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8/17/2019 TM3-Fibrinolisis
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FIBRINOLISISLestari Ekowati
STIKES ICME JOMBANG
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LOGO
Proses yang terjadi setelah mengala
miluka
Kontraksi pembuluh darah(Vasokonstiksi)
Pembentukan sumbattrombosit
Proses Pembekuan Darah
Fibrinolisis
2
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LOGOFibrinolisis
Proses keseimbangan
untuk mempertahankan
supaya darah tetap cair
3
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LOGO
1
Membatasipembentukanfbrin paaaera! "uka
#
Men$!an%urkanfbrina"am sumbat
!emostasis
4
Fungsi fbrinolisis
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LOGO
PlasminAktivator
Plasminogen
nhibitor Plasmin! Anti"plasmin
# $ %
5
Komponen sistem fbrinolitik
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LOGOProses Fibrinolisis Fisiologis
&ndotel ! 'aringan
Plasminogen Aktivator
(lycoprotein)
Antiplasmin
(
$Antiplasmin)
↓
Plasminogen Plasmin Pl
asmin nAkti
↓
Fibrin *ahan +ang
,oluble ! FDP6
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LOGO
&
Plasminogen Plasmin
O"e! '
1( )"asmino$en akti*ator#( +aktor ,II akti*
-( Trombin
.( Ka"ikrein
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LOGO
)"asmino$en Anti )"asminA%ti/ator
0)"asmino$enAkti/ator In!ibitor
)"asmino$en → )"asmin → )"asmin → 2esInakti*
+ibrin +ibrin 0+3) +ra$ments 4Sp"it )rou%ts ↓ Sma""er +ra$ments ↓
2ES8
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LOGOFibrinolisis
Saat terbentukn5a bekuan fbrin6 #78-79
p"asmino$en p"asma terperan$kap i a"amn5a
Akti/ator 5an$ beraa a"am p"asma6 :arin$an6 ""6ikut masuk ke a"am bekuan6 kemuian akan
men$akti*kan p"asmino$en men:ai p"asmin
2eaksi tsb "oka" ter:ai i a"am bekuan6 bi"aakti/asi ter:ai i sirku"asi6 akan inetra"isir o"e!
in!ibitor a"am p"asma
+ibrino"isis fsio"o$is ise"esaikan "oka" tanpa aaprouk fbrino"itik i sirku"asi
9
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LOGO
)"asmin meme%a! ' +ibrin6 +ibrino$en6 +(; < ;III
)LASMIN
+ibrin4+ibrino$en +3)4+S)
+3)4+S) 0+ibrin4o$en 3e$raation4Sp"it )rou%tsmen5ebabkan '
8 !ambat a$re$asi trombosit
8 !ambat ker:a trombin paa fbrino$en
8 !ambat po"imerisasi fbrin
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LOGO
Men$!ambatpo"imerase
fbrin
Men$!ambatA$re$asi
trombosit
Men$!ambattrombinFibrin
FDP!F,P
FibrinFDP!F,P
)"asmin
11
Fibrinolisis
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LOGO
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LOGO
1-
)LASMINOGEN AKTI+ATO2 '
1( INT2INSIK ' terapat a"am ara! 5i( +(,II a6 Ka"ikrein
#( EKST2INSIK '
terapat paa enote" pembu"u! ara! rokinase 0ibentuk $in:a"
= Streptokinase 0prouk kuman StreptokokusBeta
?emo"itikus
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LOGO
1.
Plasminogen Activator nhibitor( PA)
1( )AI @ 1 ' isintesis se" enote" pembu"u!
ara!6 se" otot po"os6 fbrob"as paru6a"*a $ranu"a trombosit
#( )AI @ # ' isintesis p"asenta6 $ranu"osit6monosit makro*a$
-( )AI @ - ' a"am air seni
.( )rotease Nein @ 1 ' itemukan a"am fbrob"as6se" otot :antun$ < epite" $in:a"
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LOGO
1
P&.A/0-A. ,,/&1 K2A03A,
I( at 5an$ terapat a"am tubu! '
1( Anti8trombin8- ' men$8inakti*asi trombin6 ;IIa6 I,a6,a6 ,Ia6
,IIa6 )"asmin6 Ka"ikrein
#( )rotein8C ' meme%a! *aktor ;a an ;IIIa
-( A"*a # makro$"obu"in ' enDim proteo"itik meme%a! Trombin
< Ka"ikrein
.( C81 In!ibitor ' men$inakti*asi ,Ia6 ,IIa6 Ka"ikrein
( A"*a818Antitripsin ' men$inakti*asi trombin6 ,Ia6Ka"ikrein <
?MK
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LOGO
1F
II( ALI2AN 3A2A? '
Men$!i"an$kan4men$en%erkan *aktorpembekuan akti* ari tempat "uka(
Se" 2ES i !ati membersi!kan +ibrin <trombo p"astin :arin$an6 ?epatosit akanmen$!i"an$kan ;IIa6 I,a an ,a
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LOGO
1&
III( )rouk ari proses +ibrino"isis 1( )LASMIN ' meme%a! +ibrin6 +ibrino$en6
+aktor ; an ;III
#( +3) 0fbrin e$raation prou%t ' merupakan competitive inhibitor
ter!aap Trombin an Fibrin Polimer
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LOGO
1
I;( In!ibitor )"asmin4Anti)"asmin
1(A"*a8#@)"asmin in!ibitor4A"*a8#@Anti )"asmin
#( A"*a8#8Makro$"obu"in
-( A"*a818Antitripsin
.( Anti Trombin8- 0AT8III
K&-0,AKA. 'A-.A. !P&1*03
04
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LOGO
1H
K&-0,AKA. 'A-.A. !P&1*0304DA-A4
2eaksi pembu"u! ara!
;asokonstriksi 2an$san$an ter!aap '1( )"ate"et '
a( Aesi6 A$re$asi
b( )"ate"et $rowt! *a%tor%( )"ate"et *aktor8-
#( Sistem koa$u"asi-( Sistem +ibrino"isis
)"asmino$en akti/atorike"uarkan ari se"enot!e"
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Thank You !