2022年医学专题—小儿造血和血液特点(英文)(1).ppt

Development of the Hematopoietic System&Blood Cell Counts,Dr.Jie Yu,MD.ProfessorThe department of Pediatric,Hematology/Oncology,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第一页，共五十三页。,Contents,Development of hematopoietic systemHematopoietic organsHematopoietic blood cellsCharacteristic of cell counts and hemoglobinRBC and Hb levelHemoglobinWBC/Platelet/Blood volume Anemia,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第二页，共五十三页。,Development of Hematopoietic System,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第三页，共五十三页。,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第四页，共五十三页。,In the embryo and fetus,constant changes characterize all phases of hematopoiesis.,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第五页，共五十三页。,Development of Hematopoietic Organs,Fetal hematopoiesisMesoblastic Hematopoiesis Hepatic Hematopoiesis Myeloid Hematopoiesis Hematopoiesis after birth,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第六页，共五十三页。,Development of Hematopoietic Organs,Fetal Hematopoiesis,liver,第七页，共五十三页。,Table 1.Fetal Hematopoiesis,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第八页，共五十三页。,Development of Hematopoietic Organs,Fetal hematopoiesisHematopoiesis after birthBone marrow hematopoiesisExtrmedullary hematopoiesis,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第九页，共五十三页。,Development of Hematopoietic Organs,Hematopoiesis after birthBone marrow hematopoiesisAll blood cells are produced in the marrow after 2nd trimester Newborn and early infancy:red marrow 5-7yr:yellow marrowExtramedullary hematopoiesis,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第十页，共五十三页。,Development of Hematopoietic Organs,Hematopoiesis after birthBone marrow hematopoiesisExtramedullary hematopoiesisIn diseases status:red cell production hematopoietic tissue.blood production expands to replace fatty marrow.blood cells production extends to extramedullary sites(liver and spleen).,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第十一页，共五十三页。,Development of the Hematopoietic Blood Cells,Pluripotent Stem Cells:which are capable of both self-renewal and of clonal maturation into all blood cell lineages.Progenitor cells differentiate under the influence of hematopoietic growth factors,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第十二页，共五十三页。,Table 2.The Development of Blood Cells,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第十三页，共五十三页。,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,Fig1.Hematopoisis,第十四页，共五十三页。,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第十五页，共五十三页。,Blood Cell Counts and Hemoglobin,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第十六页，共五十三页。,Fig2.Peripheral Blood Cells,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第十七页，共五十三页。,RBC and Hb Level,At Birth:RBC:5-7x1012/L Hb:150 to 230g/L.Postnatal fall/physiology anemiaInfancy Preschool age:RBC:4 x 1012/L Hb:110 g/L 7-12yr:adult level,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第十八页，共五十三页。,RBC and Hb level,Physiological Anemia.Hemoglobin values in term infants drop to their lowest mean of 100g/L at 2-3 mo Causes Erythropoietin production Red cell life span(90/120)Blood volume Preterm infant,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第十九页，共五十三页。,RBC and Hb level,ReticulocytesAt Birth:5%/10%1-2mo:fall down to 0.3%Later adult level:0.5-1.5%Nucleated Red Blood CellsAt birth:3-10/100 WBC;10-20/100WBC1wk:disappear,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第二十页，共五十三页。,HEMOGLOBIN.,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,Function transport oxygen.Constructioniron-containing heme plus globins which is a tetramer made up of two pairs of polypeptide chains,第二十一页，共五十三页。,Table3.HEMOGLOBINS,95%,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第二十二页，共五十三页。,WBC Counts,At birth:20 x 109/LInfant:12 x 109/LPreschool:8.0 x 109/L,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第二十三页，共五十三页。,(%)70,淋巴细胞,中性(zhngxng)粒细胞,4-6岁,4-6天,605040302010,1 3 5 7 9 日数,1 3 5 7 9 11 岁数(su shu),Fig4.WBC Ratio,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第二十四页，共五十三页。,PLT&Blood Volume,PLT:150-250 x 109/LBlood Volume:Term newborn:85ml/kgPremature infant:95ml/kgAdult:75ml/kgYoung children:75-80ml/kg,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第二十五页，共五十三页。,The Introduction of ANEMIA,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第二十六页，共五十三页。,Definition of Anemia,A reduction of the red blood cell volume or hemoglobin concentration below the range of values occurring in healthy persons,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,第二十七页，共五十三页。,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,Table 4.The definition of Anemia and Degree,第二十八页，共五十三页。,Pathophysiologyincreased cardiac outputincreased oxygen extractionblood flow toward vital organs and tissues.In addition,the concentration of 2,3-DPG increases within the RBC.,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,Pathophysiology of Anemia,Self study,第二十九页，共五十三页。,Fig5:The oxygen dissociation curve,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,Self study,第三十页，共五十三页。,Manifestation of Anemia,Acute onsetelevated pulse,hemic flow murmur,poor exercise tolerance,headache,excessive sleeping,poor feeding,and syncope may occur.Slow onset weakness,tachypnea,shortness of breath on exertion,tachycardia,cardiac dilatation,and congestive heart failure,HEMATOLOGY/ONCOLOGY,CHILDRENS HOSPITAL,Self study,第