复旦大学附属华山医院：《内科学》贫血（ANEMIA）概述

ANEMIA Hematology Department, Huashan Hospital, Fudan University, Shanghai XieYan-Hui

ANEMIA Hematology Department,Huashan Hospital,Fudan University,Shanghai XieYan-Hui

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

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

Hemoglobin(Hb): male(adult <120g/L female(adult<110g/L female(gestation<100g/L Red cell count male <4.5x 1012/L female <4. 0X1012/L Hemocrit(HCT) male<0.42 female<0.37 female(gestation)<0.30

Hemoglobin(Hb): male(adult)<120g/L female(adult)<110g/L female(gestation)<100g/L Red cell count male<4.5x1012 /L female<4.0x1012 /L Hemocrit(HCT) male<0.42 female<0.37 female(gestation)<0.30

Determination of the cause A History 1. Drug administration 2. Exposure to toxic chemicals 3. Family occurrence 4. Recent transfusions 5. menstruation(woman) 6. ingestion(child) 7. chronic disease 8. Age at onset

I. Determination of the cause: A. History 1. Drug administration. 2. Exposure to toxic chemicals 3. Family occurrence. 4. Recent transfusions 5.menstruation(woman) 6.ingestion(child) 7.chronic disease 8. Age at onset

B Physical findings and complaints a pale mucous membranes and skins b, Weakness, loss of stamina, and exercise intolerance, Hypersensitivity to cold, fever C Tachycardia and polypnea, Heart murmur. anemia associated cardiac disease Hb<30g/L more than 2 months heart enlargement ST depression

B. Physical findings and complaints a. Pale mucous membranes and skins b. Weakness, loss of stamina, and exercise intolerance,Hypersensitivity to cold ,fever. c. Tachycardia and polypnea,Heart murmur. anemia associated cardiac disease: ➢ Hb<30g/L more than 2 months ➢ heart enlargement ➢ ST depression

d headache. dizziness e anorexia, nauxea, abdominal fullness diarra or constipation, Icterus f menstruation disorder or amenorrea hemoglobinuria g Shock if >1/ blood volume lost in short period

d. headache,dizziness e.anorexia,nauxea,abdominal fullness diarria or constipation, Icterus. f.menstruation disorder or amenorrea hemoglobinuria g. Shock if >1/ 2blood volume lost in short period

C Laboratory findings 1 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

C. Laboratory findings 1. 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

2. Hb and RBC may be used to further classify the anemia

2. Hb and RBC may be used to further classify the anemia

I Classification A Size(MCv) and Hb Concentration (MCHC) 1. Normocytic, macrocytic, microcytic 2. Normochromic, hypochromic (Hyperchromia does not occur)

II. Classification A. Size (MCV) and Hb Concentration (MCHC) 1. Normocytic, macrocytic, microcytic. 2. Normochromic, hypochromic. (Hyperchromia does not occur)

ype MCv(f)MCHC(%)MCH(pg disorder Macro >100 >32 32-35 megaloblastic anemia MDS Normo 80-100 26-32 32-35 aplastic anemia, blood lost, hemolytic anemia Micro <80 <26 <32 iron deficiency anemia sideroblastic anemia thalassemia

Type MCV(fl) MCHC(%) MCH(pg) disorder Macro >100 >32 32-35 megaloblastic anemia MDS Normo 80-100 26-32 32-35 aplastic anemia,blood lost, hemolytic anemia Micro <80 <26 <32 iron deficiency anemia sideroblastic anemia thalassemia