药理学thromb03.ppt

第三章 局部血液循环障碍;1器官或组织内循环血量异常。2血液内出现异常物质。3血管内成分逸出血管外。;第一节??? 充血器官或组织因血管内血流含量增多称充血（hyperemia）。一动脉性充血---充血器官或组织因动脉输入血量增多而发生的充血称动脉性充血，主动性充血。生理性充血。炎症充血。减压后充血。;二静脉性充血。器官或组织由于静脉回流受阻，血液淤积于毛细血管和小静脉内而发生的充血称为静脉性充血，被动性充血，淤 血。原因：1静脉受压，2静脉腔阻塞，3心力衰竭。病变：器官肿胀，暗紫色（还原HB），。全身淤血，皮肤和粘膜紫蓝色，称发绀（cyanosis）.以口唇和指趾甲明显。局部温度低。镜下，组织内小静脉和毛细血管扩张，充满血液，伴有水肿。;Fig The arm at the bottom is swollen (edematous) and reddened (erythematous) compared to the arm at the top. ;第二节??? 出血破裂性出血，漏出性出血。一破裂性出血。发生于心脏和大血管。;二 漏出性出血。毛细血管和毛细血管后静脉通透性增加，血液经扩大的内皮细胞间隙和受损的基底膜漏出于血管外。止血环节障碍：1血管损伤，2血小板减少或血小板功能障碍，3凝血因子缺乏。;Fig A localized collection of blood outside the vascular system within tissues is known as a hematoma. Here is a small hematoma under the toenail following trauma, which has a bluish appearance from the deoxygenated blood within it.;Fig The blotchy areas of hemorrhage in the skin are called ecchymoses (singular ecchymosis), or also as areas of purpura. Ecchymoses are larger than petechiae. They can appear with coagulation disorders.;病理变化镜下：组织的血管外可见红细胞和巨噬细胞，巨噬细胞胞浆内可见红细胞或含铁血黄素，组织中可见游离的含铁血黄素。;Fig Disseminated intravascular coagulation (DIC) is a consequence of widespread activation of the coagulation system through endothelial injury and/or release of thromboplastic substances into the circulation. Small fibrin thrombi can form in small arteries of brain, heart, lungs, kidneys, and other organs to produce ischemic tissue damage.;Fig The earliest change histologically seen with acute myocardial infarction in the first day is contraction band necrosis. The myocardial fibers are beginning to lose cross striations and the nuclei are not clearly visible in most of the cells seen here. Note the many irregular darker pink wavy contraction bands extending across the fibers.;第三节??? 血栓形成在活体的心脏和血管内血液成分形成固体质块的过程称为血栓形成（thromnosis）。所形成的固体质块称为血栓（thrombus）。血栓是在血液流动状态下形成的。;Fig A thrombosis of the internal carotid artery is seen here. Arterial thromboses are far more common in the brain than venous thr