高氧亲和力血红蛋白性红细胞增多症

08:36 Feb 23, 2008 

请先参考以下三个连接中的内容，然后看分析性小结：
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High-oxygen-affinity hemoglobin
高氧亲和力血红蛋白病
http://www.dbmi.columbia.edu/hripcsak/icd9/1tabular280.html
o 289.0 Polycythemia, secondary （继发性红细胞增多症）
 High-oxygen-affinity hemoglobin （高氧亲和力血红蛋白病）
 Polycythemia:
 acquired
 benign
 due to:
 fall in plasma volume
 high altitude
 emotional
 erythropoietin
 hypoxemic
 nephrogenous
 relative
 spurious
 stress
 Excludes: polycythemia:
 neonatal (776.4)
 primary (238.4)
 vera (238.4)

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http://www.mm2n.com/bbs/post/view?bid=40&id=16463&tpg=1&ppg=...

继发性红细胞增多症

　　吸烟　可以引起可逆性的红细胞增多症.碳氧血红蛋白是吸入烟草的烟雾所造成的结果.红细胞增多症之所以出现,是因为组织缺氧(由于血红蛋白与一氧化碳结合,而不能输送氧气)；氧气从血红蛋白解离而进入组织的能力下降,这可由氧合血红蛋白解离曲线左移来显示.

　　动脉血氧过低　有慢性肺部疾患或自右心至左心分流而致血氧过低的患者,可出现红细胞增多症.长期处于高海拔地区(参见第281节)或患中枢性换气不足综合征时,红细胞数量也可增加.对肺部疾患病人的治疗旨在改善其肺部功能.可能需要氧气疗法,小心地放血可以降低血液的粘滞度,从而改善病人的感觉.

　　高氧亲和力血红蛋白病　如果有红细胞增多症的家族史者要考虑此病,通过测定血红蛋白达到50%饱和度的氧分压(见前真红诊断中所述),以及如可能,测定完整的氧合血红蛋白解离曲线,可确定诊断.但标准的Hb电泳通常不能显示异常Hb带,因而不能赖以排除引起红细胞增多症的本病.

　　与肿瘤有关的红细胞增多症　肾脏肿瘤和囊肿,由于促使红细胞生成素分泌增多,可引起红细胞增多症.将其切除可奏效.肝肿瘤,小脑血管母细胞瘤和子宫平滑肌瘤也可引起红细胞增多症.

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Polycythemia
红细胞增多症


http://www.answers.com/Polycythemia?cat=health

condition characterized by an increase in the production of red blood cells, or erythrocytes, in the blood. Primary polycythemia, also called erythremia, or polycythemia vera, is a chronic, progressive disease, most common in middle-aged men. It is characterized by overgrowth of the bone marrow, abnormally increased red blood cell production, and an enlarged spleen. Symptoms, include headache, inability to concentrate, and pain in the fingers and toes. There is a danger of blood clotting or hemorrhage (see thrombosis). Primary polycythemia is treated by radiation, periodic removal of some blood (phlebotomy), or chemotherapy with antimetabolite drugs, e.g., Cytoxan. In secondary polycythemia, or erythrocytosis, the proliferation of red blood cells results from the body's attempt to compensate for other conditions, such as prolonged lack of oxygen at high altitudes or chronic lung or heart insufficiency. Certain tumors are also associated with increased red blood cell production. In secondary polycythemia the treatment is directed toward the underlying cause.

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分析性小结：红细胞增多症分为原发性和继发性。原发性红细胞增多症（真性红细胞增多症)是一种原因不明的慢性骨髓增殖性疾病,其特点是血红蛋白浓度和红细胞数大量增多. 继发性红细胞增多症是由于其他疾病或医学相关的状态导致的，也就是说，如果导致“红细胞增多”的那个疾病或医学相关的状态消除了，“红细胞增多症”也就随之消除。导致继发性红细胞增多症的原因很多，问题中提到的“High-oxygen-affinity hemoglobin高氧亲和力血红蛋白病”的其中之一。因此，“高氧亲和力血红蛋白性红细胞增多症”这句话，所表示的意思，由于高氧亲和力血红蛋白病导致的红细胞增多，前半部分，是一个病的名字(高氧亲和力血红蛋白病)，后半部分，是这个病导致出现的一个现象(红细胞增多症). 用英文来表达，是“（Secondary ）polycythemia caused by high-oxygen-affinity hemoglobin”