TS.

MAI PHNG THO

BM SINH L HC
HYD TPHCM

MC TIU
1. Trnh by hnh dng, thnh phn cu to HC.

2. Trnh by 5 yu t nh hng n s lng

HC.
3. Phn tch 4 chc nng ca HC.
4. Trnh by s iu ha sinh sn HC v bo
qun HC truyn mu.
5. Vn dng cc kin thc ng dng trong LS.

I. Hnh th, thnh phn, s lng

1.1. Hnh th - Thnh phn
2 m

7.5 m

- C mng bn thm bao quanh

C 150 200 K l/ mng ngoi

Tch in (-) nh phn t acid sialic

Bl cu to mng hoc do dng thuc
thay i tc lng mu
Lp trong cng: protein gn G6PD
- Bo tng : khng c bo quan, Hb, H20

1.2. S lng hng cu:

- ngi VN trng thnh bt :
Nam: 4,2 triu HC 210.000/mm3 mu
N : 3,8 triu HC 160.000/mm3 mu

- S lng HC ph thuc :

Phn p O2 trong khng kh

Mc h/

La tui

S bi tit Erythropoietin

- S lng HC thay i trong bnh l:

trong a HC, ngt, mt nc,

suy tim

trong trng hp thiu mu, XH

II. S thnh lp Hb
2.1. Hb trong hng cu
HEMOGLOBIN

GLOBIN: 94%

Fe: 0,34%

4 HEME

Protoporphyrin: 4,66%

- Nng bt = 13 16 gr/100 ml mu TP
- Mi HC c # 3436 g Hb

2.2. S thnh lp Hb

Vander Human Physio., 8th

- ngi bt c 2 loi Hb:

HbA (Adult) : 2 & 2
HbF (Foetus) : 2 & 2
- BG m ha aa trong chui Hb
bt

thng: HbS,HbC,HbE,HbJ...

III. Chc nng ca hng cu

3.1. Chc nng h hp : Hb
a. Hb vn chuyn O2 t phi m
- 1 phn t Hb gn c vi 4 phn t
O2
- P/ gn O2 vo nguyn t Fe2+/ Hem
100 ml mu c 1316 g Hb gn # 20 ml O2

* Cc yu t nh hng i lc Oxy - Hb

* i lc Oxy - Hb

b. Hb vn chuyn CO2 t m phi

- # 20% CO2 trong mu kt hp vi
Hb Carbon Hb ( HbCO2 )
- CO2 kt hp vi Hb qua nhm NH2
ca Globin P Carbamin
Hb + CO2 HbCO2

c. Hb kt hp CO
Hb + CO HbCO ( Carboxy Hb )
-

HbCO rt bn & khng vn chuyn O2

Ngt bn trong

CO c i lc /v Hb gp 210 ln so vi
O2 Ng c oxyt carbon : HbO2 + CO
HbCO + O2

Nng O2 cao c th lm phn ly

HbCO th hhp kh 95% O2 & 5% CO2

3.2. CN min dch

- Bt gi phc hp KN+ KT+ BT
To thun li cho qtrnh thc bo
- HC bm vo lympho T giao np KN
- Men b mt HC (Peroxydase) HC tip
cn TB
- KN trn mng HC Nhm mu

3.3. CN iu ha cn bng toan kim

- Hb chim 75% td m ca mu TP
Globin

Globin

+ H+ pH t

thay i

N
NH
Dng acid

N
NDng kim

3.4. CN to AS keo
- Do cu to ca HC phn ln l
Protein gp phn to AS keo ca
mu.

III. Cc cht cn cho s thnh lp HC

a. St

b. Folic acid
c. Vitamin B12 (cobalamine)

3.1. St

Transferrin
Huyt tng
Vander Human Physio., 8th

Transferrin
htng

Bnh thng

Thiu mu do thiu st

S lng HC

a hng cu

S lng HC

3.2. Folic acid - vitamin B12

Vander Human Physio., 8th

- Thiu mu c tnh :

Vander Human Physio., 8th

3.3. Mt s cht khc

- Erythropoietin : to t REF (Renal
Erythropoietin Factor)

kch thch ty xng SX HC

- Androgen : to HC
- Cholin, Thymidin : to nn & mng
HC

IV. i sng HC
Thoi bin Hb

V. Bo qun HC truyn mu
Ch bo qun HC m bo HH
cho ngi nhn mu
- Cht chng ng - Cht dit trng
- Mui khong

- Nhit : 40C

- Glucose
(Dextrose)

- Thi gian tr: tt

nht 2 tun

Dd u trng

ng trng

Nhc trng

HC bt u v
( sc bn ti thiu)

HC v hon ton
( sc bn ti a)

MTP

4,6 NaCl

3,4 NaCl

HC ra

4,8 NaCl

3,6 NaCl