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Jingdong book

临床血栓病学

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Books Medical Science Obstetrics and Gynecology
Jingdong book

临床血栓病学

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《临床血栓病学》是一本系统介绍临床血栓病的专著。全书由4篇21章组成；第一篇血栓形成的相关理论；第二篇临床血栓病；第三篇血栓病的影像学诊断和实验诊断，第四篇血栓病的治疗和预防。《临床血栓病学》相关理论仅占全书的20%，临床血栓病占80%。《临床血栓病学》的创新点是介绍血栓形成的成分；介绍系统／器官血栓病；介绍他汀类降脂药和中医药在防治血栓病中的作用；介绍血栓病的基因诊断、基因治疗、诊断指南和治疗指南等。《临床血栓病学》是一部关于临床血栓病既实用又有学术参考价值的专著，适用于临床各科，如普通内科及其各个专科、普通外科及其各个专科、妇产科、小儿科、老年病科、五官科以及影像医学科、检验科、药剂科、输血科工作人员和研究人员的参考书。
Catalogue

第一篇 血栓形成的相关理论
第一章 止血机制的基础知识
第一节 生理性止血机制
第二节 血管内皮细胞
第三节 血小板
第四节 凝血系统
第五节 抗凝系统
第六节 纤溶系统
第七节 血液流变学
第二章 血栓形成的机制及病理改变
第一节 血栓形成机制
第二节 血栓的病理学
第三节 血栓的转归及对机体的影响
第三章 血栓形成的相关成分
第一节 白细胞与血栓形成
第二节 炎症与血栓形成
第三节 黏附分子与血栓形成
第四节 膜磷脂产物与血栓形成
第五节 血脂与血栓形成
第六节 肾素-血管紧张素与血栓形成
第七节 膜联蛋白与血栓形成
第八节 动脉粥样硬化与血栓形成

第二篇 临床血栓病
第四章 血栓病概述
第一节 血栓病的流行病学
第二节 血栓病的临床分类和特征
第三节 血栓前状态
第四节 老年人的血栓倾向及其预防
第五节 弥散性血管内凝血
第五章 遗传性易栓症
第一节 遗传性抗凝血酶缺陷症
第二节 遗传性蛋白C缺陷症
第三节 遗传性蛋白S缺陷症
第四节 其他遗传性易栓症
第六章 动脉血栓病
第一节 概述
第二节 急性冠脉综合征与血栓形成
第三节 脑血管病与脑血栓形成
第四节 糖尿病与血栓形成
第五节 高血压与血栓形成
第六节 外周动脉血栓形成
第七章 静脉血栓病
第一节 静脉血栓形成
第二节 肺栓塞与血栓形成
第三节 恶性肿瘤与血栓形成
第四节 产科疾病与血栓形成
第五节 创伤与血栓形成
第六节 骨科疾病与血栓形成
第八章 微（小）血管血栓病
第一节 血栓性血小板减少性紫癜和溶血尿毒症综合征与血栓形成
第二节 视网膜血栓形成
第三节 突发性聋与血栓形成
第九章 系统
第一节 医源性血栓形成
第二节 肾脏病与血栓形成
第三节 血液透析与血栓形成
第四节 消化道疾病与血栓形成
第五节 造血干细胞移植与血栓形成
第六节 血液病与血栓形成
第七节 自身免疫病与血栓形成
第八节 烧伤与血栓形成
第九节 心脏外科与血栓形成
第十节 器官移植与血栓形成
第十一节 新生儿与血栓形成
第十二节 ICU与血栓形成
第十三节 黏性血小板综合征与血栓形成
第十四节 脑静脉及脑静脉窦与血栓形成
第十五节 门静脉和肠系膜静脉与血栓形成
第十六节 口服避孕药与血栓形成
第十七节 心房颤动的抗栓治疗
第十八节 内分泌及代谢性疾病与血栓形成

第三篇 血栓病的影像学诊断和实验诊断
第十章 血栓病的影像学诊断
第一节 胸部X线摄片诊断
第二节 动脉血栓病的CT
第三节 静脉血栓病的CT／MRI诊断
第四节 血栓病的血管造影诊断
第五节 血栓病的超声诊断
第六节 血栓病的放射性核素诊断
第十一章 血栓病的实验诊断
第一节 血管内皮细胞损伤检测
第二节 血小板活化的检测
第三节 凝血机制的检测
第四节 抗凝机制检测
第五节 纤溶活性检测
第六节 血液流变学检测
第七节 血栓性疾病的基因检测

第四篇 血栓病的治疗和预防
第十二章 抗血小板治疗
第一节 抗血小板药物
第二节 抗血小板治疗
第十三章 抗凝治疗
第一节 抗凝药物
第二节 抗凝治疗
第十四章 溶血栓治疗
第一节 溶血栓治疗的机制
第二节 溶血栓药物
第三节 溶血栓治疗
第四节 溶血栓治疗的并发症和影响溶血栓疗效的因素
第十五章 冠状动脉血栓形成与介入治疗
第十六章 降黏治疗
第一节 概述
第二节 降纤药物及其应用
第三节 改善血细胞聚集的药物及其应用
第四节 降低血细胞比容的治疗方案
第十七章 血栓病的他汀类药物治疗
第一节 他汀类药物的调脂作用
第二节 他汀类药物的非调脂作用
第三节 他汀类药物的抗血栓形成作用
第四节 他汀类药物
第五节 他汀类药物的临床应用
第十八章 血栓病的中医药治疗
第一节 抗血栓中药及成分
第二节 血栓病的中医药治疗
第十九章 血栓病的外科治疗
第一节 下肢深静脉血栓形成
第二节 下肢动脉硬化闭塞症
第三节 原发性动脉血栓形成
第二十章 血栓病防治指南解读

附录《基于循证医学的抗栓治疗与血栓预防临床实践指南》解读节选
第二十一章 血栓病的预防
第一节 心理健康
第二节 饮食科学
第三节 坚持运动
索引
Book Abstract

第一节生理性止血机制
在生理条件下，人体内的止血、凝血系统与抗凝血和纤维蛋白溶解（纤溶系统）系统相互制约，处于动态平衡状态，以维持血液不断循环流动。小血管破损后引起的出血几分钟内就会自行停止，这种现象称为生理性止血。临床上常用出血时间来反映生理性止血功能状态。生理性止血机制与临床医学关系较为密切。生理性止血机制障碍就会引起出血；亢进则可导致血栓形成。
一、生理性止血的三个时相
生理性止血机制主要包括血管收缩、血小板止血栓形成及纤维蛋白凝块的形成与维持三个时相。这三重反应在时间上是相继发生且相互重叠的。首先的表现就是受损局部及附近的血管立即收缩。由于血管平滑肌数量与收缩程度有关，故动脉收缩比静脉收缩更有意义。发生血管收缩的原因除损害性刺激反射性地引起收缩外，还可能包括：①黏附于受损处的血小板释放5一羟色胺（5一HT）与血栓烷A2（TXA2）；②血管内皮细胞受刺激后释放的内皮素（ET）；③凝血过程中产生的某些小肽如纤维蛋白肽B等。在血管收缩的基础上，血小板黏附与聚集于血管破损处，并且形成足够大的聚集体以实现初步止血。初步止血后，凝血系统启动使血浆凝固，以纤维蛋白网加固血小板止血栓达到二期止血。在正常情况下，纤维蛋白完成加固止血使命后逐渐溶解。如果纤维蛋白溶解过早，原已止血的血管破损处就会发生再出血，故纤溶系统也参与生理性止血过程。现在认为生理生止血应该还存在一个终止期，即损伤致纤维血小板凝块形成后，凝固过程应该受到限制，防止血栓堵塞于周围正常的脉管系统。一旦凝血未受控，凝固过程将会扩布至整个血管网。
二、血管壁和血小板在生理性止血过程中的作用
机体的正常止血主要依赖于完整的血管壁结构和功能、有效的血小板质量和数量、正常的血浆凝血因子活性。血小板和凝血因子是生理性止血的重要成分。
（一）血管壁的作用
在正常情况下，血管壁内膜光滑。血管内皮细胞，是被覆于血管壁内表面的机械屏障膜，是维持血液流动状态的重要条件，也是机体重要的内分泌器官之一。血管内皮细胞既不与血浆成分反应发生凝血，也不与血小板等细胞反应，从而防止细胞（尤其是血小板）黏附、凝集；内皮细胞之间的黏合质紧密相连，与内皮细胞一起发挥着阻止血液成分渗出血管外的屏障功能；内皮细胞下层的结缔组织（如胶原、弹力纤维等）结构完整，能维持血管壁一定的张力。以上各种因素保证血液在血管内既畅通无阻又不至于渗出到血管外。
……

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Jingdong book