医学生理学课件(血液).ppt

单击以编辑母版标题样式,单击以编辑母版文本样式,第二级,第三级,第四级,第五级,*,Introduction,血液,血浆：,血细胞,电解质（electrocytes)、营养成分(nutrients)、气体(gases)、代谢产物(waste products)、蛋白质（proteins)、水分（water)。,Red blood cells,White blood cells,Platelets,一、血液的基本组成,二、血液的功能,1、运输作用（Transportation),4、缓冲作用,5、传递信息,3、生理止血(hemostasis),2、防御功能（defense),Plasma,一、,Components,and functions of plasma,1.Electrolyte:,血浆晶体渗透压,2.Protein,(1)albumin:形成血浆胶体渗透压及物质转运,(2)globulin：,1、2、globulin,物质转运及特异性免疫,(3)fibrinogen：血液凝固,:,:,:,:,:,:,血管内外的水分交换,Plasma colloid osmotic pressure,三、plasma pH,pH 7.35-7.45,血细胞（Blood cell),一、Red blood cell,Male:(4.5-5.5)10,12,/L Female:(3.8-4.6)10,12,/L,(2.0-3.0)10,6,Hb/RBC,每一个Hb分子可结合4个O,2,分子,Physiological properties of RBC,1、渗透脆性（fragility),2.Plastic deformation of RBC,3.Erythrocyte sedimentation rate,4.Rouleaux formation of erythrocyte,5、红细胞比容（Hematocrit value）,Male:40-50%female:37-48%,0.9%NaCl,0.7%,NaCl,0.5%NaCl,0.4%NaCl,0.3%NaCl,0.9%NaCl isotonic solution(physiological saline),hemolysis,Suspension stability,ESR:male,3mm,female,10mm,二、white blood cell,White blood cells,Polymorphonuclear neutrophils,Polymorphonuclear eosinophils,Polymorphonuclear basophils,monocytes,lymphocytes,4000-10000/mm,3,50-70%,2-5%,0.5-1%,3-8%,20-30%,Monocytes,Neutrophils(phagocytosis),Nonspecific immunity,lymphocytes,T cells,B cells,Cellular immunity,Small sensetized lymphocytes,antiboby,Humoral immunity,eosinophils,Parasiticidal action,basophils,Secretion of heparin,三、platelet,（100-300）10,9,/L,hemostasis,生理止血（Hemostasis),生理止血：正常人血管受损伤后，有blood从血管流出来，数分钟后自行停止。,包括：local vasoconstriction(局部小血管收缩）,formation of platelet plug(血小板栓子的形成）,blood coagulation(血液凝固）,fibrinolysis and prevention of coagulation(,纤维蛋白溶解和抗凝）,一、Local vasoconstriction response,Transiently delay or stop bleeding(暂时延缓或停止blood的流动),Numerous influences may cause vasoconstriction:,1.Excitation of sympathetic nerve:,2.Release of 5-HT,TXA2,ET etc.,二、Formation of platelet plug,Adhesion and aggregation,内皮细胞（vW factor),Receptors on platelets,Platelet adhesion,Aggregation(ADP,NE and 5-HT),Release of ADP,ATP,5-HT,K+,platelet factor 3,TXA&lysosomal enzyme,Contractile function,三、Blood coagulation,1.Coagulation factor,1)用罗马字 I-XIII表示，共12种和PK,HMWK,PL等;2）the factor IV is calcium,PL is a lipid,while others are proteins;3)vitamin K is involved in the combination of factor II,IIV,IX,X;4)factor III is a tissue thromboplastin.,2.Coagulation stages,1)formation of prothrombin-converting enzyme凝血酶原激活物的形成).,2)conversion of prothrombin to thrombin(凝血酶的形成).,3)conversion of fibrinogen to fibrin(纤维蛋白的形成).,3.Pathways:,1)intrinsic pathway:,由activation of factor XII 所启动的凝血途径,which is completely finished by the coagulation factors in plasma.,2)extrinsic pathway:,由activation of factor III 所启动的凝血途径XII,XIIa,collagen,HMWK,XI,XIa,Ca,+,IX,IXa,VIIIa Ca,+,PL,II,IIa,I,Ia,XIII,Fibrin polymer,X,Xa,III VIIa Ca,+,PL,Va,Ca,+,PL,PK,Kallikrein,Plasminogen plasmin,(纤溶酶原)(纤溶酶),Activator(纤溶酶原激活物),Fibrin(纤维蛋白),Fibrin degradation products(纤维蛋白降解产物),4.Fibrinolysis(纤维蛋白溶解),inhibitor,5.Prevention of coagulation,1)Antithrombin III:,-globulin,与thrombin结合 thrombin的失活(inactivation),Antithrombin-heperin complex,Effect of Antithrombin,Coagulation factor IXa,Xa,XIa,XIIa,的失活,2)Heparin:,Antithrombin-heparin complex,Effect of antithrombin,3)Protein C:,Vit.K dependent plasma protein,(1)在protein S 的帮助下,使 factor Va,VIIIa失活,(2)使plasiminogen activator 的抑制物失活,4),2,巨球蛋白:与coagulation factor 结合而防止它们的激活,Blood group,1.ABO blood group system,2.Rh blood group system,一、ABO blood group system and Rh blood group system,二、Blood transfusion and cross matching,Rh blood group system,Rhesus monkey,的red blood cell,rabbit,Serum(antibody),80-99%人类的red blood cell,agglutination,出现,agglutination的blood group:Rh positive,不出现,agglutination的blood group:Rh negative,1.Antigen of Rh blood group system,C,c,D,d,E,e.D antigen,的特异性最强,2.,Antibody of Rh blood group system,Anti-C,anti-c,anti-D,anti-E,anti-e antibody.,Hematopoiesis and Hematoclasis,hematopoiesis,