blood disease
Introduction
Introduction to blood diseases Blood diseases are diseases that originate in the hematopoietic system, or diseases that affect the hematopoietic system with abnormal blood changes and are characterized by anemia, hemorrhage, and fever. The hematopoietic system includes blood, bone marrow mononuclear-macrophage system and lymphoid tissue. All diseases involving the pathology and physiology of the hematopoietic system and mainly manifested by them are in the category of blood diseases. Most of the blood system diseases are refractory diseases, and the disease is insidious, and the symptoms are hidden. Even if the disease is sick, the patient often cannot detect it by himself, and is often found because of other diseases for medical treatment or health examination. Therefore, it is particularly important to raise awareness of the disease so that early detection and early treatment can avoid unnecessary losses to health. The following ten conditions require a high degree of alertness to blood system diseases. basic knowledge The proportion of illness: 0.02% Susceptible people: no special people Mode of infection: non-infectious Complications: anemia, congestive splenomegaly, leukemia, purpura
Cause
Cause of blood disease
First, hepatitis B causes blood diseases:
1. Hepatitis B patients have many immune dysfunctions. Some patients can produce a variety of autoimmune antibodies. These antibodies are adsorbed on blood cells or freed from the blood, causing hepatitis B blood disease.
2. When liver function is impaired, the liver's ability to detoxify the intermediate metabolites and foreign poisons of the body is reduced, so that the concentration in the blood continues to increase, thereby inhibiting hematopoietic function and causing hepatitis B blood disease.
3. If the hepatitis B virus is actively replicating, then we need antiviral therapy. However, current antiviral drugs have more or less the function of inhibiting hematopoiesis, and interferon has a large side effect in this respect. Interferon has been reported to cause immune-mediated hemolytic anemia, autoimmune thrombocytopenia, and the like.
4. Hepatitis B is a pan-tropic virus, which may replicate in the bone marrow and directly damage bone marrow hematopoietic stem cells, causing abnormal hematopoietic function. In acute hepatitis, granulocytopenia can occur temporarily, lymphocytes are relatively increased, red blood cell half-life is shortened and mild anemia; very few cases of hyperbilirubinemia and hemolytic crisis. The incidence of aplastic anemia in chronic viral hepatitis is increasing, and the prevalence of total blood reduction in the age of 20 years is 75%.
Second, dietary factors:
The study found that children often eat bacon, sausage, sausage, salted fish and other processed meat products, the chance of suffering from blood diseases will increase. Conversely, children who regularly consume vegetables or soy products are half as likely to suffer from cancer as those who eat less vegetables.
The researchers found that eating these processed meats more than once a week, the incidence of blood diseases is 74% higher than the average person.
Prevention
Blood disease prevention
At present, the development of science and technology, bone marrow transplantation for the treatment of hematological malignancies, aplastic anemia (aplastic anemia), paroxysmal nocturnal hemoglobinuria and other congenital or hereditary diseases are increasing; high-dose chemotherapy for hematologic malignancies and The efficacy of anti-thymocyte globulin/anti-lymphocyte globulin in the treatment of severe aplastic anemia has been greatly improved. However, most patients with blood diseases themselves have low immunity and neutropenia, plus the effects of radiotherapy and chemotherapy, often lead to infection. Infection is a common complication of blood system diseases, and clinical treatment is difficult, which is one of the main causes of death. Therefore, strengthening prevention and treatment of infection complications is a key issue in improving the efficacy of blood diseases.
Complication
Blood disease complications Complications anemia, congestive splenomegaly, leukemia
1, the body is getting weaker, mental fatigue, limbs are sore, less gasless, lazy.
2, easy to catch a cold, often low heat, or even high fever.
3, dizziness, headache, dizziness, vertigo, tinnitus, palpitations, shortness of breath, and even fainting.
4, pale and sallow, pale lips, see the eyes are dark, or the complexion is red and purple and dull.
5, the hair is dry, not hair, hair loss; nail collapsed, easy to fold and easy to crack; dry skin shrinkage, poor elasticity; oral erosion, swelling of the gums, tongue peeling without moss.
6, the skin common bleeding spots or bruising plaques, a little stab wound, scratching, that is, bleeding, collision and extrusion, subcutaneous see a large piece of bruising.
7, often nosebleeds, bleeding gums, oral and tongue purpura blood; women's menstruation is like a collapse, or continuous cycle.
8, sternum, tibia tenderness, joint pain or bone pain. Bloating, liver, spleen, lymph nodes.
Symptom
Symptoms of blood diseases Common symptoms Repeated infection of gingival bleeding, bleeding tendency, lymphadenopathy, blood spot, jaundice, hemolytic jaundice
1. Aplastic anemia:
Aplastic anemia (AA), referred to as aplastic anemia, is a group of bone marrow hematopoietic group reduction, hematopoietic failure, leading to a reduction in peripheral blood whole blood cells. Clinically, it is often characterized by more severe anemia, bleeding and infection. There are more males than females in primary aplastic anemia, and younger people are older than older ones. According to the speed and severity of the disease, combined with blood and bone marrow, the aplastic anemia can be divided into acute and chronic. If the cause of the disease, such as drugs, chemicals, radiation, infection, is secondary.
2. Thrombocytopenia:
"Platelets" in human blood, normal people contain about 100,000 to 300,000 platelets per cubic millimeter of blood, and its life span is 8 to 12 days. The platelet count is lower than the lower limit of reference value for various reasons. cut back. If the thrombocytopenia is severe, it can cause a series of symptoms, such as nose bleeding, bleeding gums, bleeding from the oral mucosa, bleeding in the gastrointestinal tract, and more menstrual blood and hematuria. Bleeding spots or ecchymoses of varying sizes can occur on the skin, and the disease is medically called "thrombocytopenic purpura".
3. Leukemia:
Leukemia is a type of malignant clonal disease of hematopoietic stem cells. Clonal leukemia cells proliferate and accumulate in bone marrow and other hematopoietic tissues due to uncontrolled proliferation, differentiation disorders, and blocked apoptosis, and infiltrate other tissues and organs, while normal hematopoiesis is inhibited. Clinically, varying degrees of anemia, hemorrhage, infection, fever, and swelling of the liver, spleen, lymph nodes, and bone pain can be seen. According to reports, the incidence of leukemia in various regions of China is the sixth among various tumors.
4, hemophilia:
Hemophilia is a group of hemorrhagic diseases of hereditary coagulopathy. The common feature is the active thromboplastin formation disorder, prolonged clotting time, and a tendency to post-traumatic bleeding after life.
5, allergic purpura:
Henoch-Schönlein purpura (HSP) is a small vasculitis characterized by skin purpura, arthritis, abdominal pain, and hematuria. In most cases, allergic purpura is a benign, self-limiting disease.
Examine
Blood disease examination
First, the primary blood disease refers to the abnormality of the blood hematopoietic organs and the coagulation mechanism itself; the secondary blood disease refers to the hematological abnormalities caused by diseases of other various systems and organs of the human body. Some common diseases of blood diseases can be used for examination of leukemia, anemia, myelodysplastic syndrome, coagulopathy, and other blood diseases. And bone marrow examinations, etc.
Second, laboratory tests for blood diseases:
1, blood routine and platelet count, for the most basic laboratory tests.
2, net red blood cell count to understand the condition of bone marrow hyperplasia. The determination of the average red blood cell index, the morphological classification of anemia patients, helps to find the cause of anemia.
3, bone marrow examination: including bone marrow puncture smear and bone marrow biopsy, medical education | breeding network collection and diagnosis of certain blood diseases have a diagnostic value (such as leukemia, myeloma, myelofibrosis, etc.) and reference value (such as hypertrophy anemia).
4, hemorrhagic disease: bleeding time, clotting time, prothrombin time, part of the time of thrombin in the white clay, fibrinogen quantification is the basic examination. Blood clot retraction tests, platelet aggregation, and adhesion tests can be performed to understand platelet function.
5, hemolytic disease examination: commonly used tests are free hemoglobin determination, plasma haptoglobin determination, Rous / test, urinary occult blood (intravascular hemolysis); acid hemolysis test, sucrose water test (PNH); osmotic fragility test (congenital Ball-forming polycythemia); methemoglobin reduction test (G6PD enzyme deficiency); anti-human globulin test (autoimmune solution) to determine the cause of hemolysis.
6, cytochemical staining: valuable for the diagnosis of acute leukemia types, such as peroxidase, alkaline phosphatase, non-specific esterase.
7, biopsy: biopsy such as lymph nodes or infiltrating masses have diagnostic value for the diagnosis of lymphoma or hematological infiltration.
8, biochemical and immunological examination: autoimmune blood diseases and lymphatic system often have abnormalities in immunoglobulins and abnormal cellular immune function. In recent years, monoclonal antibodies have been used to immunologically classify acute leukemia.
9, device examination: such as ultrasound, CT diagnosis of mediastinal and retroperitoneal lymphoma.
10, radionuclide: applied to red blood cell life, red blood cell destruction site determination, bone marrow imaging, lymphoma imaging.
Diagnosis
Diagnosis of blood diseases
A comprehensive analysis of laboratory tests and clinical performance can be used to make a correct diagnosis.
Clinical manifestations:
If the patient has anemia, infection, bleeding, jaundice, liver and spleen and lymphadenopathy. One or more of these common features must describe in detail the clinical characteristics, time of occurrence and process of change in the medical record. In addition, attention should be paid to abnormalities in the gastrointestinal tract, respiratory tract, and nervous system.
Pay attention to the existence of important infectious diseases, bleeding tendency and contact history with physicochemical poisons.
Womens menstrual history, production history, length of breastfeeding, and hereditary diseases with or without hematopoietic system among family members and relatives should be understood in detail.
Physical examination should also be carried out in a comprehensive and systematic manner, paying particular attention to the color of the skin and mucous membranes, whether there is bleeding point; whether the tongue is inflamed or atrophied; whether there is local or systemic lymphadenopathy, whether the liver and spleen can be touched; Cardiac and kidney examinations, such as abnormal findings; ophthalmoscopy, anal examination, gynecological examination, etc., should be noted.
Laboratory inspection:
Including peripheral blood, bone marrow, liver and spleen puncture, lymph node biopsy, special examination of hemorrhagic and hemolytic diseases, blood immunological examination and application of radionuclide. According to the clinical characteristics, the necessary examinations should be carried out selectively, and the peripheral blood and bone marrow should be understood in detail.
