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1、执业助理医师考试笔记汇总血液系统笔记复习总结新编贫血概述：一、分类：1.根据红细胞形态特点分类：大细胞性贫血：巨幼贫、溶贫。正常细胞性贫血：再障、溶贫、急性失血性。小细胞低色素性贫血：2.根据贫血的病因和发病机制分类：红细胞生成减少：缺乏造血原料、骨髓疾病（干细胞增生和分化异常、异常组织浸润）。红细胞破坏过多：内在缺陷、外在因素。失血性贫血一、临床表现：1.一般表现：疲乏、困倦、软弱无力。2.心血管系统表现：活动后心悸气短、心率过快、心搏有力、脉压增加。3.中枢神经系统表现：头痛、头晕、目眩、注意力不集中、嗜睡。4.消化系统：食欲减退、腹胀、恶心。5.泌尿生殖系统：轻度蛋白尿、尿浓缩功能减退。
2、6.其它：皮肤干燥、毛发枯干。缺铁性贫血一、铁的代谢：1.铁的分布：功能状态铁、贮存铁。2.铁的来源和吸收：需要2025mg/d，大部分来自衰老的红细胞破坏，食物中摄取11.5mg/d 可维持铁的平衡。3.铁的运输：高铁与转铁蛋白结合，运到各组织，经过胞饮进入细胞，在胞内再次还原为亚铁文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L
3、3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:C
4、V5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR
5、6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO
6、2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码
7、:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2
8、HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4
9、ZO2L3E1R7U6资料仅供参考4.再利用和排泄：RBC正常寿命为120 天。5.铁的储存：铁蛋白、含铁血黄素。二、病因：铁摄入不足慢性失血三、临床表现：1.贫血表现2.组织缺铁表现：发育迟缓、体力下降、智商低、易兴奋、注意力不集中、烦躁易怒、异食癖，吞咽困难。3.体征：皮肤粘膜苍白、毛发干燥、指甲扁平、失光泽、易碎裂。四、实验室检查：1.血象：小细胞低色素性贫血；红细胞染色浅淡，中心淡染区扩大、网织红多正常或轻度增多。2.骨髓相：增生活跃，幼红细胞增多。铁染色：铁粒幼细胞极少或消失，胞外铁亦缺少。3.生化：血清铁降低，总铁结合力增高。血清铁蛋白降低FEP增高五、诊断：六、治疗：1.病因治疗
10、：2.补充铁剂：网织红于7 天左右达高峰血红蛋白于2 周后应上升，12 周后正常。血红蛋白完全正常后仍需补充铁剂36 个月，或待血清铁蛋白50ug/L 后停药。巨幼细胞贫血：文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5
11、Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H
12、10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L
13、3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:C
14、V5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR
15、6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO
16、2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6资料仅供参考一、临床表现：1.贫血表现：部分患者可出现轻度黄疸。2.胃肠道症状：食欲不振、
17、腹胀、便秘、腹泻，牛肉舌。3.神经症状：对称性麻木，深感觉障碍，共济失调。二、实验室检查：1.血象：全血细胞减少；红细胞大小不等；中性粒分页过多。2.骨髓相：增生活跃，以红系最为显著，各系均巨幼变，骨髓铁染色增多。三、治疗：1.去除病因2.补充叶酸和vitb12 再生障碍性贫血一、临床表现：1.重型：起病急，进展迅速，贫血进行性加重，出血部位广泛，皮肤感染、肺部感染多见，严重发生败血症。2.慢性：贫血为首发和主要表现：出血较轻感染以呼吸道多见。二 实验室：1.血象：全血细胞减少，网织红明显降低。2.骨髓相：骨髓颗粒很少，脂肪滴增多。三 诊断和鉴别诊断：1.诊断：严重贫血、伴有出血、感染和发热，
18、脾不大，血象为全血细胞减少，网织红细胞绝对值减少，骨髓增生低下，骨髓小粒非造血细胞增多，能除外其它全血细胞减少的疾病。重型再障的血象诊断标准：文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G
19、4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1
20、R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y
21、1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H1
22、0G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3
23、E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV
24、5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6资料仅供参考网织红 0.01，绝对值 15109/l中性粒绝对值 0.5109/l血小板20109/l2.鉴别诊断：PNH
25、，MDS，恶性组织细胞病四 治疗：1.支持及对症治疗。2.雄激素：大剂量，对慢性疗效较好，服药23 月后起效。3.免疫抑制剂。4.造血细胞因子。5.骨髓移植：年龄不超过40 岁。溶血性贫血一、发病机制：1.红细胞易于破坏寿命缩短（1）红细胞膜的异常（2）血红蛋白的异常（3）机械性因素2.异常红细胞破坏的场所：（1）血管内：血型不合、PNH。（2）血管外：遗传性球形红细胞增多症、自身免疫性溶贫。二、临床表现：短期大量溶血：严重的腰背及四肢酸痛，伴头痛、呕吐、寒战、高热、面色苍白、血红蛋白尿、黄疸，周围循环衰竭，急性肾衰，慢性溶血：贫血、黄疸、肝脾大。三、实验室：文档编码:CV5Y1I8U8B2
26、HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4
27、ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档
28、编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B
29、2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D
30、4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6
31、文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U
32、8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6资料仅供参考1.提示红细胞破坏：（1）血管外溶血：a.高胆红素血症b.粪胆原排出增多c.尿胆原排出增多（2）血管内溶血：a.血红蛋白血症b.血清结合珠蛋白降低c.血红蛋白尿d.含铁血红素尿2.提示骨髓幼红细胞代偿性增生的实验室检查：a.网织红细胞增多b.周围血中出现幼红细胞3.提示红细胞寿命缩短的
33、实验室检查：a.红细胞形态改变b 吞噬红细胞现象及自身凝集反应c.Heinz小体d.红细胞渗透脆性增加自身免疫性溶贫一、实验室：正常细胞性贫血，周围血可见球形细胞，网织红细胞增高，急性溶血白细胞增多，血小板多正常（如伴血小板减少为Evans 综合症），骨髓呈增生性反应，以幼红细胞为主。coombs试验阳性，免疫球蛋白增多，抗核抗体阳性，循环免疫复合物增多，c3 低于正常。二、治疗：文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H
34、9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7
35、U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I
36、8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G
37、4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1
38、R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y
39、1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H1
40、0G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6资料仅供参考1.病因治疗2.糖皮质激素3.脾切除4.免疫抑制剂：指征：糖皮质激素和脾切除都不缓解者；脾切除有禁忌；泼尼松量需10mg/d 以上才能维持。阵发性睡眠性血红蛋白尿一、临床表现：1.血红蛋白尿：伴乏力、胸骨后及腰腹痛、发热，早晨较重2.贫血、感染与出血3.血栓形成二、实验室：1.血象：严重贫血，粒细胞减少，血小板减少。2.骨髓相：三系增生活跃。3.尿：隐血阳性，含铁血黄素持续阳性。4.特异性血清血试验：ham试验，蔗糖溶血试验，热溶血试验，蛇毒因子溶血试验。白血病急
41、性白血病：一、临床表现：贫血：发热：口腔炎、牙龈炎、咽峡炎、肺部感染、肛周炎、肛周脓肿、革兰氏阴性杆菌多见。出血：淤点、淤斑、鼻出血、牙龈出血、眼底出血、DIC。器官和组织浸润的表现：淋巴结和肝脾大骨骼、关节疼痛：骨髓坏死时可引起骨骼剧痛文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2
42、HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4
43、ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档
44、编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B
45、2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D
46、4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6文档编码:CV5Y1I8U8B2 HR6H10G4H9D4 ZO2L3E1R7U6