(一)、正常小儿的造血特点 包括胚胎期造血和生后造血两个阶段 n 胚胎期造血(Fetal Hematopoiesis) n 中胚叶造血(Mesenchymal Hematopoiesis n 肝脾造血(Liver/Spleen Hematopoiesis n 骨髓造血(Medullary Hematopoiesis
Percent of globin chains present 100 80 60 40 20 0 6 m -3 m Birth 3 m 6 m Relative rates of synthesis of different globin chains during embryonic, fetal and neonatal life.
(三)、贫血的程度 n 轻度:Hb 90 -120 g/L,RBC 3 -4 1012/L n 中度: Hb 60 -90 g/L,RBC 2 -3 1012/L n 重度: Hb 30 -60 g/L,RBC 1 -2 1012/L n 极重度: Hb <30 g/L,RBC < 1 1012/L
(四)、贫血的分类 1. 形态学分类(morphological classification): n 正细胞正色素性贫血(MCV=80 -96;MCHC=33 -35) (Normocytic Normochromic Anemia) n 小细胞低色素性贫血(MCV<80;MCHC <33) (Microcytic Hypochromic Anemia) n 大细胞正色素性贫血(MCV>96;MCHC=33 -35) (Macrocytic Normochromic Anemia)
2. 病理生理学分类 (Pathophysiological Classification): n n RBC生成减少(Decreased RBC Produciton) 红细胞破坏过多或丢失。 (Increased RBC Loss or Destruction)
三、营养性缺铁性贫血 Nutritional Iron Deficiency Anemia
n 重视RBC的形态: ü IDA时典型的RBC形态:小细胞低色 素性贫血 (Microcytic Hypochromic Anemia)(MCV ,MCHC )。
正常外周血RBC形态 RBCs: central pallor about 1/3 the size of the RBC; minimal size and shape variations.