Hemolytic anemia

Introduction to hemolytic anemia Hemolytic anemia refers to an anemia that occurs when red blood cell destruction is accelerated and bone marrow hematopoietic function is insufficiently compensated. If the bone marrow can increase erythropoiesis and is sufficient to compensate for the shortened survival of red blood cells, no anemia will occur. This state is called compensatory hemolytic disease. basic knowledge Sickness ratio: 10%-15% Susceptible people: no special people Mode of infection: non-infectious Complications: renal failure, shock

Cause of hemolytic anemia

Cause (65%):

According to the shortening of red blood cell life, it can be divided into erythrocyte intrinsic defects and hemolytic anemia caused by external factors.

Hemolytic anemia caused by internal defects of red blood cells:

(1) Defects in the erythrocyte membrane.

(b) Hemoglobin structure or production defects.

(3) Defects in erythrocyte enzymes. Hemolytic anemia caused by external defects of red blood cells: external defects, usually acquired, red blood cells can be hemolyzed by chemical, mechanical or physical factors, biological and immunological factors, and hemolysis can be in blood vessels. It can also be outside the blood vessels.

Hemolytic anemia prevention

(1) Prevention

Cold agglutinin disease, cold hemoglobinuria patients should avoid cold, the usual naked parts should not be ignored, there is no obvious incentive for the onset of warm antibody type AIHA hemolysis, some patients with seizures related to trauma, surgery, pregnancy, mental stimulation, should Try to avoid, explain to the patient the basic concept of the disease, prevention and treatment points, explain the importance of prevention and implementation methods, encourage patients to self-train and adjust under the conditions of adequate drug treatment to improve physical fitness.

(two) conditioning

1, life conditioning infection, fatigue, mental stimulation, etc. often become the cause of acute hemolysis of the disease, life conditioning is essential, to live regularly, with the climate change in time to increase or decrease clothing, to avoid external sensation, excessive fatigue, including physical labor, Both the gods and the excessive labor can aggravate the disease and should be avoided. Encourage patients to exercise according to their physical condition to improve their physical and disease resistance.

2, diet conditioning this disease pathogenesis is a virtual inclusion, disease for a long time for the qi and blood two losses, even the spleen and kidney are empty, the plain is mainly based on virtual or virtual, taboo cold fruit to avoid damage to the spleen and stomach, spicy and greasy The product should also avoid or eat less, always take care of the spleen and stomach, the following diet can help the disease to recover:

(1) jujube millet porridge: 20 grams of medlar, 50 grams of jujube, 20 grams of yam, 20 grams of peanuts, 50 grams of millet, 150 ml of water, porridge for consumption, for hemolysis, intermittently pale, Lack of help.

(2) ginseng, Cordyceps stewed chicken: 10 grams of ginseng, Cordyceps sinensis, one black bean, 20 grams of lentils, add water, add salt and oil to simmer for 2 hours, drink soup and eat meat, treat hemolysis intermittent qi and blood deficiency, from Sweat, shortness of breath, lazy words, and witnesses with yin deficiency.

3, mental conditioning to treat diseases correctly, avoid heavy physical labor, avoid mental stress, adjust the mind, do not be excited, can exercise properly, such as tai chi, to enhance physical fitness, but those who suffer from qi and blood deficiency do not practice Qigong, so as to avoid qi and blood consumption Increase the qi and blood deficiency.

Hemolytic anemia complications Complications, renal failure, shock

Common complications such as renal failure, shock and heart failure.

Symptoms of hemolytic anemia Common symptoms High fever red blood cell malformation chills jaundice pale pale nose color pale liver splenomegaly renal failure circulatory failure limb caries drooping

The clinical manifestations of hemolytic anemia depend on the mitigation of hemolysis and the main site of hemolysis (intravascular or extravascular).

1 acute hemolysis often onset, such as infusion of blood, short-term large amount of hemolysis can have obvious chills, followed by high fever, low back and limbs pain, accompanied by headache, vomiting, etc., patients with pale and obvious jaundice, which is due to red blood cells A large number of damage, the decomposition of the product caused by the toxic effects of the body, more serious may have peripheral circulatory failure, due to hemolysis products caused by tubular necrosis and luminal obstruction, eventually leading to acute renal failure.

2 chronic hemolysis is slow, mild symptoms, anemia, jaundice, hepatosplenomegaly three characteristics, chronic hemolytic anemia patients with long-term hyperbilirubinemia can be complicated by cholelithiasis and liver damage.

In the process of acute hemolysis, acute bone marrow failure can occur suddenly, which is characterized by extremely reduced reticulocytes and aggravation of anemia. It is called aplastic crisis. The principle may be related to infection and poisoning, and may also be due to the simultaneous effect of antibodies on maturity. Caused by red blood cells and young red blood cells.

Examination of hemolytic anemia

1, blood routine: red blood cell count decreased, generally positive cells positive pigment anemia.

2. Increased serum indirect bilirubin.

3. The red blood cell survival time is shortened.

4, bone marrow.

5, special tests: red blood cell morphology observation, erythrocyte fragility test, anti-human globulin test, acidified serum hemolysis test, methemoglobin reduction test, autolytic blood test, isopropanol test and / or thermal denaturation test, hemoglobin electrophoresis and anti-caries Hemoglobin test.

Diagnosis and diagnosis of hemolytic anemia

If there is excessive destruction of red blood cells and compensatory hyperplasia of young red blood cells, or hemoglobinuria and other intravascular hemolysis, you can consider the diagnosis of hemolytic anemia, but you must pay attention to patients with hemolytic anemia if they have liver damage, and can be accompanied by Hepatic jaundice and in some cases, intravascular and extravascular hemolysis are sometimes difficult to distinguish. In some cases, intravascular and extravascular hemolysis often coexist to varying degrees. Due to viral infection or other unknown causes, acute hemolysis may be accompanied by bone marrow. The function is severely depleted. At this time, the patient only has excessive destruction of red blood cells without compensatory proliferation. The above points must be considered comprehensively in the analysis of cases.

In terms of etiology, if there is a history of exposure to chemistry and physical factors, it is generally easy to affirm. If the anti-human globulin test is positive, the immune hemolytic anemia should be considered first. The abnormal red blood cells found in the blood film should first exclude the inheritance related to the membrane defect. Hemolytic hemolytic anemia, there are more target shapes in the blood film, hemoglobin electrophoresis should be performed to exclude hemoglobin disease, red blood cell malformation is not obvious, and hemolysis caused by genetic enzyme deficiency should be excluded. In short, the diagnosis of hemolytic disease should not only follow the steps. Carry out, and grasp the essence of the relevant experiments, one by one to exclude or confirm.

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