組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)課件

1、組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Chapter 4 BloodChapter 4 Blood組組 胚胚 教教 研研 室室: 袁袁 媧媧Department of histology and embryology第一頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Learning Objectives The composition of blood (血液血液). The structure, function and normal values (正常值正常值) of the formed elements of blood(血液有形成血液有形成(xngchng)分分). Hematopoies

2、is (血細胞的發(fā)生血細胞的發(fā)生). The hematopoietic tissue (造血組織造血組織) and the hematopoietic stem cells (造血干細造血干細胞胞) . The production and significance of lymph(淋巴淋巴).第二頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)* a specialized form of C.T.* a circulating tissue* as a transporting medium* a total volume about 5 liters in health adultIN

3、TRODUCTIONINTRODUCTION第三頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Components of blood 血液血液(xuy)的組成成分的組成成分 * Formed elements-blood cells (45%)* Intercellular substance-plasma (55%)Erythrocytes 紅細胞紅細胞Leukocytes 白細胞白細胞Platelets 血小板血小板H2O ( 90% )Plasma proteins: albumin白蛋白白蛋白, globulin球蛋球蛋 白白, fibrinogen纖維蛋白纖維蛋白(xin wi dn

4、 bi)原原, etc.Others:第四頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)血液血液(xuy)的組成的組成centrifugation (離心(lxn) - plasmaLeukocytes + Platelets - Erythrocyte (Red blood cell)anticoagulant (heparin)抗凝劑（肝素抗凝劑（肝素(n s)） 第五頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)血塊血塊(xu kui)、血清、血清Serum 血清血清(xuqng) without anticoagulant Clotting 無無纖維蛋白纖維蛋白(xin wi dn b

5、i)原原第六頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)血液血液(xuy)有形成有形成分分紅細胞：男紅細胞：男 （4.04.05.55.5）10101212/L/L ； 女女 （3.53.55.05.0）10101212/L/L（350-500350-500萬個萬個/ul)/ul) 白細胞白細胞 (4.0(4.010) 10) 10 109 9 /L/L或或 4 4千千-1-1萬個萬個/ul/ul血小板血小板 （100300） 109 /L （或（或10-30萬個萬個/ul） 有粒白細胞有粒白細胞 無粒白細胞無粒白細胞中性中性(zhngxng)(zhngxng)粒細胞粒細胞 50-50-70

6、%70%嗜酸性粒細胞嗜酸性粒細胞 0.5-3%0.5-3%嗜堿性粒細胞嗜堿性粒細胞 0-1%0-1%淋巴細胞淋巴細胞 25-30%25-30%單核細胞單核細胞 3-8%3-8%血液血液(xuy)有形成分正常值有形成分正常值血象血象(hemogram)(hemogram)： 血細胞的形態(tài)、數(shù)量、百分比及血紅血細胞的形態(tài)、數(shù)量、百分比及血紅蛋白的含量蛋白的含量. . 血象是臨床疾病診斷、治療的重要指標。血象是臨床疾病診斷、治療的重要指標。第七頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)WrightWright染色法（瑞特染色法）染色法（瑞特染色法）: :染料是由酸性染料是由酸性(sun xn)(

7、sun xn) GiemsaGiemsa染色法（吉姆薩染染色法（吉姆薩染色法）色法）: :吉姆薩染液由伊紅，吉姆薩染液由伊紅，天青組成。天青組成。 血涂片血涂片 blood smear: blood smear: 觀察血細胞形態(tài)觀察血細胞形態(tài)(xngti)(xngti)染色方法染色方法: Wright : Wright 或或 Giemsa Giemsa染色染色第八頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)一、紅細胞（一、紅細胞（erythrocyte,red blood cell, RBCerythrocyte,red blood cell, RBC） 1.1.結(jié)構(gòu)結(jié)構(gòu)(jigu)(jig

8、u)特點特點 2.2.血型血型 3.3.功能功能 4.4.壽命壽命 5.5.網(wǎng)織紅細胞網(wǎng)織紅細胞第九頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Mature Erythrocyte * biconcave disc shape, providing greater surface area; * no nucleus and organelles; * Hemoglobin ( Hb ); * deformability.SEMSize: 7.5 8.5m (diameter)Number: Male: 4.25.51012/ L (Hb: 120150g/L) Female: 3.55.0

9、 1012/ L (Hb: 110140g/L)第十頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)第十一頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)2 2ABOABO血型抗原血型抗原(kngyun)(kngyun)系統(tǒng)系統(tǒng)：紅細胞膜含血型抗原紅細胞膜含血型抗原 A A型：有型：有A A型抗原型抗原 B B型：有型：有B B型抗原型抗原 O O型：無型：無A A型、型、B B型抗原型抗原 ABAB型：有型：有A A型、型、B B型抗原型抗原3 3功能功能: : 紅細胞具有攜帶紅細胞具有攜帶 O O和和COCO的功能，由血紅的功能，由血紅 蛋白執(zhí)行。蛋白執(zhí)行。 4 4壽命壽命(shumng)(s

10、humng): :紅細胞的平均紅細胞的平均壽命壽命 約為約為120120天。天。 溶血溶血(rn xu) (hemolysis) 血影（血影（erythrocyte ghost）:溶血后殘留溶血后殘留 的紅細胞膜囊。的紅細胞膜囊。第十二頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué) * not fully mature RBC * 0.5 1% of a total number of RBC * no nucleus * ribosomal RNA remnants (netlike structure) * remaining Hb synthesis * Clinic significa

11、nce ReticulocyteReticulocyte網(wǎng)織紅細胞網(wǎng)織紅細胞 第十三頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Pathological conditionsNumberSizeShape HbAnemia貧血貧血(pnxu) Erythrocytosis紅細胞增多紅細胞增多(zn du)癥癥 Spherocytosis; Sickle cell anemiaThalassemia（地中海貧血（地中海貧血(pnxu)）Large / small cell anemia第十四頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué) Sickle-cell anemia is a pain

12、ful disease in which RBCs become crescent shaped due to inheritance of an abnormal type of hemoglobin. Sickled RBCs break down, releasing hemoglobin into the circulation. 第十五頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Normal RBC Sickled RBC 鐮狀鐮狀第十六頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)第十七頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Typically, the affected

13、RBCs are small, spherically shaped, and lack the light centers seen in normal RBCs. Spherocytosis第十八頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)General characteristic of leukocytes* spherical shape * posses nuclei * presence of organelles * a total number less than that of erythrocytes * exhibiting amoeboid movement* in

14、volving in body defenses and immunity二、白細胞（二、白細胞（leukocyte, white blood cell，WBC）第十九頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué) 第二十頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Classification*Granular leukocytes 有粒白細胞有粒白細胞neutrophils 50 70% 中性中性(zhngxng)粒細胞粒細胞eosinophils 0.5 3% 嗜酸性粒細胞嗜酸性粒細胞basophils 0 1% 嗜堿性粒細胞嗜堿性粒細胞*Agranular leukocytes 無粒白

15、細胞無粒白細胞lymphocytes 25 30% 淋巴細胞淋巴細胞monocytes 3 8% 單核細胞單核細胞第二十一頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué) Neutrophil Size : 10 12 m (diameter) Morphology 形態(tài)形態(tài)(xngti) nucleus：highly morphonuclear rod-like 2-3 lobulated 4-5 lobulated young old cytoplasm：specific granules: 80%, smallazurophilic granules: 20%, lysosome 溶酶體N

16、eutrophils 中性中性(zhngxng)粒細胞粒細胞 (嗜天青嗜天青(tinqng)顆粒顆粒)第二十二頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)第二十三頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)中性中性(zhngxng)粒細胞粒細胞 （血涂片）（血涂片）Lobulated nuclei Rod-like nucleusazurophilic granules* fine, uniform細細膩，均勻膩，均勻(jnyn) * evenly distributed* pink stainingCharateristics of specific granules:第二十四頁，共五十

17、六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Specific granules (80%, samll) contain:alkaline phosphatase堿性堿性(jin xn)磷酸酶磷酸酶 * Phagocytin 吞噬素吞噬素* lysozyme 溶菌酶溶菌酶Azurophilic G. (large, less) containing:acid phosphatase 酸性酸性(sun xn)磷酸酶磷酸酶* Peroxidase 過氧化物酶過氧化物酶Neutrophil (EM)第二十五頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Chemotaxis (Mobility) 趨化性趨化性

18、: Attracted by chemotactic factor (released by macrophages)Phagocytosis & destroy bacteria: 吞噬吞噬(tnsh)和殺滅細菌和殺滅細菌 the number of leukocytes acute the % of neutrophils bacteria infection 第二十六頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Size: 10 12 m (diameter)LM:nucleus: lobulated; S or irregular; obscured outlinecytopl

19、asm: basophilic granules* variable size* uneven distribution* strong basophiliaCharacteristicBasophil 嗜堿性嗜堿性(jin xn)粒細胞粒細胞第二十七頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué) Basophil E.M.: Basophilic granules contain:* heparin * histamine F.N.: * anticoagulate * responsible to allergic reactionnucleus第二十八頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液

20、-雙語教學(xué)Size: 10 15 m (diameter)LM:- usually bilobed nucleus- eosinophilic granules * strong eosinophilia (reddish)* coarse and refractile * uniform size and evenly distributedEosinophils 嗜酸性嗜酸性(sun xn)粒細胞粒細胞Characteristic第二十九頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)（電鏡）（電鏡）Eosinophilic granules ( primary lysosomes ) wh

21、ich contain substances: * acid phosphatase* aryl sulphatase 芳基硫酸酯酶芳基硫酸酯酶* Peroxidase * histaminase 組胺組胺(z n)酶酶nucleusEosinophilic granules with crystalloid in the center(EM)第三十頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Chemotaxis（趨化性）（趨化性） attracted by chemotactic factor from the mast cells Phagocytize（吞噬（吞噬(tnsh)） for

22、eign bodies, Ag-Ab complexAnti-allergy （抗過敏）（抗過敏） Release histaminase，inactivate histamine for weakening allergic reactionAnti-parasite （抗寄生蟲）（抗寄生蟲） It is increased in patients infected w/ allergic reaction or parasite 第三十一頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Neutrophils: * ruffled membrane movement* chemetaxis*

23、phagocytosis Eosinophils: anti-parasite; anti-allergy Basophils: * anticoagulation;* involving in allergic responseFunction of granular leukocytes第三十二頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Size: 14 20 m (diameter)Nucleus: large, eccentric, light staining, deep indentation, horseshoe cytoplasm： abundant，gray-blue st

24、aining, weak basophilia, numerous purple granules (azurophilic G)Monocyte 單核細胞單核細胞第三十三頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)第三十四頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Small pseudopodia , microvillus, mitochondrionRER,Lysosomes (azurophilic granule) contain:* Peroxidase * Acid phoshpatase * Lysozyme 溶菌酶溶菌酶 (EM模式圖）模式圖）nucleusMonocy

25、te under EM第三十五頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Function of monocyte - differentiate into macrophages.- phagocytosis- immune response- give rise to osteoclasts 破骨細胞,- which are able to dissolve bone. 第三十六頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)3 types: small 68m;medium-sized 912m;large 1320mSmall lymphocyte(90%): LM: Round or

26、 ovoid; Nu.: sphericity, indentation, condensed chromatin, darkstaining. Cytoplasm: scanty, as a thinrim in light-blue w/ azurophilicgranules 第三十七頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)* a large number of free ribosomes, * a few mitochondria, and other organelles * exhibiting small cytoplasmic projections in the su

27、rface of cells.(EM模式圖）nucleusLymphocyte under EM第三十八頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué) Classification* function# T-Cell: 75% cellular immunity B-Cell: 10-15% humoral immunity large granule lymphocyte (K & NK cell)* based on the source, characteristics on cellular membrane, life & function# immunologica

28、l defence Classification & Function第三十九頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)三、血小板三、血小板 （ blood platelet, thrombocyte ）Megakaryocyte s fragment, in clumpsLM: 24m，disc-likeor irregular, anucleated. Two regions: Granulomere: centrally-located, purple-blue granules. Hyalomere: peripherallylocated, in light-blue.第

29、四十頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué) cell coat: rich inglycoproteins associated to platelet adhesion; M.T. system: a. opening tubule system開放開放(kifng)小管系統(tǒng)小管系統(tǒng): to increase the surface area for platelet adhesion. b. dense tubule system致密小管系統(tǒng)致密小管系統(tǒng): sER , support, collect Ca 2+ and synthesize prostaglandin 前列腺素前

30、列腺素E.M.:第四十一頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué) actin-like M.F 微絲微絲: mobile. granules: a. granules (special granules): containing platelet derived growth factor, PDGF; thrombospondin. b. dense granules致密致密(zhm)顆粒顆粒: serotonin (5-HT), ADP, ATP, Ca2+ & adrenaline 腎上腺素腎上腺素第四十二頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Hemostasia

31、止血止血(zh xu): 2. Coagulation 凝血凝血:3. Protect blood vessel endothelium, repairing endothelium, prevent atherosclerosis(動脈硬化動脈硬化)第四十三頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Slides review第四十四頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)第四十五頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)五、骨髓五、骨髓( su)和血細胞的發(fā)生和血細胞的發(fā)生（ bone marrow and hematopoiesis ）lHematopoietic organ

32、 造血器官造血器官(qgun) yolk sac卵黃囊卵黃囊 （early embryo) Liver肝肝 / spleen脾脾 (6w5m) bone marrow骨髓骨髓 (4m and after)Structure of bone marrow 骨髓的結(jié)構(gòu)骨髓的結(jié)構(gòu) red bone marrow: hematopoietic tissue 造血組織造血組織 + blood sinusoid 血竇血竇 yellow bone marrow: adipose tissue 脂肪組織脂肪組織 + immature hemocyte 血細胞血細胞第四十六頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-

33、雙語教學(xué) hematopoietic tissue: 造血造血(zo xu)組織組織 reticular c.t. + +hemocytes in various stage, macrophages, adipocytes, mesenchymal cells blood sinusoid: 血竇血竇 discontinuous endothelia,incomplete BM第四十七頁，共五十六頁。組織學(xué)與胚胎學(xué)-血液-雙語教學(xué)Hemopoietic stem cell self-replication powerful proliferationpotency multi-differentiation Potency Hemopoietic progenitor c.Unipotential or bipotential Produce matrue blood c. Erythrocytes series granulocyte series monocyte series megakar