内科学课件:bleeding diseases
30页1、出血性疾病总论Overview of Bleeding DiseaseDefinition Bleeding disorder refers to a group of diseases, that normal hemostatic mechanism disorder caused spontaneousbleeding, or excessive bleeding after minorinjury systems involved in hemostasisnVascular Spasm : the smooth muscle in blood vessel walls contracts immediately, while the other hemostatic mechanisms become active.nPlatelet Plug Formation: the key stages of this process are: platelet adhesion, platelet release reaction, and platelet aggregation
2、nBlood Coagulation- coagulation system, anticoagulation systemnfibrinolytic systemthe role of vascular system in hemostasisnmechanism of vasoconstrictionnthe endothelium cells nevents following vascular injury Stimulate platelet adhesion - White thrombus formation Activation of coagulation system - solid red thrombus formation 血管在止血中的作用血管损伤血管收缩儿茶酚胺/5-HT/血管紧张素/加压素/内皮素/TXA2血流减弱血管内皮表达粘附分子配体内皮下成分暴露血小板粘附、聚集、释放GPIb/vWFGPIIGPIIb b-III-IIIa a胶原/纤原ADP/TXA2/-TGPAF/Fg/vWF/Ca+合成、表达TFThrombin形成Fibrin形成血栓形成激活
3、外源凝血系统Vessel wall abnormalities (vascular purpura)Congenital vascular wall abnormalities Hereditary telangiectasiaAcquired the vessel wall abnormalities immunityallergic purpura non-immune Infection: bacteria, viruses, fungi, etc. Chemical : drugs, chemical toxins, etc. Metabolic: vitamin C deficiency, long-term use hormone Mechanical: trauma, pressure, etcSchematic diagram of platelet morphologythe role of platelets in hemostasisnplatelet adherence to collagen: GpIbnPlatelet aggregation:GpIIb/I
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