培训课件-易栓症——神内病例.pptVIP

* * * The balance hangs down * In Western Countries, the incidence of VTE is approximately 1 per one thousand persons per year, but it varies among different populations. As you can see, the incidence of DVT is definitely lower in Asians than in other ethnic groups. Not only incidence of DVT either idiopathic or secondary to various transient risk factors such as … but this study showed that also mortality rate from PE appears to be markedly lower in asian/pacific Islanders than in African Americans and whites. * * * * Such prevalences are similar all over the world, with no substantial ethnic differences. Actually there is a small study published in 1994 in TH which showed a much higher prevalence of the three deficiencies up t0 10-20% in 52 Hong Kong Chinese with VTE, but due to the small sample size and mostly to the lack of confirmation of the inheritance of the deficiencies with the family study in many of those patients, its results can not be considered conclusive. * * * * * 2.Cancer procoagulant activated directly factor X. Is expressed in blasts fron patients with ANLL. TNF stimulate production of TF 4. In a cohort of patients with idiopathic VTE who were followed for 2 years, 8% of patients developed cancer. Pancreas, lung, stomach, breast, ovarian, gliomas …………… * * * 易栓症 Normal hemostasis（止血） VII VII TF-VIIa X Xa II IIa Fbgn Fibrins IX TF Fibrinp VIII V TF TF-VIIa IXa adhesion 粘附 aggregation 聚集 coagulation pathway 凝血途径 Coagulation balance anticoagulant mechanisms procoagulant mechanisms fibrin formation VIIa Xa , IXa Ca2+ VIIa IIa TM+ IIa VIIa IIa Coagulation waterfall Precallicrein a XII XIIa XI XIa IX IXa TF X Xa VIIIa Va II IIa Fibrin clot XIIIa XIII Chininogen Protein C APC PS Inhibition IIa V VIIa VII Callicrein Fibrinogen Plasminogen PAI-1 Plasmin VIII TFPI Antithrombin APC inhibitor Ca2+ Ca2+ Ca2+ Ca2+ Fibrin monomer Endothelial cell surface coagulation factors anticoagulant proteins gain-of-function mut