Blood incidence statistics
hemoglobin is below normal (anemia), very approximate. In Russia
Every year, almost 1.5 million people are registered with this symptom.
annually, 50% of which are children under 17 years old. Most
Vulnerable populations in this regard are children under 5, pregnant women,
elderly and sick people with chronic diseases.
General idea of the meaning and norms of hemoglobin
Hemoglobin is a complex protein structure.
Its formation occurs in the erythrocytes as a result of the connection
simple protein with incoming iron atoms. Its main
function – transport. It consists in the binding of molecules
oxygen during the passage of blood in the lungs and transfer it to the tissue,
where hemoglobin binds molecules of carbon dioxide and delivers them
in the lungs. The liberated carbon dioxide is exhaled by the lungs. This
the process is also one of the links to maintain normal
acid-base blood state.
Hemoglobin levels may decrease in red blood cells, which
determined by color index (normal – 0.8 – 1.5), or
links with an absolute or relative decrease in the number of
red blood cells (in relation to the unit of mass of blood).
However, today the MCHC indicator (color indicator
– the average hemoglobin content in the erythrocyte) for the patient and
the general practitioner is not particularly informative, except just
differential diagnosis of rare types of anemia. Concept itself
color index is abolished. Instead, use two
- MCV is the average erythrocyte volume, normally from 76 to 96 femtoliter.
It is of practical importance, helping to navigate with
red blood cell size. If less than 76 – microcyte, if more
96 – macrocytic. It is useful for diagnosing the type of anemia.
Microcytosis is more often with iron deficiency, macro – with deficiency
- MCH – the average content of hemoglobin in the erythrocyte, this is the second
the indicator that replaced the color indicator. Norm from 27 to 32
picagram (if hemoglobin is counted in grams per liter). If less
27 – hypochromia, if more than 32 – hyperchromia.
Hemoglobin norm in the blood:
|in men||among women||in pregnant women||in children|
|130 to 160 g / l;||120 to 150 g / l;||from 110 g / l;||
Low blood hemoglobin is not
independent disease. It accompanies many diseases,
as well as pathological disorders, but leads to malnutrition
tissues with oxygen, changes in their acid-base state
environment, dystrophic changes and dysfunction of many organs
Forms of anemic conditions
Существуют различные причины low гемоглобина among women и
men, reflected in many complex classifications of anemic
states. Depending on the main mechanism that led to
reduce hemoglobin, anemia combined into three large groups:
- Post-hemorrhagic anemia (associated with blood loss)
They occur with injuries, ulcers and erosive processes in
esophagus, stomach or intestines, varicose veins
esophagus, hemorrhoids, as a result of uterine bleeding with myoma
or endometriosis, blood loss during heavy menstruation, nasal,
lunochkovyh (after removal of teeth) and pulmonary hemorrhage.
- Resulting from increased red blood cell destruction
These include hemolytic anemia of the newborn, anemia,
caused by autoimmune diseases, hereditary
blood diseases, chemical intoxication (acetic acid),
poisoning with certain types of fungi, transfusion incompatible
blood, kidney failure, mechanical destruction
red blood cell artificial heart valve, infectious
diseases (malaria), some blood diseases
(thrombocytopenic purpura, lymphocytic leukemia) and other
- Anemia caused by impaired blood formation
This group includes iron deficiency anemia, hereditary and
autoimmune diseases, anemia associated with gastric resection or
small intestine (due to deficiency of folic acid, vitamin B12), with
intoxication with infectious diseases and malignant
tumors, malignant blood disorders (leukemias).
This group also includes anemia caused by some
drugs; blood loss in minor
quantities, but over a long time – scarce, but
prolonged menstruation, bleeding with endometriosis, tumors
uterus and the use of contraceptives, untimely recognized
gastrointestinal bleeding, bleeding with hemorrhoids, from
kidney or bladder and many others.
Diseases in this group often cause
very low hemoglobin in the blood with quite satisfactory
subjective well-being due to adaptive abilities
Features of the course of anemia in the elderly
Anemic syndrome occurs in 10 to 25% of the elderly and people.
old age. In most cases, the causes low
гемоглобина у old people связаны не с деградацией кроветворных
tissues, and is the result of diseases that are more common
or have certain features of the course in these age
groups – tumors of various organs, thin diverticulosis
intestinal erosion and ulcers resulting from atherosclerosis
long-term infectious and inflammatory processes in
unhealthy diet (lack of food or poor
digestibility of proteins and vitamins, especially B12, C, folic
Features of anemia at this age:
- non-specific manifestations that can be masked
symptoms of major diseases;
- aggravation of cardiovascular insufficiency, ischemia
heart (increased frequency of strokes) and brain (more
pronounced course of encephalopathy));
- anemia is more common than younger
infectious and non-infectious inflammatory diseases and
According to research by American scientists conducted in
the last decade, it turned out that with low hemoglobin
old people на 41% увеличивается риск развития слабоумия. By
According to scientists with anemia, oxygen supply is greatly reduced
brain, it causes damage to the neurons and
progression of dementia.
Causes of anemia in children
In addition to various hereditary and autoimmune diseases,
most often the lowest hemoglobin in the newborn occurs when
hemolytic anemia resulting from rhesus conflict or
incompatibility of the blood of the mother and child by group.
Кроме того, анемия в 80% связана in children with iron deficiency.
It may occur due to prematurity, malnutrition.
mothers during pregnancy, disorders of placental circulation,
when artificial feeding or feeding unadapted
mixtures (goat or cow’s milk). Гемоглобин in children может
go down quickly with infectious diseases and dysbacteriosis,
premature or too late introduction of meat supplements
products, fruit and vegetable juices and mashed potatoes (see how to drive a lure
Особенно легко причины low уровня гемоглобина у ребенка
- pronounced growth spikes, as the need for iron is sharply
- prematurity, since such children do not have time to save
- возрасте старше 5 — 6 months; by this time in their body
the reserves of gland accumulated during
- skin diseases such as allergic dermatitis;
- кишечных расстройствах в связи с любыми reasons.
Frequent and fairly rapid development of anemic conditions in
children is also due to insufficient development of hematopoietic
systems that are highly responsive to any abnormalities in the body
Lack of hemoglobin leads to delayed development of other
organs and systems, neuro-reflex connections, to delay
physical and mental development, reduced immunity.
Iron deficiency anemia
Most значительную часть всех анемических состояний у
adults and children are iron deficiency anemia. Among all
women in 20–30% have a decreased level of hemoglobin due to
with iron deficiency. This симптом у них наблюдается по сравнению с
men 4 times more often. Even in the same number of women noted
latent iron deficiency, that is, their hemoglobin is still within
norms, but iron reserves are already depleted. By этой причине при
Many of them have anemia during pregnancy and there is a high
the risk of its development in newborns.
The main groups of causes of iron deficiency anemia are distributed by
- Physiological, associated with rapid growth, pregnancy (see
pregnancy with low hemoglobin).
- Alimentary, due to an unbalanced diet,
observing fasting and fasting days, a vegetarian diet,
- Associated with the pathology of the digestive system – gastritis with atrophy
gastric mucosa, resected stomach or thin
intestines, chronic colitis, hereditary diseases with
impaired absorption in the small intestine (celiac disease), tumor
stomach or rectum, bleeding from varicose veins
stomach and esophagus, bleeding from ulcers of the esophageal mucosa during
hiatal hernias, ulcers and erosions of the stomach and
intestine, from hemorrhoidal veins.
- Associated with the pathology of the urinary and genital systems.
Clinical manifestations – low hemoglobin symptoms
Common to all anemia symptoms:
- gradually increasing general weakness, tinnitus;
- fatigue with light work, drowsiness and decreased
- excessive sweating, shortness of breath with minor physical
- headache, dizziness, episodes of fainting
- increase in pulse rate, feeling of heartbeat at
minor load, lower blood pressure;
- pale skin and visible mucous membranes.
Iron deficiency anemia is also characterized by thinning,
striation, delamination and fragility of the nail plates, the appearance of
these are whitish spots, redness and the occurrence of cracks in the corners
lips, increased skin dryness, slower hair growth and enhanced their
loss, perversion of taste and smell.
The severity of chronic anemia is determined by the level and
duration of hemoglobin reduction:
- easy degree – 110 – 90 g / l for 3
- средняя степень — 90 -70 г/л на протяжении 4,5 months;
- severe degree – less than 70 g / l for six months.
Treatment of anemia
With low hemoglobin treatment is aimed at eliminating
source of bleeding if present, treatment of the main
diseases and the appointment of replacement therapy. With
iron deficiency anemia general principles of correction are as follows:
- The appointment of drugs for oral administration (Heferol, ferroplex,
ferlatum and others. See the complete list of all iron preparations for anemia)
with the content of ferrous iron, ascorbic acid,
- Prescribing drugs that enhance the absorption of iron in
- Inappropriate use of folic acid, vitamins B and
B12 without special indications for them.
- Prescribing a course of treatment lasting up to 1.5 months or more
(until normalization of hemoglobin) followed by
continuation of maintenance therapy and preventive courses.
- Prescribing iron and vitamins for intravenous and
intramuscular injection in violation of absorbability in the intestine
(Ferrum LEK, Ektopher, Ferrlezit, Venofer).
Prevention consists in identifying individuals at increased risk
iron deficiency anemia (pregnant women who have undergone surgery for complete
or partial removal of the stomach or intestines, face with sugar
diabetes, kidney and liver failure, stomach and
bowel) and the appointment of preventive treatment courses, which
includes iron supplements, vitamins, recommendations in terms of