00:38,26,Jan,2006 | (1821/0/0) | Original
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Rehabilitation of the video, a leukemia . Here, I
Polycythemia vera (the true red) is a clonal increase in red blood cells mainly associated with white blood cells, platelets increase in chronic myeloproliferative disorders, the absolute increase in total blood volume; blood viscosity, clinical manifestations of skin purpurin, dizziness , dizziness, headache, hypertension, hepatosplenomegaly, severe patients, there may be vascular, neurological complications bleeding, infarction and so on.
î ‹ î ‹ First, clinical manifestations: patients were mostly middle-aged or elderly men than women. Slow onset, may be several years before the disease symptoms. Some of the occasional blood test only to be found. The main clinical manifestations of the pathophysiological basis of blood (RBC) increased total capacity, increased blood viscosity, leading to slow blood flow in the body organs and tissue ischemia. Early stage, there may be headache, dizziness, fatigue, tinnitus, vertigo, forgetfulness and other symptoms similar to neurosis. There extremity numbness and tingling in the future, sweating, visual disturbances, skin itching and peptic ulcer symptoms. The disease also increased basophil, basophilic granules rich in histamine, stimulate the release of a large number of gastric parietal cells, can lead to peptic ulcer, pruritus significantly stimulate the skin. Due to vascular congestion, intimal injury, and reduced platelet factor 3, and poor clot retraction reasons, may have bleeding tendency. Vascular symptoms in about half of the patients had hypertension. Gaisbock syndrome refers to patients with hypertension and the spleen is not. When blood flow was significantly slower, especially when associated with thrombocytosis, may have thrombosis, infarction, or phlebitis. Thrombosis is most common in the limbs, brain, and coronary blood vessels. Severe paralysis and other nervous system manifestations of the symptoms caused by cerebral vascular injury.
î ‹ î ‹ skin and mucous membranes in patients with significant purpurin, especially in the cheeks, lips, tongue, ears, rhinitis, neck and upper extremity (Zhi Zhi and size of the thenar) staggering. Significant eye conjunctival hyperemia. Statistics show that about 79.9% of patients with hepatomegaly, in part because of congestion of lines, mostly mild, late can lead to cirrhosis, said Mosse syndrome. 87.8% of patients have splenomegaly, most obviously, splenic infarction may occur, causing inflammation around the spleen.
î ‹ î ‹ Second, additional tests:
î ‹ î ‹ blood: hemoglobin â‰¥ 180g / L (men), â‰¥ 170g / L (female); red blood cell count â‰¥ 6.5 Ã— 1012 / L (men), â‰¥ 6.0 Ã— 1012 / L (female). White blood cell count> 12.0 Ã— 109 / L (no fever and infection). Platelet count> 400
î ‹ î ‹ bone marrow: proliferation was active, grains, red and proliferation of megakaryocyte cell lines to a significant erythroid hyperplasia.
Increase in red blood cell volume î ‹ î ‹: 51Cr labeled red blood cell method: Male> 39ml/kg, female> 27ml/kg.
î ‹ î ‹ increased hematocrit: men â‰¥ 55%, female â‰¥ 50%.
î ‹ î ‹ points higher neutrophil alkaline phosphatase> 100 (no fever and infection.)
î ‹ î ‹ normal arterial oxygen saturation (â‰¥ 92%). Elevated serum vitamin B12 (> 666pmol / L)
î ‹ î ‹ III diagnostic criteria:
1. How hyperlipidemia clinical performance.
â‘ skin, mucous membrane was dark red, especially in the cheeks, lips, eyes with film, as the palm of your hand, etc.
â‘¢ high blood pressure, or the course of the disease had thrombosis.
2. Hemoglobin and red blood cell count increased significantly.
â‘ Hemoglobin: male> 180g / L, women> 170g / L;
â‘¡ red blood cell count: male> 6.5X10 ^ 12 a few women> 6.0X10 ^ 12 / L.
3. Increased hematocrit: male â‰¥ 0.54; women â‰¥ 0.50.
4. No infection and many other reasons, white blood cell count> 11.0X10 ^ 9 a few.
5. Platelet count is greater than many 300X10 ^ 9 / L.
6. Bone marrow showed marked hyperplasia of active particles, red and proliferation of megakaryocyte cell lines, especially erythroid cells as significant.
7. Other than secondary to polycythemia, especially because of cardiopulmonary dysfunction, kidney, liver, cerebellum, and those due to gynecological tumors. In addition, we should pay attention to whether smoked history of psoriasis, whether living spaces highland areas, the availability of genetic disease.
î ‹ î ‹ IV diagnosis
î ‹ î ‹ should plateau polycythemia, severe heart and lung diseases Bo î‹± abnormal hemoglobin disease; some tumors (adrenal-like tumor, liver, kidney, etc.), abnormal blood vessels caused by cysts and secondary polycythemia identification
î ‹ î ‹ five principles of treatment:
î ‹ î ‹ î ‹ î ‹ therapeutic purposes, as soon as possible so that near-normal blood volume and red blood cell volume, inhibition of bone marrow function, and thus alleviate the disease and reduce complications.
î ‹ î ‹ 1, venous blood in a relatively short period of time can be decreased to the normal blood volume, symptom relief, reduce bleeding and thrombosis opportunities. Bled every 2 ~ 3d 200 ~ 400ml, until the red blood cell number in 6.0 Ã— 1012 / L less, hematocrit less than 50%. Bleeding time effect can be maintained more than 1 month. The method is simple, can be used. Younger patients, without thrombotic complications, bleeding can be treated separately. But the bleeding caused by red blood cells and platelets after the rebound increase the possibility of iron deficiency increased tendency to have recurrent bleeding, should increase attention. The elderly and patients with cardiovascular disease, bleeding to be careful, one should not exceed 200 ~ 300ml, interval can be slightly extended. Blood cell separator can be a large number of red blood cell apheresis, but should be supplemented with one volume of the same type of mining such as plasma, blood should be accompanied by intravenous fluids to dilute blood.
î ‹ î ‹ 2, chemotherapy:
î ‹ î ‹ (1). Hydroxyurea î ‹ a ribonucleotide reductase system of polycythemia vera has a good inhibitory effect, and no side effects caused by leukemia, the daily dose of 15 ~ 20mg/kg. Such as white blood cells maintained at 3.5 ~ 5 Ã— 109 / L, long-term intermittent hydroxyurea.
î ‹ î ‹ (2). Alkylating agent î ‹ and 80% to 85%. Acid nitrogen mustard cyclophosphamide and L-aniline (Ma Falun) the role of rapid remission Zeyi busulfan and chlorambucil as long, about half a year of sustainable effect. Chlorambucil fewer side effects, are unlikely to cause thrombocytopenia, its advantages. Alkylating agents also cause leukemia, but less than radionuclides. The amount and method of alkylating agent: initial dose of cyclophosphamide is 100 ~ 150mg / d, busulfan, and chlorambucil Ma Falun is 4 ~ 6mg / d, remission after 4 weeks after the disabled to the maintenance dose, cyclophosphamide daily 50mg, such as busulfan daily or every other day 2mg.
î ‹ î ‹ (3). Harringtonine î ‹ three national reports should be using 2 ~ 4mg, plus 10% glucose solution intravenously once a day, continuously or intermittently applied to the hematocrit and hemoglobin dropped to normal. The average remission time of 60d, the number of remission in more than 18 months.
î ‹ î ‹ 3, Î± interferon therapy: î ‹ interferon can inhibit cell proliferation, in recent years has also started for the treatment of this disease, the dose of 300 million U/m2, 3 times a week subcutaneously. Spleen after 3 months of treatment reduced the number of reduced bleeding. Remission rate of up to 80%.
î ‹ î ‹ 4, 32P radionuclide therapy of Î²-ray can inhibit nuclear division, the cell number decreased. Initial oral dose of 11.1 Ã— 107 ~ 14.8 Ã— 107Bq, about 6 weeks after the red blood cell count began to decline 3 to 4 months, close to normal, the symptoms have eased, about 75% to 80% effective. Condition after 3 months if no relief can be administered once again. Remission time of 2 to 3 years. 32P has the potential to translate into leukemia risk patients, it is rarely used in recent years.
Secondary polycythemia is mainly due to tissue hypoxia, erythropoietin induced compensatory increase in the secretion; or as a result of erythropoietin can have benign or malignant, and taking to promote increased production of erythropoietin hormone preparations. Neonatal blood transfusion through the placenta or umbilical cord can be too late to cause ligation. Symptoms of varying severity, depending on the primary disease to another. In addition to an increase in red blood cells, the white blood cells and platelets were normal. Primary treatment of the primary disease. Polycythemia is a compensatory phenomenon, does not need treatment. After eradication of the primary disease, polycythemia phenomenon can be naturally recovered. If more than 65% hematocrit, the extreme increase in blood viscosity, should be stopped with an equal amount from the venous blood exchange transfusion of plasma or saline.
(A) of the drug therapy because of age, body mass medication by physicians of different needs, the antelope may be taken with powder and oysters.
(1) antelope powder, daily doses of 0.5 g, to eliminate the virus, purifying the blood.
(2) oysters, to 30 grams per day on behalf of tea with boiling water. Oysters herbal salty, slightly cold, to grabbing yin, yang, antiperspirant, Endometriosis. Modern pharmacological studies have anticancer effects oysters.
(B) of the diet
(1) cactus. Cactus herbal bitter cold, do gas and blood circulation, detoxify, heat sera silt, context barrier, a significant effect. Edible Methods: a cactus, the spines stripped, washed and chopped, take an egg, peeled and cactus Stir fry consumption. After use may increase stool frequency, but not more than 3 times per day for the degree.
(2) consumption of black fungus. Black fungus medicinal Gan Ping, rich in carbohydrates, inorganic salts, sulfur, magnesium and vitamin B, a yin fluid, blood anti-cancer effect, to dilute the platelet aggregation, lower blood viscosity.
(3) raw white turnips. Radish is rich in lignin, can enhance the activity of macrophages, phagocytic mutant cells, and enhance the body immunity.
Location: Xunyiwenyao> What polycythemia vera how to treat? Normal diet should? May I ask how to polycythemia vera treat
Article Posted by: Source: Xunyiwenyao net collections this Q: How should polycythemia vera treated? Chinese medicine with Western medicine or? Can be cured? Better treatment process? Normal diet should? What drugs are more effective? And small negative effects? Experts to reply! Thank you! â— age: 37 â— The incidence and duration: Today
A: The longer course of polycythemia vera, but not easy to cure (a cure possible). I personally believe it is traditional Chinese medicine treatment is better. Related Views: issues related to information-related diseases more>> read this article netizens read? How do we stay up later. Rickets disease traditional Chinese medicine treatment of children. How to control the female reproductive system. How to change the panda black eye for the flash. Stomach is not adult "patent." Carotid lumbar therapy is often. Experts recommend varicella vaccine should be playing. Use the attention of foreign drugs to lose weight.