First, they damage the RBC membrane, resulting in intramedullary hemolysis, or RBC breakdown in the bone marrow; or extravascular hemolysis, when RBCs are destroyed by macrophages in the spleen.

首先，它们会破坏红细胞膜，导致髓内溶血（骨髓中红细胞分解）或血管外溶血（红细胞被脾脏的巨噬细胞破坏）。

With extravascular hemolysis, we have macrophages eating up red blood cells more than normal and unconjugated bilirubin production is ramped up, which is conjugated by the liver and sent to the gallbladder.

血管外溶血时，巨噬细胞吞噬红细胞，较正常时更多，进而加速了非结合胆红素的产生，非结合胆红素在肝脏转变为结合胆红素，并输送至胆囊。