教学ppt课件贫血.pptVIP

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;Factors influencing Hb concentration;★Classification ;Kinetic classification(Classified according to etiology and pathogenesis);Marrow infiltration leukemiascarcinomamultiple myeloma myelofibrosisMalignant histocytosis;Production and maturation blockages of differentiating cells ;4 Unknown reason or several mechanisms;二、Accelerated destruction of red cells ;2)Extragenous;三.??????? Blood loss;Classified accordind to the proliferative situations of BM;Clinical manifestations;In contrast, the gradual loss (even Hb 30~40g/L) of the circulating red cell mass in a patient with pernicious anemia may occur without any symptoms at all.;Why? ;;The level of anemia at which symptoms occur is highly variable among individuals as would be expected from the widely differing degrees of physical activity , physical conditioning , circulatory adequacy , and sensitivity or stoicism of the population. ;１．General manifestations:(Nonspecific and reflect tissue hypoxia) Tiredness, fatigue→ the most common, the earliest symptom Pallor of skin and mucosa→shared chracteristic２．Cardiovascular systems : Palpitations and dyspnea on exertion,breathlessness→common symptomsValvulae murmurs  Hb 30g/L, 3m→Anemic cardic disease; 3． Neurologic system : Headache, Dizziness, Confusion, decreased mental acuity (记忆力衰退), 晕厥，注意力不集中，失眠，耳鸣． severe anemia→Coma 4 ．Digestive system:Anorexia (食欲不振)，厌食→early megaloblastic anemia Nausea(恶心)，flatulence(胀气)，diarrhoea(腹泻) or constipation (便秘)lingual abnormalities (舌的改变)：common;5．Genitourinary system:severe anemia→　polyurea (多尿), 　hypobaric urine (尿比重低), 　proteinuria (蛋白尿): 肾小球滤过功能和小管分泌及回收功能障碍female:disturbed menstruation (月经紊乱), 性功能减退多见6．Oth