文档介绍:急性冠状动脉综合征的
抗凝治疗
北京大学人民医院心内科
许俊堂胡大一
凝血与抗凝
血栓形成的条件
血管壁或者内皮细胞损伤
激活内源或者外源凝血系统
血液流变学因素
血液淤积、流速变慢
血液成分的变化
高凝状态
Diagram of thrombin molecule
Role of thrombin in haemostasis
Coagulation system
Cleave fibrinogen to form fibrin monomer
Activate factor XIII(leading to cross-linked fibrin formation)
Activate factor V and factor VIII(positive feedback loop)
Role of thrombin in haemostasis
Platelet
Direct activation leading to expression of surface GPⅡb/Ⅲa receptor
Induce platelet aggregation
Stimulate release of thromboxane A2 and ADP
Role of thrombin in haemostasis
Vascular wall
Induce leukocyte chemotaxix
Smooth muscle cell mitogenesis
Release of growth factors, cytokines and vasoactive agents, especially PDGF、b-FGF and c-fos
急性冠状动脉综合征的分型及其危险分层