Re: [申覆] 醫學二 (10)
抱歉不能推文
Harrison第十七版363頁有這一段描述:
On vascular injury, platelets adhere to the site of injury, usually
the denuded vascular intimal surface. Platelet adhesion is mediated
primarily by von Willebrand factor (vWF), a large multimeric protein
present in both plasma and in the extracellular matrix of the
subendothelial vessel wall, which serves as the primary "molecular glue,"
providing sufficient strength to withstand the high levels of shear stress
that would tend to detach them with the flow of blood. Platelet adhesion is
also facilitated by direct binding to subendothelial collagen through
specific platelet membrane collagen receptors.
Platelet adhesion results in subsequent platelet activation and aggregation.
This process is enhanced and amplified by humoral mediators in plasma
(e.g., epinephrine, thrombin); mediators released from activated platelets
(e.g., adenosine diphosphate, serotonin); and vessel wall extracellular
matrix constituents that come in contact with adherent platelets
(e.g., collagen, vWF). Activated platelets undergo the release reaction,
during which they secrete contents that further promote aggregation and
inhibit the naturally anticoagulant endothelial cell factors. During
platelet aggregation (platelet-platelet interaction), additional platelets
are recruited from the circulation to the site of vascular injury,
leading to the formation of an occlusive platelet thrombus.
The platelet plug is anchored and stabilized by the developing fibrin mesh.
第一段的意思大概是vWF是幫助沾黏的媒介
第二段大概是說沾黏可以使血小板活化
但是這樣算不算vWF直接活化血小板,這就有爭議的空間
畢竟如文內所說的,內皮細胞也能夠幫助沾黏,所以在血小板活化中,應該
沾黏才是重點
抱歉我不太會用PPT,很傷大家的眼
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