批发和零售贸易零售业.pptVIP

Hemostasis/CoagulationGregory S. Travlos, DVM, DACVPNational Institute of Environmental Health SciencesResearch Triangle Park, NC541-0653第一页，共四十九页。 HemostasisThe process by which bleeding is arrested.It is a series of physiological and biochemical events which terminate in the formation of an insoluble fibrin clotHemostatic Sequence:Interaction between vessel wall and plateletsBlood coagulationFibrinolysis第二页，共四十九页。 Hemostatic Component InteractionsThompson Harker, 1983第三页，共四十九页。 Blood VesselsIntact 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.第四页，共四十九页。 EndotheliumBesides their role in thromboresistance, endothelial cells have additional synthetic functions. Produce Von Willebrand’s factorAbsorbed by platelets; needed for adherence to collagenProduce plasminogen activator (tPA)Mediates fibinolysisInjured cells release thromboplastin (factor III)Activates the “extrinsic” coagulation cascadeOthers (e.g., type III and IV collagens, elastin, fibronectin, etc.)第五页，共四十九页。 Blood Vessel StructureThompson Harker, 1983第六页，共四十九页。 PlateletsAdhere to exposed collagen (platelet plug)Occurs in seconds; can control hemorrhage of minute injuriesSecretory functions; mediators of coagulation and fibrinolysisReleases ADP; sticky and promotes platelet adhere