Osaki Tsukasa, Ichinose Akitada
Nihon Rinsho. 2014 Jul;72(7):1206-11.
Coagulation factors play essential roles in not only hemostasis but also thrombosis. The coagulation reaction consists of a stepwise sequence of proteolytic reactions of the coagulation factors, and is generally divided into two pathways, a tissue factor(TF)-dependent "extrinsic pathway" and a contact factor-dependent "intrinsic pathway". The extrinsic pathway is responsible for the initiation of the clotting reaction, while the intrinsic pathway most likely amplifies it. Elevated levels of various coagulation factors such as TF, factor VIII and prothrombin have been linked to an increased thrombotic risk. To prevent thrombus formation, endothelial cells express several receptors and activators for anticoagulant factors such as antithrombin, TF-pathway inhibitor, protein C and protein S. Defects in this anticoagulant system also increase the risk of thrombosis.
凝血因子不仅在止血过程中发挥重要作用,在血栓形成过程中也起着关键作用。凝血反应由凝血因子的一系列逐步的蛋白水解反应组成,通常分为两条途径,即组织因子(TF)依赖的“外源性途径”和接触因子依赖的“内源性途径”。外源性途径负责启动凝血反应,而内源性途径很可能对其起到放大作用。多种凝血因子水平升高,如TF、因子VIII和凝血酶原,都与血栓形成风险增加有关。为防止血栓形成,内皮细胞表达多种抗凝因子的受体和激活剂,如抗凝血酶、TF途径抑制剂、蛋白C和蛋白S。该抗凝系统的缺陷也会增加血栓形成的风险。