教学课件 贫血.pptVIP

Anemias CUF-S (造血干C、红系祖C) ↓ proerythroblast （原始RBC）↓  Basophilic normoblast （ 早幼RBC）↓  Polychromatic mormoblast（中幼RBC）↓ Orthrochromatic normoblast （晚幼RBC）此阶段脱核进入血循环 ↓ Reticulocyte （网织RBC） 经特殊染色见到丝状或网状结构, 保留残余线粒体和核糖，仍有继续合成Hb的能力（从早幼RBC开始）↓erythrocyte Definition A reduction below normal in the concentration of hemoglobin , the mass of red blood cells and/or the hematocrit in the blood. Factors influencing Hb concentration Sex Age Altitude Alterations in plasma volume ★Classification Morphologic classification Kinetic classification(Classified according to etiology and pathogenesis) 一、Decreased erythropoiesis Proliferation and differentiation abnormalities of SC HSC: AA, Fanconis anemia, MDS Erythrocytic progenitors : Pure red cell aplasia, Anemias caused by kidney failure and endocrine disorders Marrow infiltration leukemiascarcinomamultiple myeloma myelofibrosisMalignant histocytosis Production and maturation blockages of differentiating cells DNA synthesis blockage : Vit B12, falic acid difficiencies, 嘌呤和嘧啶 metabolic defects→Megaloblastic anemiaHb synthesis blockage :  Heme production defect : IDA Heptoglobin production defect : Thalassemias 4 Unknown reason or several mechanisms Sideroblastic anemiaChronic disease anemias (chronic inflummation, infections, 尿毒症, Hepatic disorders, neoplasm, connective tissue disease, endocrine disorders) 二、Accelerated destruction of red cells  1）Endogenous (intra-erythrocyte defects) 1.Membrane defects of erythrocytes : Hereditary :Hereditary spherocytosis (HS) Hereditasy elliplocytosis (HE) Acquired : PNH2.Enzyme defects Glucose--6--Phosphate Dehydrogenase (G6PD) deficiency Pyruvate kinase deficiency 3.Abnormal haptogllbin synthesis : Sickle cell anemia, Hemoglobinopathies  Thalassemias 2)Extragenous Immune HA : AIHA, neonatal HA,mismatched