血沉骨髓红细胞沉降率的测定.ppt

ITP is caused by autoreactive antibodies that bind to platelets and shorten their life span. 1.Thrombocytopenia. 2.Platelets are slightly enlarged. 3.Mild anemia. 4. An increased number of megakaryocytes with obstacle of maturation. Idiopathic Thrombocytopenic Purpura (ITP) 1.RBC 、Hb一般正常，反复出血者可 ? 2.WBC一般正常 3.Plat?: 急性型ITP 常20?109/L； 慢性型ITP常(30~80)?109/L Blood of ITP  1.增生活跃或明显活跃 2.红系、粒系一般正常 3.巨核系细胞增多或正常，产板型巨核? 急性ITP：巨核系细胞多明显增生，以原 始、幼稚巨核?为主 。 慢性ITP：巨核系细胞增多或正常，以颗 粒型巨核?为主。 Bone Marrow of ITP 血沉参考值、临床意义 骨髓增生程度分级标准 常见血液病血象、骨髓象特点 本节要点 * Reference:P273 * POX: peroxidase; NSE: non-specific esterase; NAP: neutrophil alkaline phosphatase PAS: periodic acid-Schiff’s reaction 1.RBC ? 、 Hb? ; Hb? RBC ? 2.WBC、DC 基本正常 3.Plat 一般正常 4.Ret ? （ 10%） 5.涂片 : RBC小， 淡染区扩大 Blood of IDA 1.增生明显活跃 2.以红系为主，常常幼RBC30% ，以中、晚幼RBC为主 3.粒系大致正常 4.巨核系正常 5.铁染色：外铁消失；幼红细胞内铁减少或消失 Bone Marrow of IDA 溶血性贫血(Hemolytic Anemia，HA) Hemolytic Anemia Hemolytic anemias are pathologic conditions that sufficiently shorten the survival of red blood cells in the circulation to decrease their steady state concentration. 1.RBC ? Hb? Ret???（严重时可达 0.20~0.50）2.WBC反应性? ，中性粒细胞?伴核左移 3.Plat反应性? 4.涂片：易见大红细胞，嗜多色性红细胞，可见有核红细胞，Howell-Jolly小体，嗜碱性点彩RBC等特殊的红细胞形态。 Blood of HA 1.增生明显活跃 2.以红系为主，幼RBC30%，以中、晚幼RBC为主；其他阶段相应增多，可见核分裂象 (骨髓红系明显代偿性增生) 3.粒系大致正常 4.巨核系正常 5.成熟RBC中易见大、嗜多色RBC及Howell-Jolly小体，嗜碱性点彩RBC Bone Marrow of HA 再生障碍性贫血(Aplastic Anemia;AA) Aplastic Anemia --Empty Marrow Syndrome A disorder characterized by marked reduction or absence of erythroid, granulocytic and megakaryo-cytic cells in the marrow with resultant pancytopenia and reduced number of CD34+ and colony forming cells. Blood of AA Pancytopenia. Low Reticulocytes. Relative increase in lymphocyte percentage. Classification of AA 急性再障 （Acute aplastic anemia,AAA） 慢性再障 （Chronic aplastic anemia,CAA） Blood of AA SAA的血象诊断标