Anemia

Anemia (synonym: anemia, oligemia) - pathological condition characterized by the decrease of hemoglobin and erythrocytes in the blood.
Mass of blood anemia may be normal (normovolemic), increased (gipervolemia) or decreased (hypovolemia). The reasons that cause anemia. Elucidation of the etiological factor, it is important to select the correct treatment. For all types of anemia in the patient's organism occurs hypoxia (oxygen starvation of tissues).
In modern classification, built pathogenetic principle, all enemy divided into three groups.
I. posthemorrhagic Anemia (blood loss after): 1) acute; 2) chronic.
II. Anemia from high kirovogradschine (see Hemolytic anemia): 1) due to extravascular hemolysis (serviceclient, balalaechka and others); 2) caused intravascular hemolysis: a) acute hemolytic anemia caused by infectious and toxic factors (malaria, sepsis, hemolytic poisons, blood transfusions), hemoglobinuria - cold, medication, b) chronic hemolytic anemia disease (Marchiafava - Micheli); 3) due hemoglobinopathy (thalassemia, sickle cell anemia).
III. Anemia due to disorders of krovoobrashseniya: 1) due to exogenous and endogenous deficiency iron (iron deficiency): chlorosis, chlorinate pregnant, akusticheskaya, enteralny; 2) due to exogenous or endogenous deficiency of vitamin B12 and (or) folic acid: a) "pernicious" (Addison - Biermer), worm (difillobotrios) - from impaired absorption, b) "surgical" pernicious anaemia (akusticheskaya, enteralny), C) from the increased consumption (during pregnancy); 3) aplastic anaemia: a) due to the toxic bone marrow suppression (infection, malignant tumors, drug-effects - amidopyrine, sulfa drugs, cytotoxic funds,the so - called drug-induced anemia); b) as a result of the devastation of the bone marrow (militsionera) with radiation sickness; b) with the substitution (metaplasia) of bone marrow and systemic processes (leukemia, myeloma, a cancer metastases in bone marrow).

Anaemia (anaemia; from the Greek. negative consoles'an and haima, blood) - literally beskriva; usually the term anemia indicate anemia (oligemia) - a condition characterized by a decrease in the number of red blood cells and a decrease in hemoglobin in the unit volume of blood.
From the true anemia should distinguish polyplasmia - blood-thinning as a result of abundant inflow of tissue fluid, see for example, patients in the period of toe edema. This pseudoname passes as disappears called it "the swelling of blood". True anemia may mask, on the contrary, the thickening of the blood, for example, when abundant profuse vomiting or diarrhea; however, due to the decrease in the liquid part of blood - plasma - number of hemoglobin and red blood cells per volume of blood may be normal or even increased. Mass of blood at anemic conditions may be normal (normovolemic), increased (gipervolemia) or decreased (hypovolemia).
A characteristic feature of anemia is an absolute decrease in erythrocyte mass, or functional failure of system of erythrocytes due to reduced content of hemoglobin. The discrepancy between the severity of anemia and active behavior of the patient, often dramatically, due to the fact that action take compensatory mechanisms physiological need tissues of oxygen. The main role in compensation anemic state owned nervous and cardiovascular system: development of hypoxia in anemia leads to that in the blood come, non-completely oxidized products of metabolism; the latter, acting on the Central regulation of blood circulation, and at the neuro-muscular system of the heart, promote palpitations and accelerate blood circulation, resulting in a minute volume of blood pumped by the left ventricle, increases approximately by half (up to 8 liters instead of 4 l is OK). In addition, the development of anemia is accompanied by a spasm of peripheral vessels and entering the blood stream of blood reserves of tissue depots, mainly from subcutaneous tissue. In more severe cases of anemia supply to tissues sufficient oxygen is achieved by the increase of physiological activity of erythrocytes and permeability of the capillary wall for blood gases.
Known role in the compensation of hypoxia play iron-containing enzymes (cytochrome oxidase, cytochrome b and C, peroxidase and catalase)which are potential carriers of oxygen and oxygen-free breathing, mostly carried out with the participation of glutathione. Through these compensatory mechanisms the amount of oxygen consumed by the organism in a minute, not only does not decrease, but often even increases. Only under extreme anemizatsii or when attached poor circulation, can develop the condition of oxygen starvation of the body.
Diagnostics anemic state is based on the set of various clinical and morphological features. Clinical symptoms of anemia is usually due to a decrease in the total mass of blood and hypoxia. The latter is a consequence of infringement of oxidative processes in the body and the development of oxygen starvation of tissues. The appearance of clinical signs of anemia is not only the extent but also the speed of its development, and the degree and speed adaptive and compensatory reactions. Tissue hypoxia affects primarily the state of the nervous and cardiovascular systems. Common complaints of patients with a strong degree of anemia are dizziness, noise in the ears, sudden weakness, fatigue, nausea, weakness, decrease of visual acuity, as well as palpitations, shortness of breath and unpleasant feelings in the heart area, aggravated by physical activity.
The appearance of patients with anemia very characteristic: paleness skin and mucous membranes is usually combined with sufficient fatness, if only the lower power is not called by main disease (for example, malignant tumor of the stomach). In severe degree of A. is determined blowing systolic murmur at the apex of the heart and the pulmonary artery, "the sound of the spinning top" on a neck veins.
In addition to the General nonspecific signs of anemia, there are certain specific symptoms, allowing the right to conduct differential diagnosis and choose the further therapeutic measures. Important for the correct understanding of the origin of anemia is figuring out various circumstances which preceded its development: operations on the gastrointestinal tract, the presence of diaphragmatic hernia stomach reception of various drugs (amidopirina, syntomycin, Cincotta, thiuragyl), Professor of harmfulness (benzene, radiation therapy, and others). The differential diagnosis hemolytic A. complicated by hemoglobinuria, has a value of gynecological history (postabortne anaerobic sepsis). For the decision of a question on belonging of the given case A. to one or another classification group is a need for detailed morphological characteristics of peripheral blood and bone marrow.
For A. and the results largely depend on the regenerative capabilities of the bone marrow. The majority A. accompanied his natural compensatory hyperplasia. The exception is aplastic state, in which the complete absence of regenerative processes due to anatomic devastation in the bone marrow leads to the actual bleeding. The best measure of the state of the bone marrow, its functional usefulness is the dynamics of the peripheral blood hemoglobin, red blood cells and the percentage of reticulocytes.