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Introductie stolling en hemostase
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Introductie stolling en hemostase
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Introductie stolling en hemostaseTerminologie
- Hemostase – bescherming tegen bloedingen
- Trombose
- Coagulatie (stolling) – hemostase en trombose samen
4 processen:
- Vaatwand (intact > hemostatische processen starten niet).
- Primaire hemostase: vorming van bloedplaatpropje
Vaak bloedneus, veel bloedverlies bij menstruatie
- Secundaire hemostase: coagulatie, stollingseiwitten
- Fibrinolyse: afbraak van stolsels
Stollingscascade: eiwitten activeren elkaar. Bij hemofilie ontbreekt één van de
stollingsfactoren, waardoor het proces niet meer goed werkt. Er wordt wel een klein beetje
trombine gevormd, maar niet genoeg (doordat de amplificatie route/fase niet werkt). Er
worden geen (goede) fibrinedraden meer gevormd (denk aan domino-effect).
Te veel stolling -> trombose
Te weinig stolling -> bloedingen
Behandeling
- Repareren vs compensatie (tekort aan factor 8 -> factor 8 geven)
- Bloedverdunners voor veneuze trombose
- Medicijnen die bloedplaatjes remmen voor arteriële trombose
Hemofilie
Erfelijke ziekte (X-gebonden)
Hemofilie A komt 6x zoveel voor als hemofilie B.
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