内科学 贫血总论谢彦晖.pptVIP

内科学 贫血总论谢彦晖第一页，共五十五页，2022年，8月28日 DIAGNOSIS AND CLASSIFICATION Anemia is an absolute decrease in hematocrit , hemoglobin concentration, or the RBC count.  Anemia is not a diagnosis, but a sign of underlying disease..第二页，共五十五页，2022年，8月28日 Hemoglobin(Hb): male(adult)120g/L female(adult)110g/L female(gestation)100g/LRed cell count male4.5x1012 /L female4.0x1012 /LHemocrit(HCT) male0.42 female0.37 female(gestation)0.30第三页，共五十五页，2022年，8月28日 Determination of the cause:A. History1. Drug administration.2. Exposure to toxic chemicals 3. Family occurrence.4. Recent transfusions 5.menstruation(woman)6.ingestion(child)7.chronic disease8. Age at onset.第四页，共五十五页，2022年，8月28日 B. Physical findings and complaintsa. Pale mucous membranes and skinsb. Weakness, loss of stamina, and exercise intolerance,Hypersensitivity to cold ,fever. c. Tachycardia and polypnea,Heart murmur. anemia associated cardiac disease: Hb30g/L more than 2 months heart enlargement ST depression第五页，共五十五页，2022年，8月28日 d. headache,dizzinesse.anorexia,nauxea,abdominal fullness diarria or constipation, Icterus.f.menstruation disorder or amenorrea hemoglobinuria g. Shock if 1/ 2blood volume lost in short period.  第六页，共五十五页，2022年，8月28日 C. Laboratory findings1. The Hct is the easiest, most accurate method for detecting anemia. Its result should be interpreted with knowledge of the hydration status and any alteration caused by splenic contraction.第七页，共五十五页，2022年，8月28日 2. Hb and RBC may be used to further classify the anemia.第八页，共五十五页，2022年，8月28日 II. ClassificationA. Size (MCV) and Hb Concentration (MCHC)1. Normocytic, macrocytic, microcytic.2. Normochromic, hypochromic. (Hyperchromia does not occur)第九页，共五十五页，2022年，8月28日 Type MCV(fl) MCHC(%) MCH(pg) disorderMacro 100 32 32-