第三章 血液1培训讲学.ppt

3. Roles of Platelet in Hemostasis I．Blood Coagulation （血液凝固） (1) Form loose platelet plug to stop bleeding. (2) Partricipate in process of blood coagulation. ① supply phospholipid surface (PF3) for clotting factors to activate FX and FII ② combine many clotting factors (FI, FV, FXI, FXIII, FXa) to accelerate coagulation ③ release clotting factors (FI, PF2,FXIII) from αgranule in platelets to form more fibrin and reinforce the clot. ④ induce clot retraction to reinforce the clot (3) Repair damaged vessel wall to maintain integrity of vascular endothelium. Roles of Platelet in Hemostasis (1) Form platelet plug to stop bleeding. (2) Partricipate in blood coagulation. (3) Repair the damaged vascular wall.　 Bleeding ! ≤50x109/L 100～300x109/L Why blood is not coagulated normally ?Why the blood vessel is re-opened after blood clotting? Intravascular Anticoagulants 血液内的抗凝物质 Fibrinolysis 血纤维溶解 II．Anticoagulative System (Intravascular Anticoagulants 血液中抗凝物质） 1. Serin proteinase inhibitor (丝氨酸蛋白酶抑制物) Antithronbin III (AIII, 抗凝血酶III ) ( plasma protein,α2-globulin) （肝细胞，血管内皮） Heparin co-factor II (肝素辅助因子II) 2. Heparin (肝素) （肥大细胞） 3. Protein C system Protein C (PC, 蛋白质 C ) （肝细胞） Thrombomodulim （TM, 凝血酶调制素)（血管内皮） 4. Tissue Factor Pathway Inhibitor (TFPI,组织因子途径抑制物)（小血管内皮） Antithronbin III  (serin proteinase inhibitor) Heparin ( negative charged ) HC II Heparin co-factor II (肝素辅助因子II) AT III FIIa Active center (serin proteinase) ×100 ×1000 × × × 抗凝血酶III 肝素 FXa FIXa FXIIa FIIa Ca2+ Thrombomodulim (凝血酶调制素) PC PCa (activated PC ) VIIIa VIII Va V Release of plasminogen activators Anticoagulation Lysis of fibrin Surface of vascular e