法安明肾科应用资料.ppt

小 结 肝素使用十分广泛，涉及多个学科，肝素品种越来越多，包括普通肝素、低分子肝素和超低分子肝素，不良反应也会增加，医生需要提高认识，提高临床使用肝素的水平，注意特殊个体的并发症，加强防范严重并发症，更好为患者服务。 谢 谢 ！ 人有了知识，就会具备各种分析能力， 明辨是非的能力。 所以我们要勤恳读书，广泛阅读， 古人说“书中自有黄金屋。 ”通过阅读科技书籍，我们能丰富知识， 培养逻辑思维能力； 通过阅读文学作品，我们能提高文学鉴赏水平， 培养文学情趣； 通过阅读报刊，我们能增长见识，扩大自己的知识面。 有许多书籍还能培养我们的道德情操， 给我们巨大的精神力量， 鼓舞我们前进。 * The two main functions of tissue factor (TF) are shown: (i) to activate factor X and (ii) to activate factor IX. Factor Xa remains in the vicinity of the TF cell and activates factor V. The complex of factors Xa/Va can convert a small amount of prothrombin factor II) to thrombin with the results shown in the figure. Tissue factor pathway inhibitor (TFPI) then inhibits the complex of TF/VIIa/Xa as a control mechanism. * * The activated platelet derived from unactivated circulating platelets resulting from the thrombin generation on the TF cell shown in top panel. Activated cofactors Va and VIIIa occupy sites on the activated platelet before binding of the respective enzymes, factors IXa and Xa. Factor Xa on the activated platelets is recruited from circulating factor X and is different from the factor X on the TF cell. The burst of thrombin generation takes place on the platelet surface. Thrombin generation can be boosted by urther activation of factor IX by factor XIa. The burst of thrombin is sufficient to convert fibrinogen to fibrin. * * Relevant intravascular coagulation signaling pathways. In the coagulation initiation reaction, the ternary tissue factor (TF)–coagulation factor VIIa (VIIa)–coagulation factor X (X) complex leads to activation of X, forming protease Xa (Xa). In the transient TF–VIIa–Xa complex, the nascent product protease Xa is a highly efficient activator of protease activated receptor (PAR)1 and PAR2 (14), before its dissociation to trigger the downstream coagulation cascade. In the vasculature, thrombin (IIa) acts as an anticoagulant at low concentrations. Thrombin binds thrombomodulin (TM) and activates the activated protein C (APC)