溶血性贫血是由于红细胞破坏加速,超过造血补偿能力范围时所发生的一种贫血。正常红细胞呈双凹圆盘形状,在循环中能生存120天左右。它具有很大的可塑性和抗摩擦、撕拉的能力,能通过比它直径(8微米)小得多的微循环管道(可小到0.5微米)。正常红细胞的这种特性有赖于:(1)红细胞膜结构和功能的正常;(2)红细胞内酶和能量代谢的正常;(3)血红蛋白结构的正常。任何一方面发生异常都可使红细胞的完整性受到损害而导致溶血。这种异常可由红细胞内在的缺陷引起,也可由红细胞外部的因素所致。为了反映疾病的主要矛盾,本文拟从红细胞内、外因素两方面来讨论溶血性贫血的生化基础。红细胞内因素又分为细胞膜、代谢酶和珠蛋白三方面缺陷;红细胞外因素则包括物理、化学、生物、免疫等因 Hemolytic anemia is an anemia that occurs when red blood cell damage is accelerated and exceeds the range of hematopoietic compensation. Normal red blood cells showed a double concave disc shape, in the cycle can survive about 120 days. It has a great plasticity and anti-friction, tearing ability, can be much smaller than its diameter (8 microns) microcirculation pipeline (which can be as small as 0.5 microns). This characteristic of normal erythrocytes depends on: (1) the normal structure and function of the erythrocyte membrane; (2) normal erythrocyte enzymes and energy metabolism; and (3) normal hemoglobin structure. An abnormality on either side can damage the integrity of the red blood cells resulting in hemolysis. This anomaly can be caused by defects inherent in erythrocytes, but also by factors outside the red blood cells. In order to reflect the major contradictions of the disease, this paper intends to discuss the biochemical basis of hemolytic anemia from two aspects of intra- and extra-erythrocytes. Erythrocyte factor is divided into cell membrane, metabolic enzymes and globin three defects; extracellular factors include the physical, chemical, biological, immune and other factors