Lippi Giuseppe, Favaloro Emmanuel J, Franchini Massimo, Guidi Gian Cesare
Sezione di Chimica Clinica, Università di Verona, Verona, Italy.
Semin Thromb Hemost. 2009 Feb;35(1):9-22. doi: 10.1055/s-0029-1214144. Epub 2009 Mar 23.
Hemostasis is traditionally defined as the physiologic process whereby bleeding is antagonized and possibly stopped to minimize blood loss. The first medical description of the clinical and inherited features of hemostasis can be dated back more than 1000 years, when Abu al-Qasim Khalaf ibn 'Abbas al-Andalusi al-Zahrawi' medical treatise provided some initial insights into this puzzling process. Since then, continuous and revolutionary scientific developments have contributed to decoding several aspects of this intricate but essential physiologic phenomenon, providing a reliable model to explain the leading mechanisms involved. Although the point at which bleeding stops is commonly referred to as "coagulation," blood coagulation is actually only one part of a two-part hemostatic process that develops through sequential steps referred to as primary and secondary hemostasis. Throughout its activation and development, the coagulation cascade is strictly regulated by a series of natural inhibitors, which prevent unnecessary and excessive clotting. The aim of this article is to provide a concise overview of the major discoveries and past and current perspectives in coagulation and hemostasis.
传统上,止血被定义为一种生理过程,通过该过程出血受到对抗并可能停止,以尽量减少失血。关于止血的临床和遗传特征的首次医学描述可追溯到1000多年前,当时阿布·卡西姆·哈拉夫·伊本·阿巴斯·安达卢西·扎赫拉维的医学论著对这一令人困惑的过程提供了一些初步见解。从那时起,持续的革命性科学发展有助于解读这一复杂但至关重要的生理现象的几个方面,提供了一个可靠的模型来解释其中涉及的主要机制。尽管出血停止的点通常被称为“凝血”,但血液凝固实际上只是一个分为两个部分的止血过程的一部分,该过程通过称为初级和次级止血的连续步骤发展。在其激活和发展过程中,凝血级联受到一系列天然抑制剂的严格调节,这些抑制剂可防止不必要的和过度的凝血。本文旨在简要概述凝血和止血方面的主要发现以及过去和当前的观点。