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DevelopmentoftheHematopoieticSystem

&

BloodCellCounts

Dr.JieYu,MD.ProfessorThedepartmentofPediatric,Hematology/OncologyHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第1頁(yè)!ContentsDevelopmentofhematopoieticsystemHematopoieticorgansHematopoieticbloodcellsCharacteristicofcellcountsandhemoglobinRBCandHblevelHemoglobinWBC/Platelet/BloodvolumeAnemiaHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第2頁(yè)!Developmentof

HematopoieticSystem

HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第3頁(yè)! Intheembryoandfetus,constantchangescharacterizeallphasesofhematopoiesis.

HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第4頁(yè)!

Developmentof

HematopoieticOrgansFetalHematopoiesisliver小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第5頁(yè)!Developmentof

HematopoieticOrgansFetalhematopoiesisHematopoiesisafterbirthBonemarrowhematopoiesisExtrmedullaryhematopoiesisHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第6頁(yè)!Developmentof

HematopoieticOrgansHematopoiesisafterbirthBonemarrowhematopoiesisExtramedullaryhematopoiesisIndiseasesstatus:

redcellproduction hematopoietictissue.bloodproductionexpandstoreplacefattymarrow.bloodcellsproductionextendstoextramedullarysites(liverandspleen).

HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第7頁(yè)!Table2.TheDevelopmentofBloodCellsPROGENITORCYTOKINESPRODUCCFU-GMG-CSFNUTROPHILCFU-MegTPOPLTCFU-EBFU-EEPORBCHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第8頁(yè)!HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第9頁(yè)!Fig2.PeripheralBloodCellsHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第10頁(yè)!RBCandHblevelPhysiologicalAnemia.

Hemoglobinvaluesinterminfantsdroptotheirlowestmeanof100g/Lat2-3moCausesErythropoietinproductionRedcelllifespan(90/120)Bloodvolume

PreterminfantHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第11頁(yè)!

HEMOGLOBIN.

HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALFunction

transportoxygen.

Constructioniron-containinghemeplusglobinswhichisatetramermadeupoftwopairsofpolypeptidechains,小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第12頁(yè)!WBCCountsAtbirth:20x109/LInfant:12x109/LPreschool:8.0x109/LHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第13頁(yè)!PLT&BloodVolumePLT:

150-250x109/LBloodVolume:Termnewborn:85ml/kgPrematureinfant:95ml/kgAdult:75ml/kgYoungchildren:75-80ml/kgHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第14頁(yè)!DefinitionofAnemia

AreductionoftheredbloodcellvolumeorhemoglobinconcentrationbelowtherangeofvaluesoccurringinhealthypersonsHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第15頁(yè)!Pathophysiologyincreasedcardiacoutputincreasedoxygenextractionbloodflowtowardvitalorgansandtissues.Inaddition,theconcentrationof2,3-DPGincreaseswithintheRBC.HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL

PathophysiologyofAnemia

Selfstudy小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第16頁(yè)!ManifestationofAnemiaAcuteonsetelevatedpulse,hemicflowmurmur,poorexercisetolerance,headache,excessivesleeping,poorfeeding,andsyncopemayoccur.Slowonsetweakness,tachypnea,shortnessofbreathonexertion,tachycardia,cardiacdilatation,andcongestiveheartfailureHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALSelfstudy小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第17頁(yè)!Classification-Etiology

ReducedcapacitytoproduceredbloodcellsHemolysisBloodLossTHANKYOUHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第18頁(yè)!Classification-etiologyReducedcapacitytoproduceRBCMarrowInfiltrationLeukemiaLymphomaNeuroblastomLCHHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第19頁(yè)!Classification-etiologyHemolysisIintrinsicRBCabnormalitiesHemoglobinopathiesEnzymopathiesMembranedisordersextrinsicRBC

abnormalitiesImmunologic:AIHAHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第20頁(yè)!Classification-etiology

Hemolysis:extrinsicRBCabnormalitiesImmunologichemolysis

Isoimmune(Rh,ABOinneonate)AutoimmuneHemolyticAnemia(AIHA)HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第21頁(yè)!MountRaniner,SeattleHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第22頁(yè)!RBCIndexMCVMeancorpuscularvolumeMCHMeancorpuscularhemoglobinMCHCMeancorpuscularconcertrationHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第23頁(yè)!HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第24頁(yè)!HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第25頁(yè)!HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第26頁(yè)!小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第27頁(yè)!

HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第28頁(yè)!Developmentof

HematopoieticOrgans

FetalhematopoiesisMesoblasticHematopoiesisHepaticHematopoiesisMyeloidHematopoiesisHematopoiesisafterbirth

HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第29頁(yè)!

SITESTIMEPRODUCMeasoblastichematopoisisYolkSac10-14thday3-4wk:primitiveblasts10-12wk:ceasedErythroidHepatichematopoiesisLiverSpleen6-8wk:appear12-16wk:active6mo:diminish/stopatbirthErythroidMyeloidhematopoiesisBonemarrow4mo:start6mo:increase/steadyafterbirth:theonlyErythroidNeutrophilsMacrophagesTable1.FetalHematopoiesisHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第30頁(yè)!DevelopmentofHematopoieticOrgansHematopoiesisafterbirthBonemarrowhematopoiesisAllbloodcellsareproducedinthemarrowafter2ndtrimesterNewbornandearlyinfancy:redmarrow5-7yr:yellowmarrowExtramedullaryhematopoiesisHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第31頁(yè)!Developmentofthe

HematopoieticBloodCellsPluripotentStemCells:

whicharecapableofbothself-renewalandofclonalmaturationintoallbloodcelllineages.ProgenitorcellsdifferentiateundertheinfluenceofhematopoieticgrowthfactorsHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第32頁(yè)!HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALFig1.Hematopoisis小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第33頁(yè)!BloodCellCounts

andHemoglobin

HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第34頁(yè)!RBCandHbLevelAtBirth:

RBC:5-7x1012/LHb:150to230g/L.

Postnatalfall/physiologyanemiaInfancyPreschoolage:RBC:4x1012/LHb:110g/L7-12yr:adultlevelHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第35頁(yè)!RBCandHblevelReticulocytesAtBirth:5%/10%1-2mo:falldownto0.3%Lateradultlevel:0.5-1.5%NucleatedRedBloodCellsAtbirth:3-10/100WBC;10-20/100WBC1wk:disappearHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第36頁(yè)!

Table3.HEMOGLOBINS

HbChains8周6月出生6-12月2歲EmbryGower1ζ2ε28周前，3月消失

Gower2α2ε2

Portlanζ2γ2

FetalHbFα2γ2增加90%70%<5%<2%AdultHbAα2β2

5-10%30%>95%

HbA2α2δ2

<1%2-3%<3.5%>95%HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第37頁(yè)!(%)70淋巴細(xì)胞中性粒細(xì)胞4-6歲4-6天60

50

40

30

20

1013579

日數(shù)1357911

歲數(shù)

Fig4.WBCRatio

HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第38頁(yè)!TheIntroductionofANEMIAHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第39頁(yè)!AgeAnemiaValuesAnemiaDegreeNewborn<145g/L

1-4mo<90g/LMild:-90g/L4-6mo<100g/LModerate:-60g/L6mo-6yr<110g/LSevere:-30g/L6-14yr<120g/LExtremelysevere:<30g/LHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALTable4.ThedefinitionofAnemiaandDegree小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第40頁(yè)!Fig5:TheoxygendissociationcurveHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITALSelfstudy小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第41頁(yè)!

MCV（fl）MCH（pg）MCHC（%）Normalranges80-9428-3232-38Macrocytic>94>3232-38Normocromic/Normocytic80-9428-3232-38Microcytic<80<2832-28Hypochromic/Microcytic<80<28<32Classification-morphologyTable5HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第42頁(yè)!

Classification-etiology

ReducedcapacitytoproduceRBCAplasticanemiaFanconi’sanemiaAcquiredaplasticanemiaPureredcellaplasiacongenitalhypoplasticanemia (Diamond-Blackfan)AcquiredhypoplasticanemiaHEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第43頁(yè)!Classification-etiology

ReducedcapacitytoproduceRBCDeficiencySyndromeIronFolateVitaminB12VitaminEVitaminB6HEMATOLOGY/ONCOLOGY,CHILDREN’SHOSPITAL小兒造血和血液特點(diǎn)(英文)共52頁(yè)，您現(xiàn)在瀏覽的是第44頁(yè)!Classification-etiology

Hemolysis:intr

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