⒈ Routine peripheral blood red blood cell count and hemoglobin content are reduced, broken red blood cells and abnormal red blood cells can be seen in blood smears. When a typical abnormal red blood cell or self-agglutination occurs, it can provide clues to the cause of hemolysis.
⒉ Significance of plasma free hemoglobin determination Normal plasma has only a small amount of free hemoglobin, >40mg/L is an important indicator of hemolysis, especially intravascular hemolysis, such as paroxysmal sleep hemoglobinuria, blood type incompatibility and transfusion reaction. Extravascular hemolysis, such as hereditary spherocytosis, generally does not increase.
⒊ Significance of serum haptoglobin determination (Hp)
A The reduction of serum haptoglobin is seen in:
⑴ Various hemolytic anemias, including intravascular or extravascular hemolysis;
⑵ Liver cell damage, infectious mononucleosis, congenital agammaglobinemia, etc.
B. Increased serum haptoglobin is seen in infection, tissue damage, extrahepatic obstructive jaundice, and malignant tumors.
⒋ Significance of plasma methemoglobin albumin test This test helps to distinguish intravascular or extravascular hemolysis. A positive sign indicates severe intravascular hemolysis. Such as paroxysmal nocturnal hemoglobinuria, a methemoglobin albumin zone appears, while spherocytosis is extravascular hemolysis without this zone.
⒌ Urine examination
⑴ Increased excretion of urobilinogen;
⑵The occult blood test is positive, because when the plasma free hemoglobin is significantly increased, exceeding the amount of conjugated globin and the renal tubular reabsorption function, hemoglobinuria occurs;
⑶ Urinary hemosiderin test is positive, reflecting chronic hemolysis, especially intravascular hemolysis.
⒍ Red blood cell lifespan measurement is a reliable indicator for detecting hemolysis, commonly used 51Cr, 3P-DFP or diisopropyl fluorophosphate labeled red blood cell method, can reflect the index of red blood cell life. This measurement shows that the reduced life span of red blood cells indicates hemolysis.