苏州大学医学部儿科临床医学院儿科学 Lesson13.pdfVIP

Haematopoiesis and Anemia 造血与贫血 Department of Pediatrics Soochow University Affiliated Children’s Hospital Main Point-要点 Master clinical manifestation and diagnosis of anemia Know well etiology and classification of anemia Know well principle of treatment of anemia Understand hematopoiesis trait and blood change in childhood 一、Development of the haematopoietic system -造血系统的发育 Three anatomic stages of haematopoiesis prior to birth mesoblastic stage-中胚叶造血期 hepatic stage-肝脏造血期 myeloid stage-骨髓造血期 TABLE 1 GESTATIONAL HEMATOPOIESIS GESTATIONAL AGE PHASE LOCATION 2 weeks - 2 months Mesoblastic Wall of yolk sac 6 weeks - birth Hepatic Liver 2 1/2 month - birth Myeloid Bone Marrow Mesoblastic haematopoiesis - 中胚叶造血 Mesoblastic hematopoiesis occurs in extraembryonic structures, principally in the yolk sac wall where small nests of blood cell production can be visualized, and begins between the 10th and 14th days of gestation. These nests are referred to as blood islands. By 6–8 wk of gestation the liver replaces the yolk sac as the primary site of blood cell production, and by 10–12 wk extraembryonic hematopoiesis has essentially ceased. Hepatic haematopoiesis -肝脏造血 Islands of blood cell development occur within the liver parenchyma from 6 weeks to birth. Although the liver is the dominant site of hematopoiesis for the first half of gestation, blood cell production also occurs at lesser intensity within the spleen. Myeloid haematopoiesis -骨髓造血 Hematopoiesis within bone marrow begins in the clavicle at about 2 1/2 months. Activity continues