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8/13/2019 SINH HC T BO MU

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SINH HC T BO MU5 months ago by Nguyen Phuoc Long 0

Phng Trung Hng Nguyn Phc LongGii thiu chung
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2/31

Hnh 28.1: Minh ha s hnh thnh ca cc t bo mu t t !"#ng. Nhng t bo di ng ngang c hnh thnh mu ngoi bi n bnh thng! Nhng "# t$% hot &ng c'b(n c)a e$yth$o*oietin " nhng yu t+ ,%ch th%ch to d-ng ,hc .co/ony 1timu/ating 2acto$1 3
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3/31

4567 ,%ch th%ch 18 bi9t h:a c)a cc thnh *h;n c < c=*! > ? g$anu/ocyte@ A ?mac$o*hage@ BL ? inte$/eu,ine@ Ch$omboD th$ombo*oietin@ 546D 1temce// 2acto$!

C)y E'ng / n'i to $a tFt c( cc t bo mu ,G tH ,hi 1inh "=t $a i! N: gIm cc t bo g+c t$ng thi ng) t$ong nhi$oRth 2acto$17 " nhng *$otein ,hc c: nguIn g+c tH tiGu c;u! N: c Ec#nh / c: nhi


4/31

Hnh 28.2: Chnh *h;n *$otein t$ong huyt t'ng. 4o/o$ at/a1 o2 *hy1io/ogy th7hi cho cc chFt ,hng [ng .nh he*a$inD cit$ateDk7 "o mu G ngJn ch n 18 thnh /=* cZc

mu [ng th ta 1T thu c m&t hKn h* chFt / ng c tch /* " ,h[ng t$&n / n "o nhau

.Eem hnh7! C$ong :D t bo hIng c;u .e$yth$ocyte17 njm b n di " chim ,ho(ng p thGt%ch ton dung d#ch +i "i ngi bnh thngD tuy nhi n c: 18 1ai bi9t chYt %t hai gii! CH :Dngi ta a $a m&t ti u chuOn nh gi chFt /ng mu t$ong cc *hq* Ec nghi9m c #nhnghra nh 1auV sSematoc$it .StD Sct7 / thG t%ch hIng c;u t$ n tXng thG t%ch mu ton *h;n!
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5/31

Hnh 28.): Ainh h\a chi tit cc thnh *h;n c)a mu

Ngi ta c ng thFy $jng c: m&t /* nh;y chQa bch c;u ./eu,ocyte17 " tiGu c;u .*/ate/et17 n'i *hMn cch hIng c;u " huyt t'ngD /* ny ,qm c h'n hIng c;u " chv chim,ho(ng ` p thG t%ch!Au :ng "ai t$- / t$ung gian "=n chuyGn w xD 4wxD cc chFt chuyGn h:aD ho$mone1 " ccchFt ,hc 1inh $a tH hot &ng 1+ng c)a t bo i ,h * c' thG! % dZV wx "=n chuyGn a *h;ndi dng ,t h* "i hemog/obin .Sb7 t$ong hIng c;uD c-n 4w x c "=n chuyGn ch) yu

dng S4wU .z0p7! Ngoi $aD mu c-n giY* i


6/31

Hnh 28.*: Chnh *h;n wx t$ong cc /oi mch mu ,hc nhau

H+ng c,u


7/31


8/31

Hnh 28.-: %ch thc *h ng #nh c)a t bo hIng c;u

Nhng t bo d-ng hIng c;u .e$yth$oid /ineage7 *ht t$iGn tH t bo g+c t)y E'ng a nJng.mu/ti*otentia/ mye/oid 1tem ce//7 di 18 i


9/31


10/31

Hnh 28./: Chnh *h;n cc ion t$ong mu .4o/o$ at/a1 o2 *hy1io/ogy th7 C bo g+c hIng c;u nhy c(m "i e$yth$o*oietin .e$yth$o*oietin 1en1iti"e e$yth$ocyte*$ogenito$ ce//7 46} { .e$yth$oid co/ony 2o$ming unit7 c: ,h( nJng bi9t h:a thnh ti


11/31


12/31

Hnh 28.0: |u t$nh io/gi " cc ht ,hc! ng

ngoi "i tiGu c;u / " ng t$ong 1u+tD c: cc 1i u +ng " 1i u 1i ii(m 1+ /ng tiGu c;u /m d ch(ymu! >i(m tiGu c;u / ,hi /ng tiGu c;u t$ong mu c: 1+ /ng %t h'n ` 0!000m/! Lu D EuFthuyt t8 nhi n E(y $a ,hi tiGu c;u di x0!000m/!

>i(m tiGu c;u do gi(m to " tJng h)y tiGu c;uD do thu+c.*enici//inD 1u/2amideD digoEinDk7 "do tJng ,t tZ tiGu c;u mao mch .ban EuFt huyt do huyt t c tiGu c;u7 hay do $+i /on Wut$nh to cc chFt [ng mu t bo n&i m[ thnh mch!
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13/31


14/31


15/31

lm "o d#ch ngoi bo " cc *hMn t h:a Qng &ng! .chemoatt$actant mo/ecu/e17

]o "=yD bch c;u a nhMn t$ung t%nh c: thG $i ,h i h9 tu;n hon G n th8c hi9n chQc nJngti cc " ng ,hc! i "ai t$- / t bo c: tc &ng ;u ti n ,hi c' thG b# nhi m t$ ngD chYngti u h)y cc "=t thG " "i ,huOn _ b# o*1onin h:ath[ng Wua thZ thG 6c t$ n mng t bohayc: tc &ng /m hn ch /an $&ng *h(n Qng "i m!

4c enfyme ht cF* B .e/a1ta1e " mye/o*e$oEida1e7 " ht cF* BB ./y1ofuyme " cc*$otea1e ,hc7D cc thZ thG c)a 4 a .to /=* t$ong /& tnh bX thG7D L 1e/ectin " cc integ$in.g n "o cc *h;n t n+i t bo n&i m[ / B4A ` " B4A x7 *h+i h* giY* bch c;u t$ungt%nh ti u di9t "i ,huOn " #nh c!

4ch c,u "a aci< .{o1ino*hi/ic g$anu/ocyte7

lch c;u a acid chim tH x p tXng 1+ t bo bch c;uD nhMn c: x th yD tm thFy nhi


16/31

t$- *h(n Qng nhanh .g * t$ong b9nh 1uy n7D *h(n Qng mu&n .g * t$ong t$ng h* d# Qng da7" c: ,h( nJng gMy *h(n Qng t8 mi n!

4ch c,u %h7ng h4t

Monoc t=

Aonocyte / bch c;u /n nhFt t$ong cc /oi bch c;u .`x x0m7 " chim tH x p tXng /ngbch c;u t$ong mu " chv c: ht cF* B!Aonocyte chv t$ong h9 tu;n hon ,ho(ng x gi! 5au:D chYng bi9t h:a thnh i th8c bo " tIn ti nhi


17/31

C bo l .l ce//7 th8c hi9n chQc nJng mi n d#ch Wua t$ung gian ,hng thG 3 d#ch thG.antibody mediated humo$a/ immunity7! C bo l t$ng thnh c: *hMn t AS4 BB " ,hng thGt$ n b< m t c)a n: " 1au ,hi c hot h:aD n: 1T bin Xi G to thnh t bo tit ,hng thGd#ch thG hay c-n g\i / t'ng bo .antibody 1ec$eting */a1ma ce//17!

N ce// .natu$a/ ,i//e$ ce//7 c: ,h( nJng ti u di9t cc t bo b# nhi m "i$u1 " m&t "i/oi t bo ung thD nhng hot &ng c)a chYng ,h[ng *hZ thu&c "o 18 hot h:a c)a ,hngnguy n!

Lym*hocyte /u th[ng t$ong mu ch) yu di dng t bo C t$ng thnhD chim ,ho(ng ~00p tXng /ng /ym*hocyte! x0 U0p / t bo l t$ng thnh! F* Ev `0p t bo c Ec

#nh / /ym*hocyte ,h[ng *h(i / t bo l hay C m / t bo N hay him g * h'n / t bog+c to mu .ci$cu/ating haemo*oietic 1tem ce//17!

@Anh c" b4ch c,u B ?h&n Cng 'iDm

#nh c bch c;u .homing7 / cch thQc bch c;u t$ung t%nh di c n " ng "i m!

lc m&tD cc *h;n t n+ica$bohyd$ate b< m t bch c;u t$ung t%nh g n "o 1e/ectin tbo n&i m[.{ 1e/ectin7D giY* bch c;u t$ung t%nh /Jn t$-n t$ n t bo n&i m[!lc haiD cc integ$in L6 ` ./ym*hocyte a11ociated antigen `7 " Aac ` .mac$o*hage `7 bch c;u t$ung t%nh t'ng tc "i cc B4A ` " B4A x b< m t t bo n&i m[! B4A ` biGuhi n ,hi ch#u c(m Qng bi cyto,ine yu t+ hoi t u " inte$/eu,ine ` .BL `7 c)a i th8c bohot h:a ti " ng "i m!

C'ng tc cc *hMn t ny to $aV .`7 ,t d%nh ch t chT bch c;u t$ung t%nhD chFm dQt 1Z /Jnt$-n @ .x7 q* t bo bch c;u "o gia cc t bo n&i m[ , nhau "< " ng c: inte$/eu,ine.1(n *hOm c)a t bo "i [email protected] di chuyGn Euy n mchD c: 18 hK t$ c)a 4] U` t$ n b< m tbch c;u t$ung t%nh " t bo n&i m[!

Eai t F ca s 6Anh c" b4ch c,u .homing7

4c *$otein ,t d%nh t bo c: "ai t$- Wuan t$\ng t$ong cc *h(n ng mi n d#chD 18 /nh "tth'ngD Wu t$nh di cJn t bo ung th " ,G c( to m[! A&t t$ong 1+ cc 18 ,i9n Wuan t$\ngt$ong Wu t$nh "i m 3 d# Qng / thu hYt cc t bo "i m di c n " ng c: *h(n Qng d# Qng!N:i chungD G c: thG di c th cc *hMn t ,t d%nh t bo di c *h(i g n "o cc *h;n t n+i b< m t cc t bo ,hc!

l9nh thiu *hMn t ,t d%nh bch c;u B do thiu tiGu 'n "# integ$in /m cc bchc;u ,h[ng thG Euy n mch $i mu tu;n hon n " ng "i m! cc ngi nyD" ng "i m,h[ng c: bch c;u t$ung t%nh!

l9nh thiu *hMn t ,t d%nh bch c;u BBD thiu *h;n t n+i c: ng 2uco1e .,h[ng /;m"i 2$ucto1e7 chuy n bi9t g n ,t 1e/ectin do $+i /on chuyGn h:a 2uco1e bOm 1inh! C'ng tc1e/ectin "i hai /oi b9nh ,him ,huyt *hMn t ,t d%nh _ c ghi nh=nD c( x


18/31

5 months ago by Nguyen Phuoc Long 0Ph ng C$ung S ng 3 Nguy n Phc Long

ng uan

Ach mu tham gia i


19/31


20/31

Hnh )2.1: 4Fu t$Yc mao mch " trnh mch! Aao mch c: /* *e$icyte ,h[ng /i n tZc " trnhmch c: /* ngoi dy!

Aao mch / mch mu nh nhFtD c: m&t /* t bo biGu m[ " c: cFu t$Yc *hMn c8c "i m&tmng yD 1t b n cc t bo gi+ng c' t$'n .1mooth mu1c/e /i,e ce//7 hay c-n g\i / *e$icyte1!

h[ng gi+ng nh cc mch mu /nD *e$icyte1 ,h[ng bao /Fy ton b& /* "i mch G to thnh" bao /i n tZc .continuou1 1heath7!

Crnh mch " &ng mch c: cFu t$Yc gIm U /*V .`7 L* mng t$ong .intima7 c: m&t /* t bobiGu m[ /i n tZc "i cc mao mch! .x7 L* gia .tunica media7 c: m&t /* t bo c' t$'n! Lu

@ t$ong trnh mchD /* gia chv c: m&t "i /* t bo c' t$'n! .U7 L* ngoi .ad"entitia7 baogIm cc chFt d#ch ngoi bo / ng c ng nhi


21/31

Hnh )2.2: 4c &ng mch nh c: /* gia ng chY ! &ng mch /n c: /* gia " /* c'

t$'n bao /Fy d#ch ngoi bo!Iinh hc t bo ca m4ch mu

bo nJi m7

L /oi t bo ch%nh c)a /* t$ong mch mu! 4hYng c: nhi


22/31

h* b9nh / nh E' "a &ng mch " cao huyt *! Cnh t$ng $+i /on i


23/31


24/31

.*$o/i2e$ation7 c)a t bo c' t$'n! Ngc /iD ,hi b# tXn th'ngD cc t bo biGu m[ c: thG 1(n1inh $a cc yu t+ tJng t$ng " h:a hng &ng nh */ate/et de$i"ed g$oRth 2acto$ ch nghn G ,iGm 1ot 18 di t$Y " *ht t$iGn c)a cc t bo c' t$'n mch mu! 4c $+i /on i


25/31

L /oi t bo ch%nh t$ong mch muD /i n Wuan nhi


26/31

Hnh )2.-: |u t$nh i " BPUD 1au : hot h:a P 4 ,tWu( / tJng nIng & 4a x nh=* bo! S'n naD BPU "o cc thZ thG c hi9u t$ n mng 5 GtJng d-ng 4a x i "o t bo chFt tH cc s" ng d8 t$ 4a x .ca/cium 1to$age *oo/7!58 co cc t bo c' t$'n mch mu c ,iGm 1ot c' b(n bi 18 *ho1*ho$y/ h:a myo1in 1inh D m&t Wu t$nh c iCPa1e ho nh .*hMn t ny c hot h:a bi cc yut+ chuyGn Xi guano1ine " b# bFt hot bi cc *$otein hot h:a >CPa1e7!4( cAP " c>AP


27/31

*e*tide /i ni9u nhr hot &ngn th[ng Wua >P4 G hot h:a >4 " chuyGn >CP thnh c>AP!Nhng tc nhMn ny 1au : 1T hot h:a P " P > G bFt hot AL4 " /m gi(m t$'ng /8cc'! S'n naD P > c: thG t'ng tc t$8c ti* "i cc tiGu 'n "# c' chFt g n myo1in c)a AL4PDtJng hot t%nh *ho1*hata1e " gi(m t$'ng /8c c'! 4-n m&t 1+ c' ch iAP ,ina1eD BPUD *ho1*ho/ambanDk 1T c < c=* ch'ng /& t$nh t%n

hi9u!I %i m sot t "#ng Lc c# t #n m4ch mu
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28/31


29/31

Hnh )2. : 58 ,iGm 1ot t$'ng /8c c' c)a t bo n&i m[! C bo n&i m[ tXng h* 1au : titNwD {]S6D P>Bx .cc yu t+ gi_n c'7 " ngioten1in BBD {C ` .cc yu t+ co c'7

C$'ng /8c c' t$'n mch mu c ,iGm 1ot bi h9 th;n ,inh t8 &ng " bi t bo n&i m[!4c neu$on t8 &ng i "o /* gia c)a mch mu tH /* ngoi " i


30/31

Hnh )2./: 5' I m[ t( Wu t$nh hnh thnh mch mu *h[i thai ."a1cu/ogene1i17 " 18 tito mch mu .angiogene1i17! 4c yu t+ ti to mch c)a tHng giai on c ng c m[ t(!

58 tJng t$ng c)a cc mch mu mi * Qng /i cc tnh t$ng thiu oEy mu mn .ch$onichy*oEemia7 " thiu mu m[! 4c yu t+ tJng t$ng nh {>6 " 6>6 .2ib$ob/a1t g$oRth2acto$7 hot h:a cc /& t$nh t%n hi9u G ,%ch hot 18 tJng 1inh mch mu " 18 hnh thnh cFut$Yc +ng! 58 *ht t$iGn c)a h9 th+ng mch bng h9 .co//ate$a/ "a1cu/a$ netRo$,17 t$ong tnht$ngthiu mu cZc b& c' tim .i1chemic myoca$dium7 cho thFy Wu t$nh ny c: thG / ,t Wu(c)a hi9n tng hot h:a c: ch\n /\c cc t bo g+c c)a t bo n&i m[ .endothe/ia/ *$ogenito$ce//7! 58 ti to mch mu th=t 18 *h(i to cc mch mu c: ) U /* thng ,h[ng E(y $a h9 tim mch c)a ngi t$ng thnh!

Hnh )2.8: 4' ch ,hc nhau c)a SB6 ` " SB6 x t$ong 18 *ht t$iGn c)a mch mu!
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31/31

58 ,i9n tJng 1inh mch mu hay ti cFu t$Yc ngi t$ng thnh ,h[ng bao gi c: ) U /*nh t$ng thi ban ;u cho thFy ti cFu t$Yc hay tJng 1inh ,h[ng thG ti to mch mu honh(o " /u[n / ti

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