(北医生物化学课件)血液(Blood)

1、血液（Blood)第一节 概述（Introduction)第二节 血浆（Plasma) 第三节 血细胞（Blood cells)第四节 生理止血（Hamostasis)第五节 血型（Blood group)第六节 造血和血细胞的破坏（Hematopoiesis and Hematoclasis)血液（Blood)第一节 概述（Introduction)第Introduction 血液血浆：血细胞电解质（electrocytes)、营养成分(nutrients)、气体(gases)、代谢产物(waste products)、蛋白质（proteins)、水分（water)。Red blood ce

2、llsWhite blood cellsPlatelets一、血液的基本组成Introduction 血液血浆：血细胞电解质（elect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)二、血液的功能1、运输作用（Transportation)4(北医生物化学课件)血液(Blood)(北医生物化学课件)血液(Blood)H2OH2OPlasma crystal osmotic pressure 细胞内外的水分交换而维持细胞的正常形态和功能H2OH2OPlasma crystal osmotic

3、p:血管内外的水分交换 Plasma colloid osmotic pressure:三、plasma pHpH 7.35-7.45血细胞（Blood cell)一、Red blood cellMale: (4.5-5.5)1012/L Female:( 3.8-4.6)1012/L(2.0-3.0)106 Hb/RBC每一个Hb分子可结合4个O2分子三、plasma pHpH 7.35-7.45血细胞（BloPhysiological properties of RBC1、渗透脆性（fragility)2.Plastic deformation of RBC3.Erythrocyte se

4、dimentation rate4. Rouleaux formation of erythrocyte5、 红细胞比容（Hematocrit value）Male:40-50% female: 37-48%Physiological properties of RB0.9%NaCl0.7%NaCl0.5%NaCl0.4%NaCl0.3%NaCl0.9% NaCl isotonic solution (physiological saline)hemolysis0.9%NaCl0.7%0.5%NaCl0.4%NaCl0.Suspension stabilityESR: male 3mm, fe

5、male 10mmSuspension stabilityESR: male 二、white blood cellWhite blood cellsPolymorphonuclear neutrophils Polymorphonuclear eosinophilsPolymorphonuclear basophilsmonocyteslymphocytes4000-10000/mm350-70%2-5%0.5-1%3-8%20-30%二、white blood cellWhite blood Monocytes, Neutrophils(phagocytosis)Nonspecific im

6、munitylymphocytesT cellsB cellsCellular immunitySmall sensetized lymphocytesantibobyHumoral immunityeosinophilsParasiticidal actionbasophilsSecretion of heparinMonocytes, Neutrophils(phagocy三、platelet（100-300）109/ Lhemostasis三、platelet（100-300）109/ Lhemo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

7、钟后自行停止。包括：local vasoconstriction(局部小血管收缩）,formation of platelet plug(血小板栓子的形成）, blood coagulation(血液凝固）, fibrinolysis and prevention of coagulation(纤维蛋白溶解和抗凝）生理止血（Hemostasis)生理止血：正常人血管受损伤后一、Local vasoconstriction responseTransiently delay or stop bleeding(暂时延缓或停止blood的流动)Numerous influences may caus

8、e vasoconstriction:1. Excitation of sympathetic nerve:2. Release of 5-HT, TXA2, ET etc.一、Local vasoconstriction respo(北医生物化学课件)血液(Blood)二、Formation of platelet plugAdhesion and aggregation内皮细胞（vW factor)Receptors on plateletsPlatelet adhesionAggregation(ADP,NE and 5-HT)Release of ADP, ATP, 5-HT, K+,

9、 platelet factor 3,TXA & lysosomal enzymeContractile function二、Formation of platelet plugAd三、Blood coagulation1. Coagulation factor1)用罗马字 I-XIII表示，共12种和PK,HMWK, PL等 ; 2）the factor IV is calcium,PL is a lipid,while others are proteins; 3)vitamin K is involved in the combination of factor II, IIV, IX,

10、 X; 4) factor III is a tissue thromboplastin.三、Blood coagulation1. Coagulat(北医生物化学课件)血液(Blood)2. Coagulation stages1)formation of prothrombin-converting enzyme(凝血酶原激活物的形成).2)conversion of prothrombin to thrombin(凝血酶的形成).3)conversion of fibrinogen to fibrin(纤维蛋白的形成).2. Coagulation stages1)formati3. P

11、athways:1) intrinsic pathway:由activation of factor XII 所启动的凝血途径, which is completely finished by the coagulation factors in plasma.2) extrinsic pathway: 由activation of factor III 所启动的凝血途径。3. Pathways:1) intrinsic pathwXIIXIIacollagenHMWKXIXIaCa+IXIXaVIIIa Ca+ PLIIIIaIIaXIIIFibrin polymerXXaIII VIIa

12、Ca+ PLVa, Ca+, PLPKKallikreinXIIXIIacollagenHMWKXIXIaCa+IXPlasminogen plasmin(纤溶酶原) (纤溶酶)Activator(纤溶酶原激活物)Fibrin(纤维蛋白)Fibrin degradation products (纤维蛋白降解产物)4. Fibrinolysis(纤维蛋白溶解)inhibitorPlasminogen plasminA5. Prevention of coagulation1)Antithrombin III: -globulin, 与thrombin结合 thrombin的失活(inactiva

13、tion)Antithrombin-heperin complexEffect of AntithrombinCoagulation factor IXa, Xa, XIa, XIIa的失活5. Prevention of coagulation1)2) Heparin:Antithrombin-heparin complexEffect of antithrombin3) Protein C:Vit. K dependent plasma protein,(1) 在protein S 的帮助下, 使 factor Va, VIIIa失活(2) 使plasiminogen activator

14、的抑制物失活 2) Heparin:Antithrombin-hepari4)2 巨球蛋白:与coagulation factor 结合而防止它们的激活4)2 巨球蛋白:与coagulation factor Blood group1. ABO blood group system2. Rh blood group system一、ABO blood group system and Rh blood group system二、Blood transfusion and cross matching Blood group1. ABO blood group(北医生物化学课件)血液(Bloo

15、d)(北医生物化学课件)血液(Blood)(北医生物化学课件)血液(Blood)Rh blood group systemRhesus monkey的red blood cellrabbitSerum (antibody)80-99%人类的red blood cellagglutination出现agglutination的blood group: Rh positive不出现agglutination的blood group: Rh negativeRh blood group systemRhesus mo1. Antigen of Rh blood group systemC, c, D,d, E,e. D antigen 的特异性最强2. Antibody of Rh blood