医学生理学(血液)课件

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)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 cellsWhite blood cellsPlatelets一

2、、血液的基本组成二、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)Plasma一、Components and functions of plasma1. Electrolyte:血浆晶体渗透压2. Protein(1) albumin: 形成血浆胶体渗透压及物质转运(2) globulin：1、2、 globulin,物质转运及特异性免疫(3) fibrinogen：血液凝固二、physicochemical properties of plasma1. Plasma 的比重和粘滞性比重：2.

3、Plasma osmotic pressurePlasma osmotic pressure (313 mOsm)Plasma crystal osmotic pressure (311.5 mOsm)Plasma colloid osmotic pressure ( 1.5 mOsm)粘滞性：1.025-1.0301.6-2.4: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

4、)1012/L(2.0-3.0)106 Hb/RBC每一个Hb分子可结合4个O2分子0.9%NaCl0.7%NaCl0.5%NaCl0.4%NaCl0.3%NaCl0.9% NaCl isotonic solution (physiological saline)hemolysisSuspension stabilityESR: male 3mm, female 10mm二、white blood cellWhite blood cellsPolymorphonuclear neutrophils Polymorphonuclear eosinophilsPolymorphonuclear b

5、asophilsmonocyteslymphocytes4000-10000/mm350-70%2-5%0.5-1%3-8%20-30%三、platelet（100-300）109/ Lhemostasis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

6、白溶解和抗凝）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+, platelet factor 3,TXA & lysosomal enzymeContractile function三、Blood coagulation1. Coagulation factor1)用罗马字 I-XIII表示，共12种和PK,HMWK

7、, 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, X; 4) factor III is a tissue thromboplastin.2. Coagulation stages1)formation of prothrombin-converting enzyme(凝血酶原激活物的形成).2)conversion of prothrombin to throm

8、bin(凝血酶的形成).3)conversion of fibrinogen to fibrin(纤维蛋白的形成).3. Pathways: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。Plasminogen plasmin(纤溶酶原) (纤溶酶)Activator(纤溶酶原激活物)F

9、ibrin(纤维蛋白)Fibrin degradation products (纤维蛋白降解产物)4. Fibrinolysis(纤维蛋白溶解)inhibitor5. Prevention of coagulation1)Antithrombin III: -globulin, 与thrombin结合 thrombin的失活(inactivation)Antithrombin-heperin complexEffect of AntithrombinCoagulation factor IXa, Xa, XIa, XIIa的失活4)2 巨球蛋白:与coagulation factor 结合而防

10、止它们的激活 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 matchingRh 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 negative1. Antigen of Rh blood group syst