实验诊断学 出血、血栓与止血检测.pptVIP

血栓与止血检测(Laboratory Diagnostics in Thrombosis and Hemostasis);Contents and Objectives;Vocabulary 1;止血和凝血系统;a pathological activation of coagulation mechanisms that happens in response to a variety of diseases the massive , ongoing activation of coagulation may result in depletion of platelets and coagulation factors ,which may cause bleeding . a timely and reliable diagnosis;Case 1;thrombin fibrin-fibrinogen plasmin- plasminogen fibrin degradation product extrinsic and intrinsic pathways antithrombin heparin ;一. 止血机制： 机体的正常止血，主要依赖于完整的血管壁结构和功能，有效的血小板质量和数量，正常的血浆凝血因子活性及健全的神经体液调节。;1. Hemorrhage (Bleeding) ;4. Restoration ;二. 凝血机制;The coagulation cascade;The coagulation cascade;三. 抗凝系统： 细胞抗凝作用 体液抗凝作用 AT-Ⅲ ：最主要的生理抗凝活性物质。 蛋白C和蛋白S系统。 ;;Vocabulary 3;contains 3.2% (0.109 M) sodium citrate;一. 血管壁检测;The WHO definition of dengue haemorrhagic fever has been in use since 1975; all four criteria must be fulfilled: 2. Hemorrhagic tendency (positive tourniquet test, spontaneous bruising, bleeding from mucosa, gingiva, injection sites, etc.; vomiting blood, or bloody diarrhea) ;2 Template Bleeding Time, TBT;二. 血小板检测;The PFA-100? Analyzer ;三. 凝血功能检查;?? Most common causes – Heparin (contamination from lines or therapeutic) – Lupus Anticoagulant ?? Other causes – Liver disease (site of production for most coagulation factors) – Consumption of coagulation factors as seen in Disseminated Intravascular Coagulation (DIC) – Deficiencies of coagulation factors ? FVIII (Hemophilia A or Von Willebrand Disease), FIX, FXI, FXII ;Czar Nicholas II of Russia and his family( photographed c. 1916)showing his wife Alexandra (who was a carrier of hemophilia), his four daughters, and his son Alexis, perhaps the most famous European royal with hemophilia. ;;32～43s;International Normalized Ratio (INR) International Sensitivity Index (ISI);Causes for Prolonged PT;四、抗凝系统检测;纤溶酶原;卫生部卫医发[2000]412号文件;;Primary hemostasis;Reference