Mucocutaneous Hemorrhage课件.pptVIP

Mucocutaneous Hemorrhage Definition Mucocutaneous hemorrhage is caused by the abnormalities of hemostasis(止血) and /or coagulation(凝血), characterized by local or extensive mucocutaneous hemorrhage derived from capillary. The bleeding is usually spontaneous or from slight trauma. Hemostasis/coagulation Hemostasis/coagulation is the bodys normal physiological response for the prevention and stopping of bleeding/hemorrhage. Hemotasis Primary hemostasis ---platelet plug formation at sites of injury Secondary hemostasis ---plasma coagulation system reaction resulting in fibrin formation Etiology Pathogenesis Vessel wall disorders Abnormalities of blood platelets — Quantitative platelets defects — Qualitative platelets defects Disturbance of coagulation in circulation — Deficiency of coagulation factors Increase of anti-coagulation substances Hyperfunction of fibrinolysis(纤维蛋白溶解) Defects on the vessel wall Constriction of capillary playing the role of hemostasis Vascular wall disorders Damage to capillary endothelium Abnormalities in the vascular subendothelial matrix Defect of extravascular connective tissues that support blood vessels Formation of abnormal blood vessels. Defects on Capillary Wall Hereditary Telangioectasia(毛细血管扩张); Acquired Allergic purpura(过敏性紫癜); Senile purpura Non- thrombocytopenic purpura — Severe infection — Vitamin C deficiency — Uremia Vitamin C is needed to synthesize hydroxyproline(羟脯氨酸), an essential constituent of collagen excess production of glucocorticoids develop generalized protein wasting atrophy of the supporting connective tissue around blood vessels skin bleeding or easy bruising Senile purpura Ageing causes a similar atrophy of perivascular connective tissues In this situation,BT and CT are normal,but capillary fragility test is positive. Abnormalities of blood platelets Blood platelets function in primary hemostasis platelet adhesion and aggregation Platelet ac