甲型流感病毒H6亞型核酸檢測(cè)試劑盒

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【公司名稱】 廣州健侖生物科技有限公司
【市場(chǎng)部】    楊永漢

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【騰訊  】 2042552662
【公司地址】 廣州清華科技園創(chuàng)新基地番禺石樓鎮(zhèn)創(chuàng)啟路63號(hào)二期2幢101-103室

混合型紫紺
混合型紫紺（混合性發(fā)紺）較為容易理解，即中央型紫紺和周圍型紫紺同時(shí)存在。比如心功能不全時(shí)，因?yàn)榉斡傺墒寡t蛋白氧合不足，同時(shí)血流緩慢、周圍組織耗氧過多，導(dǎo)致還原血紅蛋白增加而出現(xiàn)紫紺。

血液中含有異常血紅蛋白
藥物及化學(xué)物品中毒導(dǎo)致血中異常血紅蛋白衍生物的出現(xiàn)亦可形成紫紺，比如腸源性紫紺，高鐵血紅蛋白血癥等。

診斷注意事項(xiàng)

病史
大多數(shù)通過仔細(xì)詢問病史可以粗略明確診斷方向，根據(jù)輔助檢查可明確診斷。所以重視病史詢問是一個(gè)非常重要的內(nèi)容。比如詢問：什么時(shí)候發(fā)病、發(fā)病的緩急、持續(xù)時(shí)間，發(fā)紺的部位，嚴(yán)重程度，是否對(duì)稱性發(fā)紺。有無其他伴隨癥狀，比如呼吸困難、咳嗽、咳痰、咯血、心慌、氣促、胸悶、胸痛、惡心、嘔吐等。有無水腫，水腫的部位，是否對(duì)稱性等。有無接觸某些化學(xué)藥物病史。既往身體狀況如何，有無心、肺疾病史等。

體格檢查
體格檢查一般跟收集病史同時(shí)進(jìn)行。結(jié)合相應(yīng)病史，觀察發(fā)紺的各個(gè)信息點(diǎn)，比如紫紺部位、局部皮膚溫度、有無杵狀指、心肺疾病體征等。

輔助檢查
輔助間一般是明確診斷所必須的。可以根據(jù)病史及體格檢查所收集的信息，加以篩選地進(jìn)行某些必要的輔助檢查。比如胸片、心電圖、超聲心動(dòng)圖等，若懷疑有心臟方面疾病，可以選擇更為復(fù)雜的輔助檢查，比如心導(dǎo)管檢查、選擇性血管造影等。懷疑肺部疾病，則血?dú)夥治觥⒎喂δ軝z查等應(yīng)該進(jìn)行。懷疑下肢靜脈狹窄或栓塞，則肢體血管的多普勒檢查就很必要。其發(fā)生機(jī)制是由于大血管間存在異常通道，部分靜脈血未通過肺進(jìn)行氧合作用即經(jīng)異常通道混入體循環(huán)動(dòng)脈血中，如分流量超過心排血量的1/3即可引起紫紺。常見的疾病包括法洛四聯(lián)癥、大血管轉(zhuǎn)位、永存動(dòng)脈干、*性肺靜脈異位引流等。

非紫紺型先天性心臟病
非紫紺型先天性心臟病后期如出現(xiàn)繼發(fā)性肺動(dòng)脈高壓即艾森門格綜合征(Eisenmenger綜合征），出現(xiàn)右向左分流，亦可出現(xiàn)紫紺，如室間隔缺損、動(dòng)脈導(dǎo)管未閉、房間隔缺損、肺動(dòng)脈狹窄及左心發(fā)育不良綜合征等。

Mixed cyanosis
Mixed cyanosis (mixed cyanosis) is easier to understand, that is, central cyanosis and peripheral cyanosis exist. Such as cardiac insufficiency, because pulmonary congestion can make hemoglobin oxygen deficiency, while slow blood flow, the surrounding tissue oxygen consumption, resulting in reduction of hemoglobin increased cyanosis.

Blood contains abnormal hemoglobin
Drugs and chemical poisoning lead to abnormal blood hemoglobin derivatives can also form cyanosis, such as gut-derived cyanosis, methemoglobinemia and so on.

Diagnostic considerations

Medical history
Mostly by carefully asking the medical history can be a rough diagnosis of the direction, according to the auxiliary examination can confirm the diagnosis. So pay attention to medical history is a very important content. For example, ask: when the onset, onset of urgency, duration, location of cyanosis, severity, whether the symmetry of cyanosis. Is there any other accompanying symptoms, such as dyspnea, cough, expectoration, hemoptysis, palpitation, shortness of breath, chest tightness, chest pain, nausea, vomiting. Whether or not edema, edema, symmetry and so on. Have any contact with certain medical history. Past physical condition, inadvertent, lung disease history.

Physical examination
Physical examination with the general collection of medical history at the same time. Combined with the corresponding history, to observe the cyanosis of various information points, such as cyanosis site, the local skin temperature, with or without clubbing, cardiopulmonary disease signs.

Auxiliary examination
Auxiliary room is usually a clear diagnosis of the necessary. According to medical history and physical examination collected information, to be screened for some necessary auxiliary examination. Such as chest X-ray, ECG, echocardiography, etc., if there is suspicion of heart disease, you can choose more complicated auxiliary examinations, such as cardiac catheterization, selective angiography. Suspected lung disease, the blood gas analysis, pulmonary function tests should be carried out. Doubt of venous stenosis or embolism, the limb vascular Doppler examination is necessary. The mechanism is due to the presence of abnormal channels between major blood vessels, part of the venous blood is not oxygenated through the lungs through the abnormal channel mixed into systemic arterial blood, such as subluxation volume of cardiac output of more than 1/3 can cause cyanosis. Common diseases include tetralogy of Fallot, major vessel transposition, permanent artery dry, complete pulmonary venous drainage and so on.

Non-cyanotic congenital heart disease
Non-cyanotic congenital congenital heart disease secondary to secondary pulmonary hypertension or Eisenmenger syndrome (Eisenmenger syndrome), the right to left shunt may also be cyanotic, such as ventricular septal defect, patent ductus arteriosus, atrial Septal defect, pulmonary stenosis and left heart hypoplasia syndrome.