Coagulation

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synonym Blood coagulation (The process of blood changing from flowing liquid to non flowing gelatinous clot) It generally refers to coagulation

Blood Coagulation, namely: Blood coagulation It means that the blood changes from flowing liquid state to non flowing gel state process , Yes Physiological hemostasis The important link of. The essence of blood coagulation is the solubility in plasma Fibrinogen Become insoluble fibrin Process.

Chinese name: Coagulation
Foreign name: Blood Coagulation

Basic process: Limited hydrolysis process of a series of proteins
Substantive: Fibrinogenesis fibrin

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Basic process

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The basic process of coagulation is A series of protein Limited hydrolysis process of , generally divided into three stages:

thrombin Proactivator formation

thrombin formation

Fibrinogenesis

Activator formation

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thrombin primary Activator Xa, V, Ca2+and PF 3（ platelet Factor 3: phospholipid ）The formation of complex requires the activation of factor x. according to prothrombin Activator forms pick up channel Different from participating factors, coagulation can be divided into Endogenous coagulation and Extrinsic coagulation Two ways.

Endogenous coagulation

All factors involved in coagulation come from plasma.

Blood contact zone negative charge Surface of foreign matter, Coagulation factor 12 binds to the surface of the foreign body and is activated. The activated coagulation factor 12 will activate coagulation factor 11 and further promote the activation of coagulation factor 12. The process from coagulation factor 12 binding to the surface of the foreign body to the generation of activated coagulation factor 11 is called surface activation. This process also requires high molecular weight Kininogen As Cofactor Accelerate.

Activated coagulation factor 11 calcium ion In the presence of activated coagulation factor 9, activated coagulation factor 9 and activated coagulation factor 8 activated platelets provide Membrane phospholipid Surface binding generation factor 10 Enzyme complex The complex activates coagulation factor 10, which can be formed on the surface of phospholipid membrane with activated coagulation factor 5 in the presence of calcium ions Prothrombin complex , prothrombin complex activates prothrombin, thrombin activates coagulation factor 13 and Fibrinogen , Coagulation factor 13 promotes soluble fibrinogen to produce insoluble polyfibrin POLYMER To form a blood clot to stop bleeding.

Extrinsic coagulation

The starting factor is from the organization tissue factor , so this channel Also called organization factor pathway.

Organizational factor is a kind of glycoprotein , exists in most Histiocyte Of cell membrane Medium. When tissue damage When the tissue factor is exposed, the activated state in the blood Coagulation factor 7 (about 0.5% of the total coagulation factors in the blood) combines with tissue factors to form a complex calcium ion In the presence of calcium ions, the activated coagulation factor 10 can be formed on the surface of phospholipid membrane with activated coagulation factor 5 Prothrombin complex , prothrombin complex activates prothrombin, thrombin activates coagulation factor 13 and fibrinogen, and coagulation factor 13 promotes soluble fibrinogen to produce insoluble polyfibrin POLYMER To form a blood clot to stop bleeding.

Endogenous coagulation and Extrinsic coagulation two types channel The difference is:

Endogenous coagulation is completely dependent on intravascular Coagulation factor , more enzymes are involved in the process of activating factor 10, Coagulation process Slow. Extrinsic coagulation dependence Extravascular Factor III released by the tissue activates factor X, with less enzymes involved and faster coagulation.

Except for coagulation factors 3, 4, 5 and 13, other coagulation factors are synthesized by the liver.

Some people gene Defects, resulting in the synthesis of some important coagulation factors being blocked, thus causing Coagulation disorder , leading to prolonged blood coagulation time. This disease is hemophilia 。

Coagulation requires many factors, such as, Fibrinogen , Platelet, vitamin K 。

Thrombin formation

thrombin Original (II, prothrombin) contains 582 Amino acid residue Of Zymogen , cut by factor Xa at Arg Thr and Arg Ile, cut N? 274 amino acids at the end Residue The remaining 308 amino acid residues are divided into A and B Peptide chain , by a Disulfide bond It is called thrombin. Factor Va None enzymatic activity However, it can increase the activity of Xa by 350 times and accelerate the production of thrombin. Phospholipid colloidal particles are connected with enzyme (Xa) and substrate (prothrombin) by Ca++as a bridge. Because of the N? The end contains 10 γ? carboxyl glutamate Residues. Adjacent carboxyl groups can form complexes with Ca++. On the other hand, Ca++can also phosphoric acid Base, so that Xa and Va contact with prothrombin, and Xa hydrolyzes prothrombin to thrombin

Fibrinogenesis

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Soluble in plasma under the action of thrombin Fibrinogen Convert to fibrin Monomer ； At the same time, thrombin activates XIII to XIII a, making fibrin Monomers connect to form water-insoluble fibrin POLYMER , and interweave with each other Networking , will blood corpuscle Inside the net, blood clots are formed to complete the blood coagulation process.

Blood coagulation It is a series of enzymatic biochemistry Reaction process , positive in multiple places Feedback Once started, it will be carried out rapidly and continuously to Guaranteed on Coagulation and hemostasis effect appear in a short time.

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