批发跟零售贸易零售业.pptVIP

Hemostasis/Coagulation Gregory S. Travlos, DVM, DACVP National Institute of Environmental Health Sciences Research Triangle Park, NC 27709 919-541-0653 Travlos@ Hemostasis The process by which bleeding is arrested. It is a series of physiological and biochemical events which terminate in the formation of an insoluble fibrin clot Hemostatic Sequence: Interaction between vessel wall and platelets Blood coagulation Fibrinolysis Hemostatic Component Interactions Blood Vessels Intact endothelium forms a thromboresistant surface Required for the free flow of blood; does not promote platelet adherence or activate coagulation Passive mechanisms: Endothelial glycocalyx (negative charge - repels like-charged particles, e.g.,platelets). Presence of a2-macroglobulin at cell surface (protease inhibitor). Active mechanisms: Endothelial cells remove platelet aggregation promoters from circulation (e.g., PGF1, bradykinin, serotonin, adenine nucleotides). Secretion of PGI2 - potent inhibitor of platelet aggregation, induces vasodilation. Proteoglycan matrix of the vessel wall influences thrombogenicity. Heparin, heparan sulfate and dermatan sulfate have anticoagulant activity; other glycosaminoglycans and hyaluronic acid do not. Veins have the highest concentration. Endothelium Besides their role in thromboresistance, endothelial cells have additional synthetic functions. Produce Von Willebrand’s factor Absorbed by platelets; needed for adherence to collagen Produce plasminogen activator (tPA) Mediates fibinolysis Injured cells release thromboplastin (factor III) Activates the “extrinsic” coagulation cascade Others (e.g., type III and IV collagens, elastin, fibronectin, etc.) Blood Vessel Structure Platelets Adhere to exposed collagen (platelet plug) Occurs in seconds; can control hemorrhage of minute injuries Secretory functions; mediators of coagulation and fibrinolysis Releases ADP; sticky and promotes platelet adherence ADP activates phospholipase A2 which stimulates throm