医学生理学课件(血液)-PPT幻灯片

Introduction血液血浆：血细胞电解质（electrocytes)、营养成分(nutrients)、气体(gases)、代谢产物(wasteproducts)、蛋白质（proteins)、水分（water)。RedbloodcellsWhitebloodcellsPlatelets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

andfunctionsofplasma1.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

Plasmacolloidosmoticpressure三、plasmapHpH7.35-7.45血细胞（Bloodcell)一、RedbloodcellMale:(4.5-5.5)×1012/LFemale:(3.8-4.6)×1012/L(2.0-3.0)×106Hb/RBC每一个Hb分子可结合4个O2分子PhysiologicalpropertiesofRBC1、渗透脆性（fragility)2.PlasticdeformationofRBC3.Erythrocytesedimentationrate4.Rouleauxformationoferythrocyte5、红细胞比容（Hematocritvalue）Male:40-50%female:37-48%0.9%NaCl0.7%NaCl0.5%NaCl0.4%NaCl0.3%NaCl0.9%NaClisotonicsolution(physiologicalsaline)hemolysisSuspensionstabilityESR:male3mm,female

10mm二、whitebloodcellWhitebloodcellsPolymorphonuclearneutrophilsPolymorphonucleareosinophilsPolymorphonuclearbasophilsmonocyteslymphocytes4000-10000/mm350-70%2-5%0.5-1%3-8%20-30%Monocytes,Neutrophils(phagocytosis)NonspecificimmunitylymphocytesTcellsBcellsCellularimmunitySmallsensetizedlymphocytesantibobyHumoralimmunityeosinophilsParasiticidalactionbasophilsSecretionofheparin三、platelet（100-300）×109/Lhemostasis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：localvasoconstriction(局部小血管收缩）,formationofplateletplug(血小板栓子的形成）,bloodcoagulation(血液凝固）,fibrinolysisandpreventionofcoagulation(纤维蛋白溶解和抗凝）一、LocalvasoconstrictionresponseTransientlydelayorstopbleeding(暂时延缓或停止blood的流动)Numerousinfluencesmaycausevasoconstriction:1.Excitationofsympatheticnerve:2.Releaseof5-HT,TXA2,ETetc.二、FormationofplateletplugAdhesionandaggregation内皮细胞（vWfactor)ReceptorsonplateletsPlateletadhesionAggregation(ADP,NEand5-HT)ReleaseofADP,ATP,5-HT,K+,plateletfactor3,TXA&lysosomalenzymeContractilefunction三、Bloodcoagulation1.Coagulationfactor1)用罗马字I-XIII表示，共12种和PK,HMWK,PL等;2）thefactorIViscalcium,PLisalipid,whileothersareproteins;3)vitaminKisinvolvedinthecombinationoffactorII,IIV,IX,X;4)factorIIIisatissuethromboplastin.2.Coagulationstages1)formationofprothrombin-convertingenzyme(凝血酶原激活物的形成).2)conversionofprothrombintothrombin(凝血酶的形成).3)conversionoffibrinogentofibrin(纤维蛋白的形成).3.Pathways:1)intrinsicpathway:由activationoffactorXII所启动的凝血途径,whichiscompletelyfinishedbythecoagulationfactorsinplasma.2)extrinsicpathway:由activationoffactorIII所启动的凝血途径。XIIXIIacollagenHMWKXIXIaCa++IXIXaVIIIaCa++PLIIIIaIIaXIIIFibrinpolymerXXaIIIVIIaCa++PLVa,Ca++,PLPKKallikreinPlasminogenplasmin(纤溶酶原)(纤溶酶)Activator(纤溶酶原激活物)Fibrin(纤维蛋白)Fibrindegradationproducts(纤维蛋白降解产物)4.Fibrinolysis(纤维蛋白溶解)inhibitor5.Preventionofcoagulation1)AntithrombinIII:-globulin,与thrombin结合thrombin的失活(inactivation)Antithrombin-heperincomplexEffectofAntithrombinCoagulationfactorIXa,Xa,XIa,XIIa的失活2)Heparin:Antithrombin-heparincomplexEffectofantithrombin3)ProteinC:Vit.Kdependentplasmaprotein,(1)在proteinS的帮助下,使factorVa,VIIIa失活(2)使plasiminogenactivator的抑制物失活4)2巨球蛋白:与coagulationfactor结合而防止它们的激活Bloodgroup1.ABObloodgroupsystem2.Rhbloodgroupsystem一、ABObloodgroupsystemandRhbloodgroupsystem二、BloodtransfusionandcrossmatchingRhbloodgroupsystemRhesusmonkey的redbloodcellrabbitSerum(antibody)80-99%人类的redbloodcellagglutination出现agglutination的bloodgroup:Rhpositive不出现agglutination的b