参考翻译 aplastic anemia再生障碍性贫血.ppt

21 year man Presented with fatigue, pale, tiredness Hb 11.0 WBC 2.6,neutrophils 1.1, platelets 45, MCV 104. B12/folate 叶酸/ferritin 铁蛋白 were normal. Main physical examination was unremarkable. Case Presentation Marrow aspirate hypocellular 细胞减少 Marrow biopsy hypocellular Diagnosis? Treatment? Case Presentation Thank you John Radcliffe Hospital Aplastic Anemia (再生障碍性贫血) Review What is the function of bone marrow 骨髓 Hematopoiesis 造血 Red blood cells --- transport oxygen and nutrientsWhite blood cells --- fight infectionplatelets—help blood clot 凝结 Bone marrow haematopoiesis failure, HSC 造血干细胞 injured Peripheral blood pancytopenia 全血细胞减少 Typical symptoms: anemia, infection, bleeding Direct and indirect pathophysiologic pathways causing A.A The main characters of Aplastic Anemia General Introduction Classification Ⅰ Ⅱ Severe Moderate Abroad Acute Chronic Home Epidemiology Incidence China Annual incidence 7.4 per 100,000 6.0 1.4 Distribution Epidemiology female male Infant 70’s Chemical factors: drug (anticarcinogen 抗癌药, chloramphenicol 氯霉素, sulfonamide 磺胺, NSAIDs etc) chemicals (benzene 苯, insecticides 杀虫剂 etc) Physical factors radiation, X ray Biological factors viruses, severe bacterium, infection Other pathogenic factors Unknown Etiology Pathogenesis Failure in hematopoietic stem or progenitor 祖 cells Defect in microenvironment of haematopoiesis Immuno-mediated 免疫介导的 bone marrow failure Genetic aspects: HLA associated susceptibility 敏感 Seeds Soil Harmful Insects Presenting symptoms Acute AA Chronic AA Onset acute, short history slowly onset, longer history Anemia severe, remarkable 显著的 relatively moderate Bleeding heavy bleeding, Multiorgan 多器官 Hemorrhage 出血 moderate, skin and mucus Infection more frequent, moderate, upper respiratory infection Sepsis 败血症 Laboratory findings  Blood count（x109/L）  granulocytes 0.5