营养性贫血(英文)汇编课件

,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,营养性贫血(英文),营养性贫血(英文),INTRODUCTION,Definition / describing,The anemia caused by insufficient dietary iron uptake, in which the iron storage and hemoglobin synthesis decreased.,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,INTRODUCTIONDefinition / descr,Clinical characteristics,iron stores,serum iron,hemoglobin concentration , hypochromic microcytic anemia,good response to iron therapy.,6mo to 3 yrs.,Incidence,INTRODUCTION,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,Clinical characteristicsINTROD,IRON METABOLISM,CONTENTS,New born 75mg/kg,Children35-70mg/kg,Adults,M 50mg/kg,F 35mg/kg,CMOPARTMENT,Hemoglobin 64%,Storage iron 30%,ferritin,hemosiderin,Myloglobin,3%,Enzyme iron 0.4%,Serum iron 0.4%,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,IRON METABOLISMCONTENTSCMOPART,Iron sources,Hemoglobin iron,Dietary iron,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,IRON METABOLISM,Iron sourcesHEMATOLOGY/ONCOLOG,Dietary iron,High in iron,Red meat/ liver kidney/ oily fish,Average iron,Beans / fortified cereals/ dark green vegetables/ dried fruit/ nuts and seeds,Poor in iron,milk,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,IRON METABOLISM,Dietary ironHEMATOLOGY/ONCOLOG,Iron absorption,general absorption,1-20%,Meat/ fish/ chicken,10-25%,Cereals/vegetables1%,Breast/cows milk,50%/10%,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,IRON METABOLISM,Iron absorptionHEMATOLOGY/ONCO,ABSORPTION & TRANSPORT,Hemoglobin iron non hemoglobin iron,gastric juice,proteinase,proteolytic HCl,heme ferric,hemolytic,ferric reductase,*,Vit C,ferrous,duodenum,upper jujenum,ferric,mucosal cells,transferrin*,circulation,GI tract,liver /spleen,marrow,(,fig2),HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,ABSORPTION & TRANSPORT Hemogl,Ferritin,Fe,TfR,transferritin,Fe,Fe,IRON METABOLISM,Mucous cells,FerritinFeTfRtransferritinFeFe,IRON METABOLISM,Iron stores and utilizing,Liver,Spleen,Marrow,RBC,iron,Food,iron,SI,Fe,Fe,heme + globin,(,fig2),Hb,Fe,Fe,marrow,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,IRON METABOLISMIron stores and,IRON METABOLISM,Requirement and excretion,demand,excretion,adults1mg/d 1mg/d 1mg/d,4mo-3yr 1mg/kg (15ug/kg/d),premature,2,mg/kg,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,IRON METABOLISMRequirement and,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,ETIOLOGY & PATHOGENESIS,ETIOLOGY,Poor iron stores,Poor dietary intake of iron,*,Overdevelop,Chronic bleeding,HEMATOLOGY/ONCOLOGY, CHILDREN,Poor iron stores,Premature birth,Multiple birth /Low weight birth,Cord blood,Mother iron reserve,overdevelop,Poor dietary intake of iron,*,Blood loss and iron depletion,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,ETIOLOGY & PATHOGENESIS,Poor iron storesHEMATOLOGY/ONC,Poor iron stores,Poor dietary intake of iron,*,Milk and cereals,Factors influencing absorption,Diarrhea and infection,Overdevelop,Blood loss and iron depletion,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,ETIOLOGY & PATHOGENESIS,Poor iron storesHEMATOLOGY/ONC,ETIOLOGY & PATHOGENESIS,Poor iron stores,Poor dietary intake of iron,*,Overdevelop,3-5,mo/ 1yr,Premature birth,Puberty,Chronic bleeding,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,ETIOLOGY & PATHOGENESISPoor i,ETIOLOGY & PATHOGENESIS,Poor iron stores,overdevelop,Poor dietary intake of iron,*,Chronic bleeding,Cows milk,Hookworm infection,Menstruating,Others:,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,ETIOLOGY & PATHOGENESISPoor i,Pathogenesis,iron,+,protoporphyrin,IDA,heme,+,globins hemoglobin,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,ETIOLOGY & PATHOGENESIS,HEMATOLOGY/ONCOLOGY, CHILDREN,Pathogenesis,Hypochromic / microcytic anemia,ID. Iron deficiency,IDE. Iron deficiency erythropoiesis,IDA. Iron deficiency anemia,Enzymes,Immune function,Skin/mucosal,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,ETIOLOGY & PATHOGENESIS,PathogenesisHEMATOLOGY/ONCOLOG,Features,Age,The onset of the IDA,The degree of anemia,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,CLINICAL MANIFESTATIONS,Features HEMATOLOGY/ONCOLOGY,Pallor,Extramedullary hematopoiesis,Mild/ Severe condition,Digestive system,Cardiac function,Neurology/ intellectual,Immune function,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,CLINICAL MANIFESTATIONS,PallorHEMATOLOGY/ONCOLOGY, CHI,IDA,:,microcytic/hypochromic + SI,Peripheral blood：,Hemoglobin level,RBC MCV 80fl,MCH 26ug,MCHC 0.31,Bone marrow,Erythroid hyperplasia,Stainable iron,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,LABORATORY FINDINGS,IDA: microcytic/hypochromic +,IDA:,hypochromic/microtytic anemia,+ SI,SI,： 9-10.7umol/L (12.8-31.3umol/L),or 62.7umol/L (350ug/dl),TS,： 0.9umol/L or 50ug/dl),ID：,SF, 12ug/L,/,marrow iron,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,LABORATORY FINDINGS,IDA: hypochromic/microtytic an,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,Normal,ID,IDE,IDA,Marrow iron,+,+,0,SF (ug %),100,60,10-20,FEP,SI,TIBC,TS,Hb,MCV,MCH,HEMATOLOGY/ONCOLOGY, CHILDREN,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,HEMATOLOGY/ONCOLOGY, CHILDREN,Diagnosis,Impression,：,age, feeding, PBL,Diagnosis：biochemical change,Proven by therapy,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,DIAGNOSIS & DIFFERENTIAL,DiagnosisHEMATOLOGY/ONCOLOGY,Differential,Chronic & inflammatory diseases,Thalassemia,Pulmonary hemosiderosis,Siderblastic anemia,Magaloblastic anemia,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,DIAGNOSIS & DIFFERENTIAL,DifferentialMagaloblastic anem,Megaloblastic Anemia,Similar aspects to IDA,Age,Anemia by inadequate dietary intake,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,Megaloblastic AnemiaSimilar as,Megaloblastic Anemia,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,Pathogenesis,Vitamin12,Folic acid,Folic acid reductase,DNA Synthesis,Tetrahydrofolic acid,Nucleotide,Megaloblastic AnemiaHEMATOLOGY,Megaloblastic Anemia,Manifestation & Differential,Pale and puffy,Neurological involvement,Lab findings,Macrocytic normochromic anemia,Neutropenia with/ thrombocytopenia,Marrow film: megaloblastic forms of nucleated RBC,Serum Vit B12 and /or folic acid,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,Megaloblastic AnemiaManifestat,营养性贫血(英文)汇编课件,营养性贫血(英文)汇编课件,Megaloblastic Anemia,TREATMENT,General care,Drug therapy,Vitamin B12： 25-100ug/,次，2-3,times,/,w,，,weeks or to Hb normal,；,One high dose,：500,ug,im,Folic acid,： 5-10,mg, tid,2-3,w,，,Effect,Other drug,：,Vitamin C； B6；iron in recovery,Transfusion,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,Megaloblastic AnemiaTREATMENT,TREATMENT,General care,Eradicate the causes*,Iron therapy*,transfusion,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,TREATMENTGeneral careHEMATOLO,Iron therapy,Elemental iron：,4-6mg/kg/d,Oral medication,Types,Administration,Between meals,Vitamin C,Course,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,TREATMENT,Iron therapyHEMATOLOGY/ONCOLOG,Ferrous Salts,4,mg/kg/d,Ferrous sulfate （20%）,20,mg/kg/d,ferrous fumarate (,30%）,13mg/kg/d,Ferrous gluconate（11%）,40,mg/kg/d,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,Table: Ferrous salts ant the iron contents,Ferrous Salts4mg/kg/dFerrous s,Iron therapy,Infusion iron,indication,types：,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,TREATMENT,Iron therapyHEMATOLOGY/ONCOLOG,IRON THERAPY RESPONSE,（,from Nelson）,time,response,12-24,hr,Replacement of iron enzymes,subjective improvement,36-48,hr,Initial marrow response: erythroid hyperplasia,48-72,hr,Reticulocytes,peaking 5-7,4-30,days,Hemoglobin level,1-3,mo,Replenish of stores,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,IRON THERAPY RESPONSE（from N,TREATMENT,Transfusion,Indications,Severe anemia,Infection,Pre-operation,Component： red blood cells,Volume,：,Hb 30g/L, 3-5ml/kg,Hb 30-60g/L, 5-10ml/kg,Attentions,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,TREATMENTTransfusion HEMATOLOG,PREVENTION,Education,For pregnant women,For interm,Breast milk/cows milk,Iron rich supplementary food,Iron-fortified food,For premature infant,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,PREVENTIONEducationHEMATOLOGY/,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,Review these contents after class, try to make the summary on:,The characteristics of iron metabolism in fetus and infants,The etiology of IDA,Laboratory findings according to the stages,Differentials: esp with thalassemia,Important treatment,HEMATOLOGY/ONCOLOGY, CHILDREN,Factors influencing iron absorption,Positive factors,Ascorbic acid/ gastric acid/amino acid,Negative factors,Phosphate/phytate/,Tea / coffee,IRON METABOLISM,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,Factors influencing iron absor,IRON METABOLISM,Concepts,SI,serum iron,TIBC,total iron binding capacity,TS,transferrin saturation,HEMATOLOGY/ONCOLOGY, CHILDRENS HOSPITAL,IRON METABOLISM Concep,此课件下载可自行编辑修改，仅供参考！感谢您的支持，我们努力做得更好！谢谢,此课件下载可自行编辑修改，仅供参考！感谢您的支持，我们努力,