英文 溶血性贫血（徐运孝）ppt课件

《英文 溶血性贫血（徐运孝）ppt课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、徐运孝内科学多媒体教案HEMOLYTICANEMIAS一、GeneralInformation●HbStructure●DefinitionofHemolyticAnemias1、HbStructureHbA（22）HbA2（22）HbF（22）ProtoporphyrinHematinHbFe2Haptoglobinnon-22、DefinitionofHemolyticAnemiasHemolyticanemiaisonekindofanemiainwhichthedestructionofredcellisincreasedwhilethec

2、ompensatoryfunctionofmarrowhematopoisisisinsufficient。HemolyticdisordersHemolyticjaundice二、ClassificationandPathogenesis1、Hemolyticsites:ExtravascularhemolysisIntravascularhemolysisHemolysisinsitu2、HereditaryTendency:HereditaryAcquired3、PathogenesisIntrinsicabnormitiesofredcells:re

3、dcellmembranedisorders；enzymedefects；hereditaryHbdisease.Extrinsicabnormitiesofredcells:Immune；Physicalandmechanical；chemical；infections。（二）Distinguishwhetherthereishemolyticanemiaornot1、Evidenceofexcessivedestructionofredcells（1）Examinationsabouttheshortenedlifespanandtheexcessive

4、destructionoftheredcells.（2）Evidenceoftheimprovedfreehemoglobinlevel.（3）Examinationsabouttheabnormalmetabolismofserumbilirubin(1)examinationabouttheshortenedlifespanandexcessivedestructionoftheredcells.Thelifespanoftheredcellsisshortened.32P-DFPorH-DFPT1/215d(normal25-32d)cha

5、ngesofredcellmorphology:spherocyte,ellipotocyte,stomatocyte,helmetcell,sicklecell.LDH2、Evidenceofcompensatoryaccelerationoferythropoiesis（2）ExaminationabouttheincreasedplasmafreehemoglobinmoderatehemolysiscombinewithHpHpsmallpartcombinewithhemopexinhemopexinfreeHbalbuminsevereh

6、emolysissomeconverttomethemoglobinmethemalbuminrenalreabsorptionepithliummajorporthemoglobinuriabyrenaltubuleurinehemosiderinhemosiderineuriadesquamationafreeHbbHpcmethemalbumindHburineeurineroustest(+)（3）ExaminationaboutabnormalmetabolismofbilirubinIndirectbilirubinUrineurobilin

7、ogen，urinebilirubin（-）Stoolbilinogen2、Evidencesofcompensatoryaccelerationoferythropoiesis（1）Reticulocytosis（2）Bloodsmearanisocytosis,polychromatophiliaofredcells.Howoll-Jollybody.Cabotring，nucleatedredcells.（3）Hyperplasiabonemarrow（三）FindtheetiologyofhemolysisanemiaExaminations

8、about