资源描述
,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,血液和血细胞的发生,Blood and,Hematopoiesis,血液和血细胞的发生Blood and Hematop,1,血 液,Blood,血 浆,plasma,:55%,红细胞,白细胞,血小板,Platelets,血浆,白细胞，血小板,红细胞,血细胞,血液不加抗凝剂即凝固成块，周围析出的淡黄色清明液体。,血清 serum:,组成:,血 液 Blood血浆白细胞，血小板红细胞血细胞血液不加,2,血象,hemogram,定义：是血细胞,形态、数量、比例及血红蛋白含量,的测定。,血涂片的常用染色方法是,Wright,或Giemsa,染色。,意义：血象的变化是多种疾病诊断、预后及治疗效果的重要指标。,。,血象 hemogram 定义：是血细胞形态、数量、比例及血,3,血 细 胞,红细胞,femal,(,3.55.5)*10,12,/L,mal,（,4.0-5.5）*10,12,/L,白细胞,（410）10,9,/L,血小板,（100300）10,9,/L,中性粒C,有粒白细胞 嗜酸性粒C,嗜碱性粒C,无粒白细胞 淋巴细胞,单核细胞,血 细 胞 红细胞 中,4,红细胞 erythrocyte,red blood cell,大小：,形状：双凹圆盘状。,结构特点：无核，无细胞器,内含物：充满血红蛋白(Hb),红细胞骨架:,红细胞 erythrocyte,red blood c,5,HB正常值：,血型：,血影,:,HB正常值：,6,临床联系 Medical Application,A decreased number of erythrocytes in the blood is usually associated with,anemia（贫血）.,An increased number of erythrocytes(,erythrocytosis,or,polycythemia红细胞增多症),may be a physiologic adaptation.Polycythemia which is often associated with diseases of varying degrees of severity,increases blood viscosity;Polycythemia might be better characterized as an increased hematocrit红细胞压积.Erythrocytes with diameters greater than 9,m are called,macrocytes,and those with diameters less than 6,m are called,microcytes.,临床联系 Medical Application,7,网织红细胞,（reticulocyte),骨髓进入血液的未完全成熟的红细胞。用煌焦油蓝染色网织红细胞内有染成蓝色的颗粒或细网，是残留的核糖体。网织红细胞进入外周血13天后，核糖体完全消失。,网织红细胞计数常作为判断骨髓造血能力的重要指标。成人0.5-1，新生儿高达3-6。,人血涂片示网织红细胞 (煌焦油蓝染色),网织红细胞（reticulocyte)骨髓进入血液的未完全成,8,白细胞,(leukocytes,white blood cell,WBC),WBC,有粒细胞,无粒细胞,中性粒细胞,嗜酸性粒细胞,嗜碱性粒细胞,淋巴细胞,单核细胞,分类依据：,根据细胞质内有无特殊颗粒和颗粒的嗜色性,。,白细胞(leukocytes,white blood c,9,中性粒细胞,neutrophil（50%70%）,直 径：,细胞核：,胞 质:,两种特殊颗粒,（嗜天青颗粒,特殊颗粒）,核左移（1-2叶）:,核右移（4-5叶）:,功 能：,趋化作用,吞噬功能,中性粒细胞 neutrophil（50%70%）直,10,嗜酸性粒细胞,eosinophil（0.5%5%),核多2 叶，胞质内充满粗大的鲜红色嗜酸性颗粒，含,组胺酶、芳基硫酸酯酶、阳离子蛋白、过氧化物酶等。,功能：抑制过敏反应,杀灭寄生虫。,嗜酸性粒细胞 eosinophil（0.5%5%)核,11,3.嗜碱性粒细胞,basophil,（01%）,形态：,细胞质：,细胞核,功能：,与,肥大细胞,相似参与过敏反应,3.嗜碱性粒细胞 basophil（01%）形态：,12,三种有粒白细胞比较,中性粒细胞,嗜酸性粒细胞,嗜碱性粒细胞,直 径,细胞核,胞 质,正常值,和寿 命,功 能,三种有粒白细胞比较中性粒细胞嗜酸性粒细胞嗜碱性粒,13,淋巴细胞 lymphocyte（20%40%),T 细胞,B 细胞,NK 细胞,形态：胞质嗜碱性；,核圆形，占细胞的大部分。,根据发生部位、表面特征、免疫功能和寿命不同可分类为：,分类：,淋巴细胞 lymphocyte（20%40%),14,单核细胞,monocyte 3%8%,形态：,细胞表面微绒毛,胞质内有吞噬泡,颗粒有溶酶体样结构,功能：,参与免疫,单核细胞 monocyte 3%8%形态：,15,两种无粒白细胞比较,单核细胞,淋巴细胞,大小,细胞核,功能,两种无粒白细胞比较单核细胞淋巴细胞大小细胞核功能,16,血小板,（LM）,Blood platelet,血小板,（EM）,Blood platelet,特殊颗粒、致密颗粒、溶酶体,血小板（LM）血小板（EM）特殊颗粒、致密颗粒、溶酶体,17,血小板platelet,功能：,止血和凝血.,血管受,损破裂,血栓,血小板,黏附,血块,纤维蛋白原,纤维蛋白,血小板platelet血管受血栓血小板血块纤维蛋白原纤维蛋白,18,临床联系 Medical Application,Hemophilia,（血友病）,A and B are clinically identical,differing only in the deficient factor.Both are due to sex-linked recessive inherited disorders.Blood from hemophiliac patients does not coagulate normally:Persons with this disease bleed severely even after mild injuries,such as a skin cut,and may bleed to death after more severe injuries.The blood plasma of patients with hemophilia A is deficient in clotting factor VIII or contains a defective factor,VIII,;in hemophilia B,the defect is in factor,IX,.In severe cases the blood is incoagulable.Generally,only males are affected by hemophilia A,because the recessive gene to factor VIII is in the X chromosome.Females develop hemophilia only when they have the abnormal gene in both X chromosomes.,临床联系 Medical Application,19,骨髓和血细胞发生,造血器官,胚胎时期造血各器官的演变,6W,4-5M,出生后,卵黄囊肝脾 骨髓,骨髓的结构,红骨髓：造血组织+血窦,黄骨髓:脂肪组织+少量的幼稚血细胞,骨髓和血细胞发生造血器官,20,骨髓光镜结构,造血组织：网状组织+造血细胞,造血诱导微环境,（hemopoietic inductive microenvironment,）：,是造血细胞赖以生长发育的环境。包括：骨髓的神经成分、微血管系统和结缔组织。它们不仅起支架作用，还分泌多种细胞体液因子，调节造血细胞的增殖与分化,。,造血干细胞 hemopoietic stem cell,又称多能干细胞（multipotential stem cell）起源：卵黄囊等处的血岛，出生后主要位于红骨髓、脾和淋巴结，少量于外周血形态：类似小淋巴细胞，即细胞体积小，核相对较大，胞质富含核糖体特性：强增殖潜能 多向分化 自我复制，终身保持数量恒定。,骨髓光镜结构造血组织：网状组织+造血细胞造血干细胞 hemo,21,血细胞发生图,血细胞发生图,22,血细胞发生过程中的形态演变,原始阶段 幼稚阶段 成熟阶段。,1.胞体由大到小,巨核细胞由小到大,2.胞核由大到小;红细胞核最后消失；粒细胞核变成杆状到分叶;巨核细胞核由小变大到分叶;核着色由浅到深。,3.胞质量由少渐多,嗜碱性渐变弱(除淋巴细胞和单核细胞),出现特殊物质。,4.细胞分裂能力从有到无(淋巴细胞除外)。,血细胞发生过程中的形态演变原始阶段,23,临床联系,Medical Application,Growth factors have been used clinically to increase marrow cellularity and blood cell counts.The use of growth factors to stimulate the proliferation of leukocytes is opening broad new applications for clinical therapy.increasing the efficiency of marrow transplants by enhancing cell proliferation;enhancing host defenses in patients with malignancies and infectious and immunodeficient diseases;and enhancing the treatment of parasitic diseases.,Hematopoietic diseases are usually caused by suppression or enhancement of some undifferentiated cell production,with a consequent reduction or overproduction of hematopoietic cells.In some diseases,however,suppression and enhancement of proliferation of more than one type of stem cell can occur,sequentially or simultaneously.,临床联系 Medical Application,24,肌 组 织,Muscle tissue,肌 组 织Muscle tissue,25,米隆：掷铁饼者,肌肉组织的分类,骨骼肌,心肌,平滑肌,特殊名词:,1、肌细胞肌纤维,2、细胞膜肌膜,3、细胞质肌浆,4、SER 肌浆网,米隆：掷铁饼者肌肉组织的分类骨骼肌特殊名词:,26,骨 骼 肌,光镜结构:,胞体：长圆柱状，,胞核:数十至数百个,位周边,胞质：充满肌原纤维，,与肌纤维长轴平行排列，,有周期性横纹,骨 骼 肌光镜结构:,27,肌节,sarcomere,定义:,相邻,2,条,Z,线之间的一段,肌原纤维,，由,1/2,I,带+,A,带+,1/2,I,带构成，是骨骼肌纤维结构和功能的基本单位,暗带（A带）,中央有H 带,
展开阅读全文