本文關(guān)鍵詞： 血像分析 獲得性溶血性貧血 診斷 應(yīng)用　出處：《吉林大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：犬獲得性溶血性貧血主要是由于單核巨噬細(xì)胞系統(tǒng)破壞紅細(xì)胞或抗體-補(bǔ)體復(fù)合物、藥物、纖維蛋白或毒素溶解紅細(xì)胞引起的。犬獲得性溶血性貧血的發(fā)病率在逐年升高，死亡率也隨之增高，該病的診療水平受到寵物主人高度的關(guān)注。然而，犬獲得性溶血性貧血病因復(fù)雜、癥狀相似、鑒別診斷困難，所以為了給病犬提供更好地治療時間，這就需要臨床獸醫(yī)對犬獲得性溶血性貧血病因能夠作出快速、有效地鑒別診斷。除血常規(guī)外，診斷貧血病因的首選檢查項(xiàng)目就是血涂片檢查。因此，應(yīng)用血像對犬獲得性溶血性貧血病例進(jìn)行分析并對病因進(jìn)行鑒別診斷具有重要的意義，可以為臨床獸醫(yī)診斷和治療犬獲得性溶血性貧血提供理論依據(jù)和指導(dǎo)意義。 首先，本課題回顧性分析了162例獲得性溶血性貧血病犬的臨床資料，分析犬獲得性溶血性貧血的發(fā)病原因、臨床表現(xiàn)、血常規(guī)參數(shù)變化和血細(xì)胞形態(tài)學(xué)特點(diǎn)，為臨床獸醫(yī)綜合分析、鑒別診斷犬獲得性溶血性貧血的病因提供依據(jù)。結(jié)果表明：本組獲得性溶血性貧血病犬162例，年齡為4月齡~15歲；雌雄比例為1.22:1；氧化損傷引起的貧血占42.6%，免疫介導(dǎo)性溶血性貧血占32.10%，傳染性溶血病占16.70%，微血管病性溶血性貧血占5.56%，低磷血癥引起的貧血占3.04%;免疫介導(dǎo)性溶血性貧血、氧化損傷引起的貧血、低磷血癥引起的貧血程度多為輕中度；傳染性溶血病、微血管病性溶血性貧血程度多為中重度；傳染性溶血病病犬易出現(xiàn)發(fā)熱、咳嗽和肝脾腫大等臨床癥狀。獲得性溶血性貧血特有的異常紅細(xì)胞為球形紅細(xì)胞、裂紅細(xì)胞、海因茨小體、血影細(xì)胞和偏心紅細(xì)胞；免疫介導(dǎo)性溶血性貧血紅細(xì)胞形態(tài)學(xué)特點(diǎn)為大量的球形紅細(xì)胞和紅細(xì)胞自體凝集；氧化損傷引起的溶血性貧血紅細(xì)胞形態(tài)學(xué)特點(diǎn)為海因茨氏小體和偏心紅細(xì)胞；微血管病性溶血性貧血紅細(xì)胞形態(tài)學(xué)特點(diǎn)為裂紅細(xì)胞；傳染性溶血病的血涂片上可見有血巴爾通體、巴貝西蟲和埃利希氏體等。 其次，為了進(jìn)一步探討血像分析在犬獲得性溶血性貧血診斷中應(yīng)用的重要性，通過臨床檢查、血常規(guī)檢查和血涂片檢查等對6例典型的犬獲得性溶血性貧血病例進(jìn)行鑒別診斷。分析表明：血像變化可以對犬獲得性溶血性貧血的病因進(jìn)行鑒別診斷，，分別將這6個病例診斷為犬巴貝西蟲病、犬吉氏巴貝西蟲病、犬血巴爾通體病、免疫介導(dǎo)性溶血性貧血、海因茨小體性貧血和藥物引起的氧化損傷性貧血。 綜上所述，犬獲得性溶血性貧血病因復(fù)雜、容易誤診和漏診，應(yīng)用血像分析可以對犬獲得性溶血貧血病因進(jìn)行鑒別診斷，具有一定的臨床應(yīng)用價值。
[Abstract]:Dog acquired hemolytic anemia is mainly due to mononuclear macrophage system damage to red blood cells or antibody-complement complex, drugs. The incidence of acquired hemolytic anemia in dogs is increasing year by year and the mortality rate is also increasing. The diagnosis and treatment level of the disease is highly concerned by pet owners. The etiology of dog acquired hemolytic anemia is complex, the symptoms are similar, and the differential diagnosis is difficult, so in order to provide better treatment time for the sick dog, it is necessary for the clinical veterinarian to be able to make the rapid etiology of dog acquired hemolytic anemia. Effective differential diagnosis. In addition to blood routine, the first choice for the diagnosis of anemia is the blood smear. Therefore. It is of great significance to analyze the cases of dog acquired hemolytic anemia and to differentiate the etiology with blood image. It can provide theoretical basis and guidance for the diagnosis and treatment of dog acquired hemolytic anemia. Firstly, the clinical data of 162 dogs with acquired hemolytic anemia were analyzed retrospectively. The causes and clinical manifestations of acquired hemolytic anemia in dogs were analyzed. The changes of blood routine parameters and the morphological characteristics of hemocytes provide evidence for the differential diagnosis of acquired hemolytic anemia in dogs by comprehensive analysis of clinical veterinarians. The results showed that 162 cases of acquired hemolytic anemia dogs in this group. The age was 4 months old and 15 years old. The ratio of female to male is 1.22: 1; Anemia caused by oxidative injury accounted for 42.6%, immune mediated hemolytic anemia accounted for 32.100.Infectious hemolytic disease accounted for 16.70 and microvascular hemolytic anemia accounted for 5.56%. Anemia caused by hypophosphatemia accounted for 3.04%; The immune mediated hemolytic anemia, the anemia caused by oxidative injury and the anemia caused by hypophosphatemia were mostly mild and moderate. The degree of infectious hemolytic disease and microvascular hemolytic anemia was moderate and severe. Infectious hemolytic disease dogs are prone to fever cough and hepatosplenomegaly and other clinical symptoms. Acquired hemolytic anemia specific abnormal red blood cells are spherical red blood cells split red blood cells Heinz body. Blood shadow cells and eccentric red blood cells; The morphological characteristics of erythrocytes in immune-mediated hemolytic anemia were a large number of spherical erythrocytes and autologous agglutination of erythrocytes. The morphological characteristics of erythrocytes in hemolytic anemia caused by oxidative injury were Heinz's corpuscles and eccentric red blood cells. Erythrocyte morphology of microvascular hemolytic anemia was mitotic erythrocyte. The blood smears of infectious hemolytic disease can be seen on the blood Baltonella, Barbecile and Ehrlich body. Secondly, in order to further explore the importance of blood analysis in the diagnosis of dog acquired hemolytic anemia, through clinical examination. Six cases of canine acquired hemolytic anemia were differentiated by routine blood examination and blood smear examination. The analysis showed that the change of blood image could differentiate the etiology of dog acquired hemolytic anemia. The six cases were diagnosed as Barbectiasis canis Bartonella canis Bartonella disease immune mediated hemolytic anemia small Heinz anemia and oxidative damage anemia caused by drugs. To sum up, the etiology of dog acquired hemolytic anemia is complex, easy to be misdiagnosed and missed diagnosis, and the application of blood image analysis can differentiate the etiology of dog acquired hemolytic anemia, which has certain clinical application value.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：S858.292

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