下载此文档

任职资格预审表“主要业务ppt课件.ppt

文档分类：通信/电子 | 页数：约42页举报非法文档有奖

1/42

下载提示

1.该资料是网友上传的，本站提供全文预览，预览什么样，下载就什么样。
2.下载该文档所得收入归上传者、原创者。
3.下载的文档，不会出现我们的网址水印。

同意并开始全文预览

(约 1-6 秒)

1/42 下载此文档

文档列表 文档介绍

HEPARININDUCEDTHROMBOCYTOPENIA:,MDProfessorofAnesthesiologyDeputyChair,ResearchEmoryUniversitySchoolofMedicineCardiothoracicAnesthesiologyandCriticalCareEmoryHealthcareAtlanta,PONENTSOFHEMOSTASISVasculatureCoagulationproteinsPlateletsAdhesionGpIIb/IIIaStimulationofPlateletsGpIIb/IIIaGpIIb/hrombinPlateletGpIbExposedCollagenEndotheliumvWFPAR-1(Thrombinreceptor)PAR-4GpIIb/IIIaGpIIb/IIIaAggregationGpIIb/IIIaGpIIb/IIIaAggregationAdhesionAggregationAdhesionADPAdrenalineAprotininHEPARINPolyanion:(-)chargeFromcowlung/pigintestineMixtureof3Kto30KMWtBindsATIII/inhibitsthrombinInhibitsXa,espLMWHReversiblewithprotamineCausesHITHeparin-inducedThrombocytopenia(HIT)Definition:HITisaseriousimmune-mediatedsyndromewhereheparinadministrationisassociatedwith:ThrombocytopeniaThegenerationofheparin-dependentantibodies(typicallyIgG)Ahighriskforthrombosiscausingsignificantmorbidityandmortality30%–50%;101:502–507Heparin-inducedThrombocytopeniaClinicalPresentation:Followingheparin:Thrombocytopeniaobserved5–14dayslater;ursoonerwithpreviousheparinexposurePlateletcount<100,000/µLorPlateletcount50%ofbaseline(pre-heparinvalue)HIT:PathophysiologyPresenceofIgGantibodiesthatrecognizePF4/plexesonplateletsurfacesandvascularwallsBindingofIgGtoPF4/plexesonplateletsAntibodyactivatesplateletsviatheFcreceptorActivatedplateletsreleasemicroparticleswithprothromboticactivityPathophysiologyofHITandThrombosisLaboratoryTestingforHITTest Advantages DisadvantagesSRA Sensitivity>85% Technicallydemanding,radioisotopes; LowpredictivevalueHIPA Rapid,available Variablesensitivity(30%–80%); Technique-dependentELISA Highsensitivity Highcost,lowspecificity, 10%false-negativetestsThereisnoGoldStandardindiagnostictesting;HITrequiresaclinicaldiagnosis

任职资格预审表“主要业务ppt课件来自淘豆网www.taodocs.com转载请标明出处.