Anemia is a series of symptoms caused by many different causes or diseases, and is not an independent disease name.
I. Diagnostic criteria for anemia (domestic).
Adult male: hemoglobin <120g/L, adult female: hemoglobin <110g/L.
Currently, hemoglobin <110g/L is used as the standard for anemia in the elderly.
Second, the degree of anemia.
Mild 90 g/L ~ normal low value
Moderate 60g/L ~90g/L
Severe 30g/L ~60g/L
Extremely severe <30g/L
III. Mechanism of anemia.
(i) Decreased erythropoiesis
1. Hematopoietic stem cell abnormalities: reblast, myelodysplastic syndrome, etc.
2. Bone marrow destruction by immersion: leukemia, myeloma, metastatic cancer, etc.
3. Maturation disorders: megaloblastic anemia, iron deficiency anemia, etc.
(II) Excessive destruction of erythrocytes
1. Defective red blood cells themselves: hereditary spherocytosis, serum sickness, thalassemia, etc. 2. Extrinsic red blood cell factors: immunological, chemical, physical, etc.
(C) Blood loss Acute or chronic blood loss due to various causes.
(iv) Clinical manifestations of anemia.
It is mainly a systemic symptom caused by the decrease of hemoglobin and the decrease of oxygen-carrying capacity of blood.
1. Fatigue and weakness.
2. Cardiovascular system: palpitations, rapid heart rate, enlarged heart, etc.
3.Central nervous system: dizziness, tinnitus, drowsiness, etc.
4.Digestive system: loss of appetite, abdominal distension, etc.
5.Genitourinary system: increased nocturia, menstrual disorders, etc.
The severity of anemia symptoms is related to the degree of anemia, the speed of occurrence, the body’s ability to compensate and adapt, the degree of physical activity, and whether it is combined with cardiovascular and cerebrovascular diseases.
V. Diagnosis of anemia.
1.Inquiry into medical history and physical examination.
2.Blood picture, bone marrow aspiration and biopsy, biochemistry, other special laboratory tests, etc.
3. Imaging examinations such as ultrasound, CT, gastrointestinal imaging or gastroscopy, etc.
VI. Characteristics of anemia in the elderly.
1. Gastrointestinal tumors: anemia is often an early symptom. Stomach cancer, intestinal cancer, etc. are common.
2, nutritional anemia: common in iron deficiency anemia, megaloblastic anemia, etc.
3.Hematological disease: It occupies a considerable proportion in senile anemia. Myelodysplastic syndrome, aplastic anemia, myeloma, leukemia, etc. are common.
4.Nephrogenic anemia: diabetic nephropathy, hypertensive nephropathy, prostate hyperplasia, urological tumors, etc.
5.Bone marrow hematopoietic tissue is gradually replaced by fat and connective tissue in the elderly. after the age of 70, only about 30% of the bone marrow is hematopoietic, so anemia is likely to occur.
7. Precautions for anemia in the elderly.
1. Pay attention to diet: increase high protein diet appropriately, because protein is the raw material for hemoglobin synthesis. Lean meat, eggs, milk and soy products can be used.
2. Eat iron-rich foods such as pig liver, shrimp, egg yolk, soybeans, fungus, kelp, dates, celery, etc. Correct bad habits such as partial diet, vegetarian diet, drinking strong tea, etc.
3. Elderly people with anemia often go to cardiology and neurology for dizziness and weakness, chest tightness and palpitations, so it is easy to miss the diagnosis of blood diseases. For those who have leukocyte and platelet reduction at the same time, they should be highly suspected of hematologic diseases and go to hematology department as soon as possible for clear diagnosis and targeted treatment.