing anemia,Diagnosis,Bone ma