蘿卜家園-Chapter6Blood血液.ppt

Chapter 6 Blood 血液,Section 1 Body Fluid and Blood (體液與血液) Body fluid(體液): Fluid of existing in body 人體內(nèi)的液體 Intracellular fluid 40% Blood plasma(血漿) 4% Tissuefluid(組織液) 15% Extracellular fluid 20% Lymph (淋巴) 1% Cerebrospinal fluid (腦脊液),Body fluid,機(jī)體內(nèi)環(huán)境,1. Components of blood (血液的基本組成),(1) Plasma (血漿) Water 水 Substance crystal (晶體物質(zhì)): inorganic phosphate (無機(jī)鹽) 5320mmHg Substance colloid (膠體物質(zhì)) Others 其它,Functions of plasma protein 血漿蛋白的功能:,Albumin(白蛋白): Forming colloid osmotic pressure (形成膠體滲透壓) Globulin(球蛋白): Taking part in body immunity and transport of some substances (參與機(jī)體免疫和某些物質(zhì)的運(yùn)輸) Fibrinogen(纖維蛋白原) : Taking part in clotting (參與凝血),(2) Blood cell 血細(xì)胞,Erythrocyte, or red blood cell, RBC (紅細(xì)胞),modality (形態(tài)): Function ：Transporting O2 and CO2 Cushioning pH (緩沖PH) Quantity: Male ： 5 1012/L Female: 4.2 1012/L Lifespan and produce (壽命與生成）,Neural regulation神經(jīng)調(diào)節(jié) : Sympathetic nerve (+) 交感神經(jīng) (+) Humoral regulation體液調(diào)節(jié): Erythropoietin ,EPO （促紅細(xì)胞生成素 ） Accelerating system ahaemale progenitor of later period to differentiate and propagate. 促進(jìn)晚期紅系祖細(xì)胞的分化、增殖 Accelerating young RBC to differentiate and propagate. 加速幼RBC增殖,分化,CFU-E 紅系前體細(xì)胞red progenitor RBC,Blood oxygen partial pressure 血氧分壓,腎 主 Kidney (main) 肝 次 Liver (secondary),Androgen雄性激素 Stimulating bone marrow, promoting RBC 直接刺激骨髓，促進(jìn)RBC生成 Promoting kidney to produce EPO 促進(jìn)腎臟產(chǎn)生EPO,Leukocyte, or white blood cell, WBC (白細(xì)胞) basophoil(嗜堿性顆粒細(xì)胞)0-1% granular cell eosinophil(嗜酸性顆粒細(xì)胞)1-4% Leukocyte 顆粒細(xì)胞 neutrophil(嗜中性顆粒細(xì)胞)50-70% 白細(xì)胞 lymphocyte(淋巴細(xì)胞)20-40% no granular cell 無顆粒細(xì)胞 monocyte(單核細(xì)胞) 1-7% Quantity : 4-10 109/L,Function of basophil 嗜堿性粒細(xì)胞功能：, Releasing heparin stimulating decomposition of blood fat 釋放肝素 激活血脂分解 Releasing histamine hypersensitive response 釋放組織胺 過敏反應(yīng) Releasing eosinophile chemotactic factor A,限制,(釋放嗜酸性粒細(xì)胞趨化因子A),Function of eosinophil 嗜酸性粒細(xì)胞功能：, Restricting hypersensitive response caused by basophil and fat cells. (限制嗜堿性粒細(xì)胞和肥大細(xì)胞引起的過敏反應(yīng).) Taking part in immune response for worm. (參與對蠕蟲的免疫反應(yīng).),Function of neutrophil 中性粒細(xì)胞功能：, Englobing and killing bacteria (吞噬、殺滅細(xì)菌) Clearing away immunity complex and necrosis tissue (清除免疫復(fù)合物及壞死組織),Lymphocyte (淋巴細(xì)胞),T cell : Function of cell-mediated immunity 具有細(xì)胞免疫功能 Function of regulating other immunocyte 調(diào)節(jié)其他免疫細(xì)胞的功能 B cell ：Taking part in humoral immunity. 參與體液免疫 NK cell ：Killing and wounding tumor cell. 殺傷腫瘤細(xì)胞,Mononuclear macrophage單核-巨噬細(xì)胞, Englobing and killing pathogenic microorganism in cell. (吞噬、消滅細(xì)胞內(nèi)致病微生物) Releasing many kinds of cytotoxic, interferon(INF) , interleukin(IL) and taking part in body defense. (釋放多種細(xì)胞毒、干擾素和白細(xì)胞介素，參與機(jī)體防衛(wèi)機(jī)制) Producing factors of promoting endothelial cell (內(nèi)皮細(xì)胞)and smooth muscle cell. (產(chǎn)生促進(jìn)內(nèi)皮細(xì)胞和平滑肌細(xì)胞的因子),Platelet or thrombocyte (血小板),Quantity ：100-300（109個/L） Function : Keeping vessel wall completeness. 維護(hù)血管壁完整性 Taking part in physiological hemostasis 參與生理止血（見后）,Section 2 Function of blood 血液的機(jī)能,1.Function of carrying and integrating (運(yùn)載作用和聯(lián)系作用) Water, Red blood cells, plasma protein,2.Keeping stability of internal environment (維持內(nèi)環(huán)境的穩(wěn)定) HL + Na HCO3 NaL + H2CO3 H2CO3 H2O + CO2 Stimulus respiration OH- + H2CO3 HCO3- + H2O,3. Function of defense and protection (防御和保護(hù)作用),neutrophil 中性粒細(xì)胞 Phagocytosis 吞噬作用 monocyte 單核細(xì)胞 cellular immunity 細(xì)胞免疫 T Immunity humoral immunity 體液免疫 B,Section 3 Blood volume, Blood Transfusion and Blood Groups 血量 輸血 和血型,1.Blood volume (血量) Blood volume 血量：It is total of blood in body ，7-8% of body weight,Preserving blood volume 血量的維持： Less blood loss 少量失血, 20%， Clinical symptom (臨床癥狀) The most blood loss 大失血 30%, Blood transfusion (輸血),Recovery blood volume 血量的恢復(fù): Water, saltplasma protein blood cell 水,鹽血漿蛋白血細(xì)胞,2. Blood group (血型),Agglutination (紅細(xì)胞凝集): It is the a bunch of irregular cell agglutinates which is agglutinated by Red blood cell.(紅細(xì)胞彼此凝集成一簇簇不規(guī)則的細(xì)胞團(tuán).) Rouleaux formation (紅細(xì)胞疊連): The red blood cells which are attach hollow side to each other overlapped to accelerate blood sank.(紅細(xì)胞彼此以凹面相貼,重疊在一起使血沉加速.),Agglutinogen of red blood cells agglutinin of blood serum blood group 紅細(xì)胞上的凝集原 血清中的凝集素 血型 A B A B A B AB AB AB O,3. Principle of blood transfusion (輸血原則),Red blood cell Red blood cell Blood donor Blood recipient 供血者 受血者 Blood serum血清 Blood serum血清 Cross-match test (交叉配血實驗),主側(cè),次側(cè),Section4 Blood Coagulation and Fibrillarin Dissolution 血液凝固和纖維蛋白溶解,1. Hemostasis mechanism of small blood vessel impairment小血管損傷的生理止血機(jī)制,Hemostasis生理止血 : It is a kind of phenomena that small blood vessel is impaired normally and after several minutes bleeding was stopped naturally. 正常時小血管損傷出血，經(jīng)數(shù)分鐘后出血自然停止的現(xiàn)象。 Process：Small blood vessel contraction小血管收縮 Platelet thrombus血小板血栓 hematopexis血凝 Fig 6-7,2. Blood coagulation (血液凝固),Blood coagulation (血液凝固) : It is a process that blood changes fluidity into solid agglomeration. 血液由液體狀態(tài)變?yōu)椴涣鲃拥哪z凍狀凝塊的過程. Serum (血清): It is a kind of fluid which is generated by blood clot retraction after hematopexis. 血凝后，血凝塊回縮釋出的液體。,(1) Process of blood coagulation凝血過程, a step 1 prothrombin activator凝血酶原激活物 +PF3 step 2 a step 3 a,Activator of factor X,Activation pathway of factor X 因子的激活途徑：,Intrinsic pathway(內(nèi)源性激活途徑 ): It is a process that blood coagulation factor of plasma activated factor X. 完全由血漿內(nèi)凝血因子激活因子的過程。 Extrinsic pathway(外源性激活途徑 ): It is a process that factor activated factor . 由因子觸發(fā)激活因子的過程。,Intrinsic pathway內(nèi)源性途徑 Extrinsic pathway外源性途徑 Blood vessel is damaged Tissue is damaged. Platelet,Collagen was revealed Releasing blood coagulation factor +Ca2+ a Prothrombin activator Prothrombin activator (a , ,Ca2+, phospholipid ) Thrombin Fibrinogen Fibrillarin,a,粘著 聚集,(2) Acceleration and delay of processes of blood coagulation 凝血過程的加速與延緩,Acceleration: Abnormal surface ;異常表面 Heat 加熱 Delay: Smooth surface ;光滑表面 Defibrination 去纖維蛋白 Decalcium 去