Transcript 10월-2일_혈액학_특강

거핵구(Megakaryocytic)
Thrombocyte(Platelets )
Platelet Satelitism (혈소판 위성현상)
EDTA
Pseudothrombocytopenia
1) Adhesion (점착능)
GpIa
GpIIb GpIIIa
GpIb
Platelet
membrane
Adhesion site
Aggregation, vWF and
fibrinogen binding site
vWF
VIII
Collagen binding site
Subendothelium(collagen myofibrils)
2)
(응집능)
Platelet Function Test
Aggregation test
광선투과율(%)
정상
정상
PPP
Ristocetin
(1.2ug/ml)
EPI(3mM)
경증
vWD
방출이상
PRP
혈소판무력증
0
1
2
3
4
5(min)
중증 vWD
0
1
2
3
4
정상
정상
Collagen
ADP(3uM)
(1:200)
방출이상
방출이상
혈소판무력증
0
1
2
5(min)
3
4
5(min)
혈소판무력증
0
1
2
3
4
5(min)
(방출능)
3)
, ATP, Serotonin, Ca
vWF
4) Clot retraction (혈병수축능)
정상
Normal
저하
Decreased
불량
Poor
5) Coagulation
support
5) Coagulation support
Platelet Function Test
BT (Duke)
Platelet Function Test
BT (Ivy)
40mmHg
Platelet Function Test
80mmHg
모세혈관 저항성검사
(Rumpel-Leede tourniquet test)
INTRINSIC PATHWAY
… CT, RECALCIFIED CT, APTT
(XII, XI, IX, VIII)
EXTRINSIC PATHWAY
… PT (VII)
COMMON PATHWAY
… TT (I)
Platelet Function Analyzer-100
COL/EPI cartridges with pipetting of blood
sample in PFA-100
Collagen-Epinephrine cartridges
Cartridge plug formation
Start
End of test
aperture
150 µm
collagen +
EPI or ADP
capillary
200 µm
membrane
sample
800 µl
platelet
plug
Development of plug closure
15 sec
45 sec
80 sec
110 sec
Coagulation groups
1) Fibrinogen group
(I, V, VIII, XIII)
2) Prothrombin group
(II, VII, IX, X)
- BaSO4 absorbed plasma ??
- Vitamin K dependent
- Serine protease
3) Contact group (XII, XI, HMWK,
Prekalikrein)
INTRINSIC PATHWAY
… CT, RECALCIFIED CT, APTT
(XII, XI, IX, VIII)
EXTRINSIC PATHWAY
… PT (VII)
COMMON PATHWAY
… TT (I)
Intrinsic pathway
Coagulation time
(Lee-White method)
Coagulation time
(capillary method)
8mm 시험관 => 5-8분
11mm 시험관 => 6-12분
3) aPTT
2) Recalcified CT
1) CT
4) Factor 8 assay