凝血和弥散性血管内凝血课件

,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,REGULATION OF COAGULATION/DISSEMINATED INTRAVASCULAR COAGULATION,嘲钎舅棱屏便值榴活淌愈富屉歼缺鲤锣密瑶挟辽声菱戒跋章往凯站阶惰衬凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,REGULATION OF COAGULATION/DISS,1,REGULATION OF COAGULATION,Introduction,Coagulation necessary for maintenanceof vascular integrity,Enough fibrinogen to clot all vessels,What controls clotting process?,聚毁局礁莫氰婚遭扳来脓浙记圣雄蒜澄爹四凌方绣撼肺眯晚悠冀俗机曰馏凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,REGULATION OF COAGULATIONIntr,2,COAGULATION CASCADE,Va/Xa/PL,VIIIa/IXa/PL,or,VIIa/TF,FXII,FXIIa,TF,FVII,FG,F,HMWK,FXI,FXIa,VIIa/TF,or,FVIIa,Ca,+2,FIX,FIXa,Ca,+2,Ca,+2,Ca,+2,VIII,VIIIa,T,V,Va,T,Ca,+2,FX,FXa,Ca,+2,Ca,+2,PT,T,Common Pathway,Middle Components,Surface Active Components,INTRINSIC PATHWAY,EXTRINSIC PATHWAY,粘杭挽被白八蓟瑶仑涩害囱涣搜史纵焦案沥状罗桨争修昧凑袋大虫捌囱乳凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,COAGULATION CASCADEVa/Xa/PLVII,3,COAGULATION INHIBITORS,Tissue Factor Pathway Inhibitor(TFPI),Lipoprotein Associated Coagulation Inhibitor(LACI)Extrinsic Pathway Inhibitor(EPI),Complexes with Factors VIIa/TF/Xa;inactivates Xa,Antithrombin III/Heparin Cofactor II/Heparin,Binds and Inactivates Enzymes,Protein C/Protein S/Thrombomodulin,Cleaves&Inactivates Cofactors(Va&VIIIa),Plasminogen-3 hemostasis,Cleaves Fibrin,吏熟牲佰狠倍捍卢副萍芋朽额韩诚阴银济呐倚毛品卡碧窗湾坍仔猖身条溺凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,COAGULATION INHIBITORSTissue F,4,ATIII,+,Thrombin,ATIII.Thrombin,Heparin,ANTITHROMBIN III-MECHANISM OF ACTION,犀究莹秋溅想钾缉响左苇蜂针灰韦匈庆赂啼扦契窟境肝擞蚌载宗辙开惜臣凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,ATIII+ThrombinATIII.ThrombinHe,5,PROTEIN C ACTIVATION,Protein C,+,Thrombin,Activated,Protein C,T,T,T,M,Protein C,Activated,Protein C,Thrombin,Thrombomodulin,+,*,*,Ca,捍感单咖跟倔脱剧琼训棒塔徐讥酵盒蝎喇走据碟他公匀卉狞柜好拇丝屠顽凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,PROTEIN C ACTIVATIONProtein C+,6,PROTEIN C-MECHANISM OF ACTION,APC,Factor Va/Factor VIIIa,Pro SPL,iFVa/FVIIIa,笋槽吹悟鲁拨镐毋郁毋趾蝴绚申埃皂根耗布姬肄膜洗鹅咙榴皮先签熄屈疑凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,PROTEIN C-MECHANISM OF ACTIO,7,COAGULATION INHIBITORS,Tissue Factor Pathway Inhibitor(TFPI),Lipoprotein Associated Coagulation Inhibitor(LACI)Extrinsic Pathway Inhibitor(EPI),Complexes with Factors VIIa/TF/Xa;inactivates Xa,Antithrombin III/Heparin Cofactor II/Heparin,Binds and Inactivates Enzymes,Protein C/Protein S/Thrombomodulin,Cleaves&Inactivates Cofactors(Va&VIIIa),Plasminogen-3 hemostasis,Cleaves Fibrin,尖骗军蔫虱乃麦槽筑琶胎落涨血业蛮圾聚眨喜冬缆喜缩思甘饥己桂氟灯允凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,COAGULATION INHIBITORSTissue F,8,ANTICOAGULANT PROTEIN DEFICIENCY,Disease entities,Heterozygous Protein Deficiency,Increased Venous Thrombosis,Occasional Increased Arterial Thrombosis,Warfarin Induced Skin Necrosis,Homozygous Protein Deficiency,Neonatal Purpura Fulminans,Fibrinogenolysis,Chronic DIC,桓押僚守轻呀畏盾宇渐钎共娥消亩悯熄陀爵晶捡呼肝柿辕疯伸迅斑促氢猜凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,ANTICOAGULANT PROTEIN DEFICIEN,9,ANTICOAGULANT PROTEIN DEFICIENCY,Dominant,Increased Venous Thrombosis,Young Age of Thrombosis,No Predisposing Factors to Thrombosis,Increased Thrombin Generation,Positive Family History,Recessive,No history of thrombosis,No family history,Neonatal Purpura Fulminans,Increased Thrombin Generation,首对纳束仿肛瑟砧跳琳阿珊泉开扬辫耕舜爱扛群国绣森陨勾至擂阵涨敝趁凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,ANTICOAGULANT PROTEIN DEFICIEN,10,ACTIVATED PROTEIN C RESISTANCE,1st described by Dahlback,1994,Hallmark:Failure of activated Protein C to prolong aPTT,First noted in screening of plasma samples of patients with increased clotting,Functional defect described before protein defect noted,贱兔傻痢枫豁介曹场廖撩荡误聂伍肺吗臼辙架并它茎吮彰炭户龙幸乳淘谷凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,ACTIVATED PROTEIN C RESISTANCE,11,ACTIVATED PROTEIN C RESISTANCE,Bertina et al described genetic defect,Mutation of Arg 506,Gln,Named Factor V Leiden,Found in 98%of patients with APC Resistance,碾疚寇淌遂狼拾唁房智豺放廊绕痹砸虾轮顺霞使上胜晦唆悄穷睫躯除熬凯凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,ACTIVATED PROTEIN C RESISTANCE,12,ACTIVATED PROTEIN C RESISTANCE,Extremely common(5-20%of Caucasian population with mutation),Increases risk of venous thromboembolism(VTE)c.4x in heterozygous form,more in homozygous,Can exist in combination with other defects(protein C,protein S,ATIII,plasminogen),In combination,has synergistic effect on other anticoagulant protein deficiencies,芋绕毯剥胚戊光湍蝶摊衷怔侦揍挫毫倚乳吏智易仰秤栗广薛嵌独锗迈患隅凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,ACTIVATED PROTEIN C RESISTANCE,13,FACTOR Va INACTIVATION,Factor Va,iFVa,APC,Pro S,PL,PROTEIN C-MECHANISM OF ACTION,狼斟雏指敖荒踏优卡们执屋交焰捆醋台泥肉泻拓不针弱熄拇贤铣始快炊漾凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,FACTOR Va INACTIVATIONFactor V,14,FACTOR VIIIa INACTIVATION,Factor VIIIa,iFVIIIa,APC,Pro S,PL,Factor V,PROTEIN C-MECHANISM OF ACTION,枫溯某厢憾拭短擞束樟捧隙痪熬肌敌潍撤袋控硷罩仙辈邱挡晃兰账敬诽抗凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,FACTOR VIIIa INACTIVATIONFacto,15,HYPERCOAGULABLE STATES,Acquired,Anticardiolipin Syndrome,Malignancy,Immobilization,TTP,DIC,Oral Contraceptive Therapy,Prosthetic Valves,PNH,Myeloproliferative,diseases,Nephrotic Syndrome,Inflammatory Diseases,Atherosclerosis,Surgery,Diabetes mellitus,给泥能湖潞体温总匪甭变湖刮赔舞蜜削撕铸鸭映幻倡棉耸喇输嘉恃立醋广凝血和弥散性血管内凝血ppt课件凝血和弥散性血管内凝血ppt课件,HYPERCOAGULABLE