《内科学》贫血概述.ppt

TreatmentofAnemiaAllogeneicHSCTransplantation?Indicatedinlife-threateningBMmarrowfailureorhereditaryanemia-Bonemarrowtransplantation(BMT)-PeripheralbloodHSCtransplantation(PBSCT)-CordbloodHSCtransplantation(CBSCT)*TreatmentofAnemiaSplenectomy?Hereditaryspherocytosis(curative)?Hereditaryelliptocytosis?Autoimmunehemolyticanemia?Pureredcellaplasia?Hypersplenismgenetherapyisbecominganewwaytocuresomeanemia*TreatmentofAnemiaSummary?Treatmentofanemiaisbasedonetiology?Oneforallisonlyamyth?Correctivediagnosisleadsthewaytoacure?Treatingunderlyingdiseasesensureacure*QUESTIONS1.Whatisanemiadefinedas?

2.Whatarethemajorcausedofanemia?

3.Howdoyoucommentuponclassificationsystemsofanemia?

4.Trytodescribetheprinciplesoftreatmentofanemia.**thalassemia,hemoglobinopathyvipervenom蝰蛇毒thalassemia,hemoglobinopathy①甲状腺功能减退：由于甲状腺素分泌减少，全身的代谢减低，肾脏产生的EPO亦减少而致贫血。另外，部分甲状腺功能减退的患者存在胃壁细胞抗体和内因子阻断抗体，可合并恶性贫血。②甲状旁腺功能亢进：甲状旁腺可抑制红细胞生成，促使红细胞破坏及导致骨髓纤维化，5%-21%的患者常会有轻至中度贫血。Congenitalatransferrinemia先天性无转铁蛋白血症PhysiopathologicalClassificationAbnormalDNASynthesis?VitaminB12deficiency?Folicaciddeficiency?CongenitaloracquireddefectsinpurineandpyrimidinemetabolismDecreasedRBCProduction*PhysiopathologicalClassificationAbnormalHbSynthesis?IrondeficiencyanemiaCongenitalatransferrinemia?ThalassemiaandhemoglobinopathyDecreasedRBCProduction*PhysiopathologicalClassificationDeregulationofErytheropoiesis?Lowoxygenaffinityhemoglobinopathies?HighoxygenaffinityhemoglobinopathiesDecreasedRBCProduction*PhysiopathologicalClassificationDecreasedRBCProductionUnknownorMultipleMechanisms?Anemiaofchronicdisorders(ACD)?Anemiaduetonutritionaldeficiencies?Sideroblasticanemia*PhysiopathologicalClassificationIncreasedRBCDestructionIntrinsicabnormalities