出血性疾病概述（An overview of hemorrhagic diseases）.docVIP

出血性疾病概述（An overview of hemorrhagic diseases） Chapter 14 overview of hemorrhagic diseases When the blood vessels are damaged, blood can be drained or seeped from blood vessels. At this point, the body will stop the bleeding through a series of physiological reactions, which is to stop the bleeding. The hemostatic process involves multiple factors and involves a complex series of physiological and biochemical reactions. A disease characterized by spontaneous or vascular injury caused by a defect of hemostasis is known as hemorrhagic disease. [normal hemostatic mechanism] (1) vascular factors Vasoconstriction is the earliest physiological response to hemorrhage. When blood vessels are damaged, local blood vessels contract, resulting in a narrowing or closure of the cavity. Vasoconstriction is accomplished by neural reflex and multimedium regulation. Vascular endothelial cells have the following role in hemostasis during hemostasis: expression and release of vascular hemophilia factor (vWF), which results in the adhesion and aggregation of platelets at the site of injury; To express and release the tissue factor (TF) to initiate exogenous coagulation; (3) basal exposed collagen, activate factor Ⅻ Ⅻ (F), start the endogenous clotting; To express and release thrombin regulation protein (TM), activate protein C (PC) system. In addition, vascular endothelial cells can affect platelet function by regulating the concentration of blood nitric oxide (NO), and enhance vasoconstriction by expressing and releasing endothelin (ET). (2) platelet factor Blood vessels are damaged, through platelet adhesion, aggregation and release reaction involved in hemostasis process: (1) the platelet membrane glycoproteins (GP I b) b I as receptors, through the bridge between vWF, make the blood platelet in damaged skin collagen fibers, the formation of platelet thrombus, mechanical repair damaged blood vessels; (2) the platelet membrane glycoproteins Ⅱ b, Ⅲ (GP Ⅱ b, Ⅲ), connected with each other