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At line 6 changed 4 lines
1.贫血可表现为单一红系减少,也可表现全血细胞减少。细胞形态学特征是本病诊断的主要依据。外周血中大卵圆形细胞、中性粒细胞核分叶过多,5叶者>5%,如见6叶者就应考虑有巨幼细胞贫血的可能。\\
2.骨髓呈增生象,巨幼红细胞占30%~50%,其中巨原、早红细胞可达半数以上,可见巨晚及巨杆状粒细胞;成熟巨核细胞核与核之间不相连呈分核状。\\
3.血清叶酸水平<6.81nmol/L(<3ng/L),红细胞叶酸<227nmol/L(<100ng/ml)可诊断为叶酸缺乏症\\
4.血清维生素B12<74~103pmol/L(<100~140pg/ml)、伴有红细胞叶酸低于正常,可诊断为维生素B12缺乏。10%~20%的维生素B12缺乏者,血清维生素B12水平是正常的,在N2O中毒、先天性TCⅡ缺乏者及伴有骨髓增生性疾患者,血清维生素B12水平可正常。此类患者应做维生素B12吸收试验,正常人排出量>7%,巨幼细胞贫血患者<7%,恶性贫血患者<5%。
__叶酸缺乏性巨幼细胞性贫血__\\
1.MCV增大,常>100fl,血涂片成熟细胞体积增大,多呈卵圆形。\\
2.白细胞和血小板数减少,中性粒细胞分叶过多(多见>4叶者)\\
3.骨髓增生活跃,红系呈典型巨幼细胞改变(>10%),粒系和巨核系细胞呈巨幼样变和核分叶过多。\\
4.血清叶酸水平<6.91nmol/L和红细胞叶酸<227nmol/L\\
__维生素B%%sub 12/% 缺乏性巨幼细胞性贫血__\\
1.MCV增大,常>100fl,血涂片成熟细胞体积增大,多呈卵圆形。\\
2.白细胞和血小板数减少,中性粒细胞分叶过多(多见>4叶者)\\
3.骨髓增生活跃,红系呈典型巨幼细胞改变(>10%),粒系和巨核系细胞呈巨幼样变和核分叶过多。\\
4.血清维生素B12水平<75pmol/L,红细胞叶酸<227nmol/L\\
5.血清甲基丙二酸水平升高\\
At line 14 changed one line
[血清维生素B12测定]
[血清维生素B12测定]\\
[血常规]
Version Date Modified Size Author Changes ... Change note
8 15-Oct-2013 15:27 0.688 kB 1614216108 to previous 红细胞形态检查 ==> 异常红细胞形态检查
7 29-Jul-2013 11:06 0.686 kB 1614216108 to previous | to last
6 09-Jul-2013 10:20 0.684 kB 1614216108 to previous | to last 维生素B12测定 ==> 血清维生素B12测定
5 09-Jul-2013 10:20 0.682 kB 1614216108 to previous | to last 血清维生素B12测定 ==> 维生素B12测定
4 04-Jul-2013 10:50 0.684 kB 1614216108 to previous | to last
3 05-Feb-2013 14:59 0.707 kB 1614216108 to previous | to last
2 05-Dec-2012 14:12 0.041 kB 1614216108 to previous | to last 叶酸 ==> 叶酸测定
1 05-Dec-2012 14:12 0.039 kB 1614216108 to last
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