组织学与胚胎学血液双语教学资料

Chapter4Blood组胚教研室:袁娲DepartmentofhistologyandembryologyLearningObjectives

Thecompositionofblood(血液).

Thestructure,functionandnormalvalues(正常值)oftheformedelementsofblood(血液有形成分).Hematopoiesis

(血细胞的发生).

Thehematopoietictissue(造血组织)andthehematopoieticstemcells(造血干细胞).Theproductionandsignificanceoflymph(淋巴).*aspecializedformofC.T.*acirculatingtissue*asatransportingmedium*atotalvolumeabout5litersin healthadultINTRODUCTIONComponentsofblood血液的组成成分

*Formedelements------bloodcells(45%)

*Intercellularsubstance------plasma(55%)

Erythrocytes红细胞 Leukocytes白细胞

Platelets血小板H2O(90%)Plasmaproteins:albumin白蛋白,globulin球蛋白,fibrinogen纤维蛋白原,etc.Others:血液的组成centrifugation(离心)-------

plasmaLeukocytes+Platelets

--------Erythrocyte(Redbloodcell)anticoagulant(heparin)

抗凝剂（肝素）

血块、血清—Serum血清

—withoutanticoagulant

Clotting无纤维蛋白原血液有形成分红细胞：男（4.0—5.5）×1012/L

；女（3.5—5.0）×1012/L（350-500万个/ul)白细胞(4.0—10)×109

/L或4千-1万个/ul血小板（100—300）×109

/L

（或10-30万个/ul）

有粒白细胞

无粒白细胞中性粒细胞50-70%嗜酸性粒细胞0.5-3%嗜碱性粒细胞0-1%淋巴细胞25-30%单核细胞3-8%血液有形成分正常值血象(hemogram)：血细胞的形态、数量、百分比及血红蛋白的含量.血象是临床疾病诊断、治疗的重要指标。Wright染色法（瑞特染色法）:染料是由酸性染料伊红和碱性染料亚甲蓝组成。与酸性染料伊红结合，染粉红色；与碱性染料亚甲蓝结合，染紫蓝色。

Giemsa染色法（吉姆萨染色法）:吉姆萨染液由伊红，天青组成。

血涂片bloodsmear:观察血细胞形态染色方法:Wright或Giemsa染色一、红细胞（erythrocyte,redbloodcell,RBC）

1.结构特点2.血型3.功能4.寿命5.网织红细胞MatureErythrocyte

*biconcavediscshape,

providing

greatersurfacearea;

*nonucleusandorganelles;

*

Hemoglobin(Hb

);

*deformability.SEMSize:

7.5~8.5µm(diameter)Number:

Male:4.2~5.5×1012/L(Hb:120~150g/L) Female:3.5~5.0×1012/L(Hb:110~140g/L)2．ABO血型抗原系统：红细胞膜含血型抗原

A型：有A型抗原

B型：有B型抗原

O型：无A型、B型抗原

AB型：有A型、B型抗原3．功能:

红细胞具有携带

O２和CO２的功能，由血红蛋白执行。4．寿命:红细胞的平均寿命约为120天。溶血(hemolysis)血影（erythrocyteghost）:溶血后残留的红细胞膜囊。

*notfullymatureRBC*0.5

1%ofatotalnumberofRBC*nonucleus*ribosomalRNAremnants(netlikestructure)*remainingHbsynthesis*ClinicsignificanceReticulocyte网织红细胞

PathologicalconditionsNumberSizeShapeHbAnemia贫血

Erythrocytosis红细胞增多症

Spherocytosis;

SicklecellanemiaThalassemia（地中海贫血）Large/smallcellanemia

Sickle-cellanemiaisapainfuldiseaseinwhichRBCsbecomecrescentshapedduetoinheritanceofanabnormaltypeofhemoglobin.Sickled

RBCsbreakdown,releasinghemoglobinintothecirculation.NormalRBCSickledRBC镰状Typically,theaffectedRBCsaresmall,sphericallyshaped,andlackthelightcentersseeninnormalRBCs.

SpherocytosisGeneralcharacteristicofleukocytes

*sphericalshape *possesnuclei *presenceoforganelles *atotalnumberlessthanthatoferythrocytes*exhibitingamoeboidmovement *involvinginbodydefensesandimmunity二、白细胞（leukocyte,whitebloodcell，WBC）

Classification *Granularleukocytes有粒白细胞

neutrophils5070%中性粒细胞

eosinophils0.53%嗜酸性粒细胞

basophils01%嗜碱性粒细胞 *Agranularleukocytes无粒白细胞 lymphocytes2530%淋巴细胞

monocytes38%单核细胞

Neutrophil

Size:1012µm(diameter)

Morphology形态

nucleus：highlymorphonuclear

rod-like

2-3lobulated 4-5lobulated young old

cytoplasm：

specificgranules:80%,small

azurophilicgranules:20%,lysosome

溶酶体

Neutrophils

中性粒细胞

(嗜天青颗粒)中性粒细胞模式图（示杆状核演变至5叶核,新生到衰老）中性粒细胞（血涂片）NeutrophilsLobulatednuclei

Rod-likenucleusazurophilicgranules*fine,uniform细腻，均匀

*evenlydistributed*pinkstainingCharateristicsofspecificgranules:Specificgranules(80%,samll)contain:alkalinephosphatase碱性磷酸酶

*Phagocytin

吞噬素*lysozyme

溶菌酶AzurophilicG.(large,less)containing:acidphosphatase

酸性磷酸酶*

Peroxidase

过氧化物酶Neutrophil(EM)FunctionChemotaxis(Mobility)趋化性:

Attractedbychemotacticfactor(releasedbymacrophages)Phagocytosis&destroybacteria:

吞噬和杀灭细菌

thenumberofleukocytes↑

acute

the%ofneutrophils↑

bacteriainfection

Size:

1012µm(diameter)LM:nucleus:

lobulated;Sorirregular; obscuredoutlinecytoplasm:basophilicgranules

*variablesize*unevendistribution*strongbasophiliaCharacteristicBasophil

嗜碱性粒细胞

Basophil

E.M.:

Basophilicgranulescontain:*heparin*

histamineF.N.:

*

anticoagulate*

responsibletoallergicreactionnucleusSize:1015µm(diameter)LM: -usuallybilobednucleus-eosinophilicgranules

*strongeosinophilia(reddish) *coarseandrefractile

*uniformsizeandevenlydistributedEosinophils

嗜酸性粒细胞Characteristic（电镜）

Eosinophilicgranules(primarylysosomes)whichcontainsubstances:

*acidphosphatase *arylsulphatase

芳基硫酸酯酶 *Peroxidase

*histaminase

组胺酶nucleusEosinophilicgranules

withcrystalloidinthecenter(EM)FunctionChemotaxis（趋化性）

attractedbychemotacticfactorfromthemastcellsPhagocytize（吞噬）

foreignbodies,Ag-AbcomplexAnti-allergy（抗过敏）

Releasehistaminase，inactivatehistamineforweakeningallergicreactionAnti-parasite

（抗寄生虫）

Itisincreasedinpatientsinfectedw/allergicreactionorparasite

Neutrophils:

*ruffledmembranemovement*chemetaxis*phagocytosis

Eosinophils:anti-parasite;anti-allergy

Basophils:

*anticoagulation; *involvinginallergicresponseFunctionofgranularleukocytesSize:

1420µm(diameter)Nucleus:large,eccentric,lightstaining, deepindentation,horseshoe

cytoplasm：

abundant，gray-bluestaining, weakbasophilia, numerouspurplegranules(azurophilicG)Monocyte

单核细胞

Smallpseudopodia,microvillus,mitochondrionRER,Lysosomes(azurophilicgranule)contain:*Peroxidase

*Acidphoshpatase

*Lysozyme

溶菌酶(EM模式图）nucleusMonocyteunderEMFunctionof

monocyte

-differentiateintomacrophages.

phagocytosisimmuneresponsegiverisetoosteoclasts

破骨细胞,whichareabletodissolvebone.

Lymphocytes淋巴细胞3types:small6～8μm;medium-sized9～12μm;large13～20μmSmalllymphocyte(90%):LM:Roundorovoid;

Nu.:

sphericity,indentation,condensedchromatin,darkstaining.

Cytoplasm:

scanty,asathinriminlight-bluew/azurophilicgranules

*alargenumberoffreeribosomes,*afewmitochondria,andotherorganelles*exhibitingsmallcytoplasmicprojectionsinthesurfaceofcells.(EM模式图）nucleusLymphocyteunderEM

Classification*function#

T-Cell:75%cellularimmunityB-Cell:10-15%humoralimmunitylargegranulelymphocyte(K&NKcell)*basedonthesource,characteristicsoncellularmembrane,life&function#immunologicaldefence

Classification&Function三、血小板（bloodplatelet,thrombocyte

）Megakaryocyte’sfragment,inclumpsLM:2～4μm，disc-likeorirregular,anucleated.

Tworegions:

①Granulomere:centrally-located,purple-bluegranules.②Hyalomere:peripherallylocated,inlight-blue.①cellcoat:richinglycoproteins

associatedtoplateletadhesion;②M.T.system:

a.openingtubulesystem开放小管系统:toincreasethesurfaceareaforplateletadhesion.

b.densetubulesystem致密小管系统:

sER,support,collectCa2+andsynthesizeprostaglandin前列腺素E.M.:③actin-likeM.F微丝:

mobile.④granules:

a.αgranules(specialgranules):containingplateletderivedgrowthfactor,PDGF;thrombospondin.

b.densegranules致密颗粒:

serotonin(5-HT),ADP,ATP,Ca2+&adrenaline肾上腺素FunctionHemostasia

止血:

2.

Coagulation凝血:3.

Protect

bloodvesselendothelium,repairingendothelium,preventatherosclerosis(动脉硬化)Slidesreview五、骨髓和血细胞的发生

（bonemarrowandhematopoiesis

）

Hematopoieticorgan造血器官

yolksac卵黄囊

（earlyembryo)→Liver肝/spleen脾(6w—5m)

→bonemarrow骨髓

(4mandafter)Structureofbonemarrow

骨髓的结构

redbonemarrow:hematopoietictissue造血组织

+bloodsinusoid血窦

yellowbonemarrow:adiposetissue脂肪组织

+immaturehemocyte

血细胞Redbonemarrow

hematopoietictissue:

造血组织

reticularc.t.+hemocytesinvariousstage,macrophages,adipocytes,mesenchymalcells

bloodsinusoid:

血窦

discontinuousendothelia,incompleteBMHemopoieticstemcell(HSP)andHemopoieticprogenitorcell(HPC)Hemopoieticstemcell

self-replicationpowerfulproliferationpotencymulti-differentiationPotency

Hemopoieticprogenitorc.UnipotentialorbipotentialProducematruebloodc.Erythrocytesseriesgranulocyteseries

monocyteseries

megakaryocyte

series*Lymphocytesderivedfromlymphaticorgans&tissuesPb:原红Be:早幼红Pe:中幼红晚幼红ErythrocyteseriesMb:原粒Pm:早幼粒MbM,Mb:中幼粒