Why do some after heart valve replacement in hemolytic anemia

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RBC with flexibility and plasticity, in its normal circulation of blood turbulence that can withstand the impact of the heart valve and the sword, coupled with normal human blood vessel walls smooth, so the blood can be uninterrupted. But when the human heart valve sick or a heart valve replacement surgery, patients may arise intravascular hemolysis. This is because:

(1) When the human heart valve sick, ventricular pressure change, the larger forces at this time ejection, when the red blood cells through a small hole or a narrow Road, the red blood cells by the pressure or impact than the normal time, More than the normal red blood cells can bear the force, resulting in broken and a red blood cell hemolysis.

(2) after the artificial heart valve replacement, heart valve if the location was not properly placed, or because of blood in case of separation impact, tear, the valve in the middle or around the return of blood caused by a damaged red blood cells, also occurred hemolysis. This aortic valve replacement to see more, mitral valve replacement may also occur.

(3) artificial heart valve replacement a long time, the valve due to aging or surface lipid deposition cause swelling, the valve can become mobile, flexible enough, the blood flow out of date vulnerable to narrow or insufficiency, hemodynamic changes caused hemolytic .

(4) artificial heart valve because of different materials, if the surface smooth enough, and some have cellulose (a coagulation protein) deposition, RBC flows through here often are subject to greater friction or fragmented, likely to cause injury and broken , Resulting in hemolysis.

Why anemia, to check reticulocyte

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To make clear this problem, need to understand the absorption of iron mechanism. Food is mainly in the iron content in organic matter, is the high price of three iron compounds, through the digestive role in gastric juice to high iron released, the price reduction of 2 low iron or iron, only for the small intestine (the main In the duodenum) Xishouruxue liquid.

When the lack of gastric acid, such as atrophic gastritis, gastric cancer, the price of iron in the food can not be reduced to low-iron, iron absorption difficulties, after a period of time, can cause iron deficiency anemia.

On the other hand, the lack of anemia can increase the acid, anemia, the blood supply to reduce the stomach, gastric secretion declined. Can also be caused Sheyan, dyspepsia, diarrhea, etc..

Above that of the acid and anemia. When a lack of gastric acid, we can oral dilute hydrochloric acid, vitamin C, to facilitate the absorption of iron to prevent anemia.
Reticulocyte is the predecessor of red blood cells. Red blood cells in bone marrow hyperplasia development of the system are: multi-stem cells → → original single-stem cells as early as David RBC RBC → → David in late David RBC RBC → → reticulocyte → mature red blood cells. From the original red blood cell proliferation to the late stage of the young red blood cells to split 3-4, and will take about 72 hours, by a number of red blood cells into 8 1 16, the nucleus changed from the small and concentrated in the cytoplasm of hemoglobin gradually increased. Late David is no longer red blood cell after cell division, development of the nuclear been discharged as a reticulocyte. Reticulocyte containing a small amount of RNA RNA), with the blue-a tar-stained, Gu Ming reticulocyte mesh. Reticulocyte further mature, RNA disappearance of red blood cells to mature. David from the night of red blood cells to mature red blood cells will take about 48 hours, the life span of red blood cells mature about 120 days. Under normal circumstances nucleated red blood cells in the bone marrow is not released to the blood circulation, only reticulocyte and mature red blood cells to release into the blood. Therefore, examination of peripheral blood reticulocyte few, can push that red blood cells in bone marrow of Health. As RBC Life is about 120 days, per day

l/120 been destroyed, while about l/120 freshmen, so the normal adult reticulocyte for less than 1%. Due to physical growth in children, the corresponding increase in output, relative increase in daily output of Health, the reticulocyte l normal about a 2 per cent. Therefore children reticulocyte for more than two percent higher. Acute hemorrhagic or hemolytic anemia right, bone marrow compensatory hyperplasia, reticulocyte can be as high as 20-50 per cent; nutritional anemia treatment before hematopoietic due to lack of raw materials, the Health and blood were restricted, reticulocyte not high, but added the missing is a hematopoietic Material, the Health and the rapid blood reticulocyte 2-3 days after treatment began to rise, 5 of a 10-day peak of hemoglobin increase is not clear at this time, the inspection reticulocyte can predict treatment. Health and other bone marrow lower blood anemia, reticulocyte is not high, the course of treatment inspection reticulocyte increase that effective treatment, but treatment is invalid.

From that, anemia, check reticulocyte not only helps to determine the nature of anemia, and in the course of treatment can also be used to observe the early effects.

Anemia and related acid?

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To make clear this problem, need to understand the absorption of iron mechanism. Food is mainly in the iron content in organic matter, is the high price of three iron compounds, through the digestive role in gastric juice to high iron released, the price reduction of 2 low iron or iron, only for the small intestine (the main In the duodenum) Xishouruxue liquid.

When the lack of gastric acid, such as atrophic gastritis, gastric cancer, the price of iron in the food can not be reduced to low-iron, iron absorption difficulties, after a period of time, can cause iron deficiency anemia.

On the other hand, the lack of anemia can increase the acid, anemia, the blood supply to reduce the stomach, gastric secretion declined. Can also be caused Sheyan, dyspepsia, diarrhea, etc..

Above that of the acid and anemia. When a lack of gastric acid, we can oral dilute hydrochloric acid, vitamin C, to facilitate the absorption of iron to prevent anemia.

And anemia related to the partial eclipse?

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Partial eclipse refers to a class or fixed-eat types of food, and other food to eat. For those who touch-eat vegetables instead of meat, but some people will not eat animal protein, daily vegetarian. Do not eat one or more of the food, such as do not eat pork, mutton or potatoes are not called partial eclipse.

With the development of society, one child increased, people’s living standards improve, but there are still many young people appear anemia, Why is this «This and the partial eclipse on.

Modern study found that: the main material for the blood protein, iron, folic acid. Lack of a three kinds of one kind of will to erythropoietin obstacles, have anemia. If the people do not eat Huncai, protein supply is often poor, malnourished easy to produce anemia, and some of the partial eclipse, poor supply of iron, low-risk small-cell anemia pigment. So with anemia related to the partial eclipse.

In order to prevent anemia caused by improper diet, we should start with infants and young children, catering to diversified structure, not partial eclipse.

What food will help to correct anemia

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Clinical observations show that many patients with anemia, hemoglobin is due to the lower body of a shortage of raw materials arising from the blood. As long as the different types of anemia, add the corresponding blood raw materials, anemia can be corrected. And supplementary materials, the majority of patients will be able to do so as long as attention to diet.

(1) of iron deficiency anemia. Need to add iron-rich foods. Of such food are: liver, bovine liver, poultry liver, Zhu Yao, Zhudu, lumbar cattle, cattle lung, beef juice, egg yolk powder, sweet fish dry, dry owls, squid, sea sting, such as shrimp and shrimp Huncai; spinach, rape, Shepherd’s Purse, Jinzhen Cai, leek, celery, Dou Fupi, Doufu Gan, and peach, orange, date, and so on. More food to pig liver, bovine liver, poultry liver best.

(2) of folic acid and vitamin B12 deficiency anemia, liver and kidney animals should be added, lean meat, green leafy vegetables such as.

(3) of protein supply shortage caused by anemia, should be added lean meat, chicken, duck, beef and mutton and beans products.

It is worth noting that, anemia in patients with lower gastrointestinal function in a general state of supplementary food should be increased gradually, so as not to increase the burden of gastrointestinal tract, cause bad digestion and absorption.

Iron tablets of anemia

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Iron tablets anemia (SA.) Is a group of iron use disorders. Characterized by a large ring in the bone marrow iron tablets David RBC, red blood cell production is invalid, too many organizations iron reserves and low blood pigment was small-cell anemia. Get into this disease and hereditary, vitamin B6 response to anemia. Acquired is divided into primary and secondary. Rail use of non-performing, hemoglobin synthesis of obstacles and red blood cells generate invalid incidence of the disease is the main link. And hemoglobin synthesis of Fu-Mei Mei and the lack of activity and reduce the disruption is the pathogenesis of the disease. Any of these reasons-the activity can lead to bad use of iron and hemoglobin synthesis obstacles, the formation of low pigment anemia and iron in red blood cells and tissue accumulation of a large number, shape and function of red blood cells damaged by premature destruction of red blood cells that Invalid generation. Iron deposition in a large number of organizations, a blood disease, affecting all organs function

[Symptoms of disease]

1. Inherited more for young people, both male and a family history; acquired often no family history. Primary, without reason, more than 50 over the age of onset. Secondary more common in tobacco use vary corpus, than the Qinshan amines, of chlorine-and anti-cancer drugs for too long after the onset. Can also be found in bone marrow cancer and proliferative diseases. 2. Incidence slow, mainly anemia-based disease symptoms and signs. Often pale skin, some patients with dark skin black. Weak, moving the palpitation, shortness of breath. 3. Mildly enlarged liver and spleen, a blood disease when the latter part of (that is, hemosiderosis deposition of genistein) hepatosplenomegaly significant. 4. Occur when a blood disease heart, kidney, liver, pulmonary insufficiency, a small number of diabetes may occur. 5. Blood: general for the moderate anemia (hemoglobin in the 70-90 g / L) a small number of severe anemia (hemoglobin 30-60 g / L) red blood cell size, red blood cells that naive. Reticulocyte normal or mildly elevated. WBC and platelet majority of normal. 6. Marrow: Red obvious proliferation of active, pathological phenomenon of blood, plasma visible vacuoles, less pulp, a lack of hemoglobin, the iron stain that iron tablets David erythrocytosis, a circular iron tablets David RBC> 15%, this is Disease characteristics, with diagnostic significance. And tablets of the nuclear giant of normal. 7. Serum iron and iron saturation of protein, iron plasma conversion rates, increased red blood cells free of Bolin. Serum iron binding capacity, lower utilization of iron. Neutrophil alkaline phosphate-points reduction.

[Diagnosis]

1. Incidence slow, as the main symptoms of anemia. 2. Hepatosplenomegaly can have. 3. Indication of low blood pigment anemia, that the young red blood cells, reticulocyte normal or mildly elevated. WBC and platelet normal. 4. Myelodysplastic significantly active, RBC shape vary, and a circular iron tablets David RBC> 15%. Granulocyte, giant of the nuclear normal. 5. Serum iron, iron-saturation, plasma and red blood cell iron conversion rates, free original Bolin increased plasma iron binding capacity, lower utilization of iron. 6. Neutrophil alkaline phosphate-points reduction.

[Treatment of]

1. The use of large doses of vitamin B6. 2. The use of male hormones. 3. The proper use of adrenal cortex hormones. 4. Preparations can be used in addition to iron, iron reduction in the excessive accumulation. 5. Anemia, as appropriate, may re-infusion of red blood cells or whole blood.

[Evaluation]

There was no reference at home and abroad efficacy standards. 1. Ease: clinical symptoms improved significantly higher hemoglobin, the iron metabolism laboratory basically normal. David RBC ring iron tablets significantly reduced. 2. Progress: clinical symptoms had improved, increased hemoglobin, iron metabolism laboratory tests has improved, ring David iron tablets to reduce red blood cells. 3. Invalid: clinical symptoms and laboratory tests without progress.

[Expert Tips

Secondary iron tablets anemia is secondary to certain drugs or treatment of toxic chemicals (such as anti-tuberculosis drugs, chlorine-Su, Wanhua Ji, and other anti-cancer drugs and lead, alcohol, etc.) and certain diseases (such as bone marrow The proliferation of diseases and cancer, myelodysplastic syndrome chronic infection), the circular iron tablets of the number of young red blood cells, anemia and iron load lighter, once the withdrawal from the chemical poisons or control the disease, the use of vitamin B6, symptoms may disappear . Primary iron tablets anemia of unknown etiology, treatment is often not so ideal. Hereditary iron tablets anemia relatively rare, the most common for sex-linked genetic chromosome. Most men in their age of onset earlier, the pathogenesis of different parts of the effective treatment of vitamin B6, vitamin B6 another part of the treatment ineffective. Reasons unclear.

Anemia patients taking iron attention should be paid what

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Taking iron, the first choice should pay attention to preparation. Three iron and organic iron absorption in the intestine is not easy, we must become free of the price of iron, were not absorbed. Existing agents in ferrous sulfate, ferrous carbonate, iron fumarate, ferrous gluconate is the price of. Ammonium citrate iron prices for the three iron to the reduction in the gastrointestinal tract, because it soluble in water, can match 10% solution, for taking the children, it applies to pediatric patients.

This was followed by administration of the dose and time should be sufficient. Patients with iron deficiency anemia, bleeding from the exclusion of factors, if the administration is not adequate, anemia caused by many years, but not completely correct. Reasonable usage is that each adult clothes ferrous sulfate 0.3 - 0.6 grams, three times a day, until the resumption of normal hemoglobin level, and then continue to take a small amount of iron (0.3 per day - 0.6 g) 3 - 6 Months, in order to restore the amount of iron. General iron absorption in the duodenum. When the body is not iron deficiency, iron absorption stop, too much iron from the gut from, the oral iron normally does not cause excessive intoxication. Injection will have to pay attention to when the iron content. Iron on the gastrointestinal tract are stimulating effect, and often cause nausea, vomiting, abdominal pain, should be taken after meals suitable. Serious reaction can be stopped serving a few days later, and then from a small amount, until the required dose. If this can not be tolerated, can switch to injections.

Acid and vitamin C can promote three for the price of iron reducing iron and is conducive to the absorption of iron, iron the clothes, often served with vitamin C, diluted hydrochloric acid. And Antacids, Nongcha decoction of Chinese medicine and can not be the same clothes and iron, can result in Antacids and acid; Nongcha and decoction of Chinese medicine contains tannic acid, iron and iron with a tannic acid precipitation, the impact of iron Absorption. In addition, iron and hydrogen sulfide enteral the combined iron sulfide, a decrease of hydrogen sulfide to stimulate the intestinal wall, so that peristalsis weakened. At the same time, iron sulfide on a convergence of the wall, cause constipation. Precipitation is a black iron sulfide, a black stool samples from patients, patients should be told in advance to avoid misunderstanding patients, causing unnecessary tension.

Girls are easy to anemia

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In recent years the medical staff found that many young girls suffering from anemia, has the following main reasons.

To be inadequate supply of iron: the adolescent growth and development of women in the exuberant period, the volume of iron at this time to be far beyond the normal requirements, if do not pay attention to increase nutrition, not in time to add additional iron, prone to shortage of iron, And anaemia.

More iron loss: each menstrual Lai Chao will be a certain amount of iron loss. General female menstrual cycle about every 30 to 50 ml blood loss, iron loss of about 15 to 25 milligrams, as a compensatory function of the human body to maintain the relative balance of iron, and women generally do not occur because the monthly menstrual Anemia. However, adolescent girls are often early in the menstrual period disorder, the phenomenon of menstrual irregularities, in particular, is suffering from “adolescent functional bleeding,” the girl is irregular menstruation, little Didi is low, not menstrual leaching Lek, such as the long dry , It seems Xuebeng. A lot of bleeding, will take a lot of iron, over time, it has anemia.
Inadequate intake of iron: the demand for iron adolescent women already high, generally more difficult to meet their dietary needs and therefore need to eat more iron containing more quality, nutrient-rich food. But there are many girls in order to seek “curve” slender figure, dietary restraint, but also to develop a choosy food, the partial eclipse of the bad habits, lack of iron intake.

Anemia has seriously affected the physical and mental health of adolescent girls. After suffering from anemia, pale skin, hair, dry, exfoliated, an activity was slightly flustered, short breath, dizziness, vertigo, tinnitus, memory diminish, or even often happen syncope, severe anemia can cause the heart to expand or even congestive heart failure It also can anorexia, nausea, vomiting, diarrhea, abdominal distention, swelling and menstrual disorders or symptoms of menopause.

After suffering from anemia, first of all to find out the reasons for anemia, if suffering from “adolescent functional bleeding” caused by anemia, should go to the hospital gynaecological treatment, to avoid loss of blood. choosy food at the same time, the partial eclipse bad habit. Eat iron rich and easy absorption of food, such as kelp, seaweed, edible fungus, mushrooms, celery, spinach, eggs, beans, and so on. Drugs can add iron, commonly used ferrous sulfate, the service three times, each time 0.3-0.6 grams, the iron in the acidic environment of easy to absorb, so in diet and more vinegar, or vitamin C per serving On three occasions, each 0.2 grams. Medication during bogey tea. Because the acid in tea can be combined with iron to lose their effect.

Anemia and sex life

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1, the relationship between anemia and

David giant red blood cell anemia: David giant red blood cell anemia is due to a lack of vitamin B12 or folic acid caused by anemia, bone marrow of patients with abnormal patterns within the Giant David red blood cells, red blood cells in the blood of large number. Vitamin B12 or folic acid is not only the lack of maturity Keyiyanhuan red cell anemia caused, and also the possible decrease in the number of male sperm, the sperm quality of male and female sexuality subside. Although all types of anemia on sexual function have been affected, but David giant red blood cell anemia is most obvious.

Iron deficiency anemia is the most common anemia, in particular, more common in women of reproductive age and pregnant women. Long-term suffering from iron deficiency anemia in women’s sexuality diminish widespread phenomenon. Rail and the epithelial cells of the nutritional status and therefore suffering from iron deficiency anemia in women, vaginal and vulvar mucosa was meagre shrinking state, sexual intercourse when they feel unwell or even pain. Over time, naturally diminish sexual desire. In addition, anemia, easy to hypoxia, which in this intense sexual activity, serious patients often have the feeling that life has become a burden.

2, sex life guide

Significant symptoms of anemia, not reluctantly Guoxingshenghuo Otherwise, it will increase the symptoms. But in good spirit and physical strength, sexual life and increasing illness. Guoxingshenghuo anemia patients should pay more attention to sexual techniques, mutual caressing the time can be longer, but when the action Kehuan He Jiaogou more time can be shorter. Female patients genital and vaginal dryness is not timely, can be used contraceptive cream or vaginal lubricants, such as to increase the lubrication, to facilitate the smooth progress of sexual intercourse.

Strengthen nutritional anaemia patients is to improve conditions of functional recovery and improve the quality of life of the fundamental guarantee. In the area of nutrition should be noted: giant red blood cell anemia David patients must pay attention to the full from the food intake of vitamin B12.

Vitamin B12 is the only vegetarian does not exist in the vitamin, it is the only meat, fish, eggs, milk and dairy products. Iron deficiency anemia patients must add iron. On food, animal blood and liver is the most ideal, not only in rich and easy to absorb.

Chronic disease anemia

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In some chronic infections such as tuberculosis, lung abscess, inflammation such as rheumatoid arthritis, systemic lupus erythematosus and Yanxingchangbing, tumors such as breast cancer, malignant lymphoma, and other surgical trauma and continued on after the 1-2 By the associated with anemia, characterized by low serum iron, total iron binding capacity is low, and increase the storage of iron known as chronic anemia disease anemia. With other systemic diseases secondary to the different anemia, such as liver disease, kidney and endocrine diseases of the secondary anemia. Its mechanism is still not very clear, that includes three areas: (1) to shorten the life span of red blood cells (2) bone marrow anemia status of the response of obstacles (3) the release and use of iron barriers. Clinical performance was mainly for mild to moderate anemia, hemoglobin little less than 90 g / L, HCT not less than 32 percent, are being pigment cell anemia, about 1 / 3 to 1 / 2 patients with low performance for the pigment or small cell Anemia. Serum iron and total iron binding capacity were lower than normal, iron saturation of lower than normal or less, increased serum ferritin, free erythrocyte protoporphyrin also increased. David iron tablets in the bone marrow cells and macrophages to reduce the increase in iron storage. For the treatment of major diseases. Generally do not need special treatment. Iron supplement invalid, added EPO can improve the anemia, subcutaneous injection. Three times a week.