凝血与抗凝血平衡紊乱出凝血异常.ppt

医学干细胞研究组欢迎你！ Email to me: dlhong@sjtu.edu.cn 洪登礼 Cancer Cell 25: 778 Science 319: 336 * 谢 谢 ！ * D-dimer formation Plasmin Thrombin Plasmin Plasmin * Plasma Protamine Paracoagulation Activation of Coagulation Fibrin monomer (FM) Secondary fibrinolysis FDP soluble fibrin monomer complex（SFMC） Protamine Sulfate FM polymerization FDP positive 3P Test Fibrin degradation product * * * * * * * DIC Definition of DIC Causes of DIC Pathogenesis of DIC Predisposing factors to DIC （易感因素，诱发因素，影响因素） Main clinical features of DIC Stages of DIC Treatment of DIC Summary and discussion * Definition DIC is a complex systemic thrombohemorrhagic disorder involving the ①generation of intravascular fibrin, ②the consumption of procoagulants and platelets, and ③secondary activation of fibrinolysis. The resultant clinical condition is characterized by intravascular coagulation and hemorrhage. Coagulation Hypercoagulable state Thrombus Fibrinolysis Hypocoagulable state Hemorrhage Question： 止血治疗 ？Why or why not？ * Question： 止血治疗 ？Why or why not？ * * DIC Definition of DIC Causes of DIC Pathogenesis of DIC Predisposing factors to DIC （易感因素，诱发因素，影响因素） Main clinical features of DIC Stages of DIC Treatment of DIC Summary and discussion * DIC is secondary to these diseases Sepsis/severe infection 30% Malignancy 25% solid and myeloproliferative malignancies Obstetric complications 20% Amniotic fluid embolism, Abruptio placentae Retained dead fetus syndrome Trauma (neurotrauma) ,Organ destruction, Burns 15% Severe hepatic failure Rheumatologic illness Adult Stills disease, Lupus Vascular abnormalities Kasabach-Merritt syndrome, Large vascular aneurysms Hemolysis DIC is secondary ! * Triggering factors ① Endothelial cell (EC) injury ② Release TF ③ LPS(细菌脂多糖, endotoxin) ④ Ag-Ab complex ⑤ Protease ⑥ Microparticles ⑦ Pathogenic Microbes (viruses) * DIC Definition