relative polycythemia
Introduction
Introduction to relative polycythemia Relative erythrocytosis is due to a decrease in plasma volume and a relative increase in red blood cells, mainly seen in transient polycythemia. Polycythemia can be divided into two major categories: primary and secondary. Primary is polycythemia vera; secondary is mainly caused by tissue hypoxia. basic knowledge The proportion of illness: 0.008% Susceptible people: no specific population Mode of infection: non-infectious Complications: cardiovascular and thromboembolic syndrome
Cause
Causes of relative polycythemia
(1) Causes of the disease
Sustained vomiting, severe diarrhea and excessive sweating can cause significant loss of body fluids, insufficient water intake, which can cause a decrease in plasma volume and a relative increase in erythrocytes.
Pseudo-erythrocytosis (relative or stress erythrocytosis, Gaisbock syndrome) The cause is unknown, some people think that it is not an independent disease, others are considered to be a benign disease, and there may be reports of excessive smoking, drinking, and emotions. Excited, chronic anxiety, high blood pressure, etc.
(two) pathogenesis
The pathogenesis of this disease is unknown. Some people count 188 men, whose hematocrit is greater than 50%. The higher the hematocrit, the higher the incidence of polycythemia; the hematocrit >54%, about half The case is true; if the hematocrit is above 60%, 100% is true, the hematocrit of stress erythrocytosis is more than 57%, and no case is more than 58%, so hematocrit should exceed 55%. It is the diagnostic criteria for polycythemia. The hematocrit of stress erythrocytosis is mostly at a normal high value. Most patients have the following pathogenic factors: most of the patients are male, the age of onset is lighter, and there are more smokers, especially smoking every day. The amount of smoke is higher than that of non-smokers by 2% to 3%. This is because the arterial blood oxygen content of smokers is reduced, the carbon monoxide content is increased, and the carbon monoxide content is 2.5% higher than that of non-smokers. 10%, smoker's blood oxygen saturation is reduced, carbon monoxide hemoglobin, oxygen dissociation curve shifts to the left, and red blood cell production and tissue oxygen release are stimulated by the renal sensor.
In addition, most patients with this disease are obese, obese people have poor ventilation due to lie in the lying position, arterial blood oxygen content is reduced; sleep apnea syndrome often occurs in sleep, aggravating hypoxia, and obese people are also prone to hypertension. The hematocrit of the latter is often higher than that of normal blood pressure, but it is still in the normal range. Hypertensive patients often have increased red blood cell volume and reduced plasma volume. If there is renal artery disease, renal ischemia usually increases the secretion of erythropoietin. People with high blood pressure often have sleep apnea syndrome, which can also lead to increased erythropoietin production.
This group of patients often have neuroticism, mental stress, affecting blood oxygen saturation and blood volume through sympathetic stimulation or catecholamine secretion; mental depression, tension can stimulate the autonomic nervous system and increased production of catecholamines, secreting adrenaline and norepinephrine, so that Reduced venous blood volume, decreased plasma volume, and increased hematocrit.
In addition, drinking can also increase red blood cells, acute heavy drinking and chronic cellulite can make respiratory depression, night snoring and sleep dyspnea, indirectly increase red blood cell production, plasma volume reduction and hematocrit increase.
Prevention
Relative polycythemia prevention
It is generally necessary to keep the patient's daily life, to maintain a good mood, to treat the disease correctly, and to establish confidence in the fight against the disease. Otherwise, the illness of the seven emotions may make the condition worse. Diet should be light, eat spicy and hot products. When the disease is in the middle and late stages, the condition is often mixed with the image of the virtual and the real. Therefore, it is necessary to prevent overwork and injury, or to reinforce the exogenous evils after labor.
Complication
Relating polycythemia complications Complications cardiovascular and thromboembolic syndrome
Thromboembolism is the main complication of this disease, which is caused by high blood volume and hyperviscosity.
Symptom
Symptoms of relative polycythemia Symptoms Common symptoms Red blood cells Dehydration Skin redness Anxiety Dizziness Circulatory failure Red blood cells are in a string shape
Temporary polycythemia, the cause of dehydration and insufficient water intake, mainly the symptoms of hypovolemia, severe circulatory failure in Gaisbock, most cases have a history of smoking, the age of onset is lighter, more common in men, most of the weight is more than normal, common Symptoms include mild headache, dizziness, neurasthenia, anxiety, face, ear, lips, conjunctiva and oral mucosa reddish purple, congestion, spleen is not swollen, half of the patients have high blood pressure, high blood pressure is common in the course of the disease, easy to develop thrombosis .
Examine
Examination of relative polycythemia
1. Peripheral blood: Red blood cell count, hemoglobin and hematocrit are higher than normal, but the number of white blood cells, platelet count and reticulocyte are normal.
2. Active bone marrow hyperplasia: There is a significant difference from normal.
3. Cholesterol is often increased: some patients have increased triglyceride.
4. Erythropoietin is in the normal range and plasma iron is normal.
Diagnosis
Diagnosis and differentiation of relative polycythemia
Combined with the characteristics of this disease, diagnosis is not difficult.
Mainly differentiated from polycythemia vera and secondary polycythemia.
