Sistem Imun-kp 1

8/17/2019 Sistem Imun-kp 1

1/64

Oleh :

Nur Aini, M.Kep

BLOK IMUN HEMATO

PROGRAM STUDI S1 KEPERAWATAN IKESUMM

PERTAHANAN TUBUH!1

1


2/64

RES "Re#i$ul%en&%#eli'l()(#e*+

Si(#e* re#i$ul%en&%#eli'l '&'l'h 'rin-'n pen-i$'# re#i$ul'r )'n-#er(e'r lu'( *en)eluun-i(inu(%i&!(inu(%i& &'r'h &i h'#i,(u*(u* #ul'n- &'n u-'*en)eluun-i ('lur'n!('lur'n

li*/e &i 'rin-'n li*/'#i$.

0


3/64

Or-'n (i(#e* re#i$ul%en&%#eli'l p'&'

*'nu(i' *elipu#i : 1. Kelen'r li*/e: *en-'n&un- (el!(el

re#i$ul%en&%#eli'l &'n (el!(el pl'(*', er/un-(i*e*l#r'(i 2'ir'n e$(#r'!(el &'n *e*u'# 'n#i%&i.

0. Li*p': *en-'n&un- (el!(el re#i$ul%en&%#eli'l,li*/%(i# &'n (el!(el pl'(*', /un-(in)' '&'l'h*e*l#r'(i &'r'h&'n *e*u'# 'n#i%&).

3. H'#i: *en-'n&un- (el!(el re#i$ul%en&%#eli'l &'nhep'#%(i#, /un-(in)' '&'l'h *e*l#r'(i &'r'h.

4. Su*(u* #ul'n-: *en-'n&un- (el!(elre#i$ul%en&%#eli'l, (el!(el '5'l &'r'h &'n (el!(elle*'$, /un-(in)' '&'l'hpe*en#u$'n (el!(el &'r'h.

3


4/64

un-(i (i(#e* ini '&'l'h :

1.Men-h'n2ur$'n (el!(el &'r'h )'n-#el'h #u', *e*u'# &'n *elep'($'niliruin $e (ir$ul'(i

0. Me*'$'n '$#eri',

*elip'#-'n&'$'n &iri $'l'u '&'in/e$(i, '&i er#'n--un- '5' &'l'**e*per#'h'n$'n'&'n *el'5'nin/e$(i

3. Me*'$'n &'n *e*pr%(e( 'n#i-en&'n *er'n-('n- (el!(el pl'(*' un#u$*e*u'# 'n#i%&i

4


5/64

Sistem Imun

Organ limfatikprimer

Sumsum tulang belakangKelenjar timus

Organ limfatiksekunder

LimpaNodus limfaTonsil

6


6/64

Fungsi Sistem Imun

7 pen'n-$'l 8en&'9 '(in- )'n- *'(u$ $e &'l'* #uuh

7 un#u$ $e(ei*'n-'n /un-(i #uuh #eru#'*' *en'-' $e(ei*'n-'n $%*p%nen#uuh )'n- #el'h #u'

7 (e'-'i pen&e#e$(i '&'n)' (el!(el 'n%r*'l, #er*u#'(i, '#'u -'n'(, (er#'*en-h'n2ur$'nn)'.

Re(p%ni*un

N%n!(pe(i$

'-%(i#%(i(

Spe(i$

In;'*'(i

I*uni#'(hu*%r'l

"'n#i%&i+

I*uni#'(&iper'n#'i(el "(el!(el+

P'#%-en &'l'*#uuh

Pe*e$u'n&'r'h

Dalam tubuh

Luar tubuh

Pen-h'l'n-*i('ln)' $uli#

Lu$'

P'#%-en*i('ln)' '$#eri

Li(%


7/64

Pertahanan Tubuh Alami

7 Neutrol! eusinol! basol! monosit!

limfosit

Sili'

Per#'h'n*e$'ni$erup'(el!(eler(ili' &'l'*('lur'n

pern'p'('n

Pertahanan Tubuh oleh Sel DarahPutih

7 Pertahanan sik : $uli#

7 Pertahanan "ekanik# r'*u# hi&un-, (ili'7 Pertahanan Kimia# 'ir *'#', *u$u(, ('li>'

7Pertahanan $iologis# '$#eri 'l'*i

?


8/64

Pertahanan Tubuh Alami

A('* le*'$ &'n

'$#eri 'l'*i

Li(%'-in'@


9/64

M'2'*!*'2'* (i(#e* per#'h'n'n #uuh


10/64

Perbedaan respons nonspesik dengan respons

spesik %espons nonspesik %espons spesik

Bere'$(i ('*' #erh'&'p

(e*u' '-en in/e$(i

Me*ili$i re'$(i ere&'

un#u$ '-en in/e$(i )'n-

ere&' Ti&'$ *e*ili$i *e*%ri

#erh'&'p in/e$(i

(eelu*n)'

Me*ili$i *e*%ri #erh'&'p

in/e$(i (eelu*n)'

Tin-$'# re'$(i ('*' p'&'#i'p '-en in/e$(i )'n-

eru('h' *en)er'n-

Tin-$'# re'$(i '$'n leihe('r #erh'&'p '-en in/e$(i

)'n- pern'h *en)er'n-

(eelu*n)'

1


11/64

A (u**'r) %/ inn'#e 'n& '2Cuire& i**uni#)I**uni#) T)pe(

INNAT& I""'NIT(%apid responses to a

broad range of mi)robes

A*+'I%&D I""'NIT( Slo,er responses to

spe)i) mi)robes

&-ternal defenses Internal defenses

S$in

Mu2%u( *e*r'ne(

Se2re#i%n(

Ph'-%2)#i2 2ell(

An#i*i2r%i'l pr%#ein(

In;'**'#%r) re(p%n(e

N'#ur'l $iller 2ell(

Hu*%r'l re(p%n(e"'n#i%&ie(+

ell!*e&i'#e& re(p%n("2)#%#%i2l)*ph%2)#e(+

In>'&in-

*i2r%e("p'#h%-en(+

11


12/64

Re(p%n( n%n(pe(i$

Per#'h'n'n l'pi( per#'*'Per#'h'n'n l'pi( $e&u'

10


13/64

Per#'h'n'n l'pi(Flini per#'*'

Kuli# "*en)e$re(i '('* le*'$ &'n $erin-'# )'n-*en-'n&un- -'r'* (ehin--' *en-h'*'# l'u

'$#eri+

Me*r'n *u$%(' "('lur'n pern'p'('n )'n-

*en)e$re(i len&ir '$'n *e*er'n-$'p '$#eri+

Se$re(i 'l'*i "Liur &'n 'ir *'#' *en-'n&un- li(%


14/64

Per#'h'n'n l'pi( $e&u''-%(i# &'n (el pe*unuh 'l'*i "SD )- *'*pu

*en-h'n2ur$'n *'#eri '(in-, e. neu#r%l *%n%(i#+Pr%#ein $%*ple*en "$e#i$' 'n#i%&i #eren#u$, pr%#

$%*ple*en#er '$'n *ene*pel p& *i$r%+

In#er/er%n "rp (el *en)e$re(i in#er/er%n u#$ *e*u'#

(el $e'l #erh'&'p p'r#i$el >iru(+Si#%$in "pe*'5' pe('n 'n#'r(el u#$ $e$e'l'n,

$r'('*' &-n SSP (i(# 'rin-'n l'in. Sel &p#*ere(p%n( pe('n i$' (i#%$in pun)' re(ep#%r )- 2%2%$+

In;'*'(i "re'$(i '$i'# #i*uln)' in/e$(i &'n#eru$'n)' 'r#eri%l &i (e$i#'r &'er'h )'n- #erlu$'(ehin--' (upl'i &'r'h $e &'er'h )'n- #erlu$'*enin-$'#. Di$%n#r%l %leh en


15/64

Re(p%n( (pe(i$

Pertahanan lapis ketiga

*eli'#$'n li*/%(i# B &'n

li*/%(i# T

16


16/64

Sel limfosit $

Sel $plasma

Sel $memori

Sel limfosit T

Sel Tpembantu

Sel Tpembunu

h

Sel Tsupresor

Sel $pembelah

1=


17/64

Organ Imun ./ematologis

1?


18/64

1. N%&u( Li*/'Merup'$'n %r-'n #er$e2il,

&i'*e#er 6 ** #er(e'r &i(eluruh #uuh ('lin-erhuun-'n *el'luipe*uluh li*/'.

Si(#e* li*/'#i$ #er&iri &'ri2'ir'n li*/e, pe*uluh li*/e&'n n%&u( li*/e. (i(#e* ini*en-'n-$u# 2'ir'n li*/e

)'n- er/un-(i un#u$*en-u*pul$'n (i('!(i('*e#'%li(*e, 'rin-'n *'#i,&'n *en-'n&un- (el &'r'h

pu#ih un#u$ *el'5'n in/e$(i.1@


19/64

Sel i*un )'n- #er&'p'# &i &'l'* n%&u( li*/e yaitu li*/%(i# "un#u$ *en)er'n- >iru(, '$#eri,&'n $u*'n l'inn)'+ &'n makrofag "*e*'$'n &'n*en-h'n2ur$'n


20/64

0. N%&ulu( li*/'#i$u(

Me*ili$i (#ru$#ur )- leih #er%r-'ni('(i&i'n&in-$'n n%&u( li*/'.

Ter&'p'# p& *u$%(' epi#el pel'pi(

('lur'n pen2ern''n, pern'/'('n per$e*ih'n.

Sel i*un%$%*pe#en B &i n%&ulu(li*/'#i$u( *en-h'(il$'n I-E &'n I-A

)'n- erper'n p& re(p%n 'ler-i '#'ure'$(i hiper(en(i#i>i#'( (e-er'.

0


21/64

3. Li*p'Flien

un-(i li*p' :

1. *en&'ur ul'n-


22/64

4. Ti*u(un-(i #i*u( #eru#'*'

un#u$ *en-e*'n-$'nli*/%(i# T. Se#el'h*'#'n-, (el!(el ini*enin--'l$'n #i*u( &'n

&i'n-$u# *el'luipe*uluh &'r'h $e$elen'r -e#'h enin- &'nli*p'.

Men2'p'i pun2'$per$e*'n-'n p'&'*'(' 'n'$0, (e#el'hpuer#'( '#r%pi #e#'pi%r-'n (i(' *'(ih '&'hin--' #u'.

00


23/64

Li*/%(i# T '#'u (el!T '&'l'h (el &'r'h pu#ih )'n-*elin&un-i #erh'&'p %r-'ni(*e '(in- "'$#eri &'n

>iru(+ )'n- #el'h erh'(il *en-in/e$(i (el!(el#uuh. Mere$' u-' *elin&un-i #uuh &'ri &irin)'(en&iri &en-'n *en-en&'li$'n (el $'n$er.

'.Sel T (i#%#%$(i$ J l'n-(un- *en-hen#i$'n 'n#i-en.

.Sel T helper J *e*i2u pr%&u$(i 'n#i%&i %leh (el!B&'n u-' *en-h'(il$'n


24/64

Ti*u( *e*pr%&u$(i pr%#ein h%r*%n

)'n- *e*'n#u li*/%(i# T *'#'n-&'n er&i/eren(i'(i. Beer'p' h%r*%n#i*u( #er*'(u$ #i*p%ei#in, #i*ulin,#i*%(in, &'n /'$#%r hu*%r'l #i*u("TH+. Ti*p%ei#in &'n #i*ulin*en-in&u$(i &i/eren(i'(i p'&' li*/%(i# T &'n *enin-$'#$'n /un-(i (el!T.

Ti*%(in *enin-$'#$'n re(p%n i*un.

04


25/64

6. Su*(u* #ul'n-

Ter*'(u$ %r-'n#ere('r &l* #uuh, p&%r'n- &e5'(' er'#(e$i#'r 3 -r.

&'l'h 'rin-'n (p%n(le*u# )'n- #erle#'$ &i&'l'* r%n--' in#eri%r

#ul'n- p'n'n-

06


26/64

A&' &u' eni( (u*(u* #ul'n-:

'.(u*(u* *er'h )'n- er#'n--un- '5' un#u$ *e*pr%&u$(i (el &'r'h*er'h, (el &'r'h pu#ih &'n #r%*%(i#

.(u*(u* $unin- )'n- #er&iri #eru#'*'&'ri (el!(el le*'$

A&' (eu*l'h pe*uluh &'r'h &'n

pe*uluh &'r'h $'piler *elin#'(i*el'lui (u*(u* *en'&i$'nn)'(eu'h %r-'n )'n- ('n-'# >'($ul'r

0=


27/64

un-(i :

1.Pe*elih'r''n (el in&u$ pluripr%#en )'n-

n'n#in)' '$'n *en'&i (el &'r'h.

0. Te*p'# u#$ &i/eren(i'(i *'#ur'(i (el&'r'h

3. Te*p'# pen)i*p'n'n neu#r%l &'neri#r%(i#

4. Tr'n(/%r*'(i li*/%(i# )'n- elu*#er&i/eren(i'(i *en'&i (el B *'#ur

6. Te*p'# pr%&u$(i 'n#i%&i p& re(p%n i*un(e$un&er #erh'&'p 'n#i-en er-'n#un- p&#i*u( )- *'(u$ *el'lui in#r'>en'.

0?


28/64

PEMBENTUKAN SEL DARAH

He*'#%p%e(i( *erup'$'npr%(e( pe*en#u$'n per$e*'n-'n (el &'r'h.

Pr%(e( ini erl'n-(un- (e'$per$e*'n-'n '5'l e*i%

*'nu(i' er'l'n (ep'n'n-hi&up *'nu(i'.

0@


29/64


30/64

Se$i#'r @ #%#'l er'# #uuh $i#' '&l &'r'h.P'&' 5'ni#' (e$i#'r 4!6 li#er, (e&'n-$'n

p'&' l'$i!l'$i (e$i#'r 6!= li#er &'r'h.%lu*e &'r'h er>'ri'(i #er-'n#un- u*ur

$%*p%(i(i #uuh. Se*'$in ren&'h le*'$#uuh, *'$' (e*'$in 'n)'$ &'r'h

per$il%-r'* er'# '&'n.D'r'h 'r#eri er5'rn' *er'h #er'n- $rn

*en-'n&un- O0 )- #eri$'# p'&' H &i SDM.Se&'n-$'n &'r'h >en' er5'rn' *er'h

-el'p $rn *en-'n&un- (e&i$i# H.

3


31/64

P&"$A0IAN DA%A/

PLASMA DARAH 66

SEL!SEL DARAH 46 TERDIRI DARI:

! SEL DARAH MERAH "ERITROSIT+

! SEL DARAH PUTIH "LEUKOSIT+

! KEPING DARAH"TROMBOSITFPLATELET+

31


32/64

KARAKTERISTIK DARAH

BERAT ENIS DARAH : 1.64 J 1.=

BERAT ENIS PLASMA : 1.04 J 1.0@

ISKOSITAS "$e$en#'l'n+: 3!6 AIR UMLAH OLUME DARAH : 6!@ BB

30


33/64

PLASMA DARAH

AIR 1 SUBSTANSI LAIN @ #&&:PROTEIN PLASMA DARAH ? :

'lu*in, rin%-en, -l%ulinENIM, #&&: '('* '*in%, le*'$, -lu$%(',

ure', -'r'*, (%&iu* i$'r%n'#

,1 HORMON, ANTIBODI, GAS

33


34/64

SEL DARAH MERAH"ERITROSIT+SDM *e*'5' O0 *enuu (el *e*'n#u

#r'n(p%r#'(i O0 $e*'li $e p'ru0, erper'n&l* $e(ei*'n-'n '('*!'('. SDM u-'*en-'n&un- 'nhi&r'(e $'r%n'#, (eu'h en


35/64

Pr%&u$(i erir#%(i# &i(eu# 8eri#r%p%e(i(9.Dipr%&u$(i &i (u*(u* #ul'n-.

P'&' pr%(e( pe*en#u$'nn)' &iperlu$'n :

1+. Sel pre$ur(%r

0+. K%n&i(i lin-$un-'n *i$r% )'n- #ep'#

3+. Supl'i e(i, >i#'*in B10, '('* /%l'#,pr%#ein, piri&%$(in &'n #e*'-' )'n- 2u$up.

i$' ('l'h ('#u $%*p%nen ini #&$ #er(e&i',*'$' eri#r%(i# )- &ih'(il$'n '$'n *u&'hru('$, en#u$ #&$ n%r*'l, '#'u *l #i&'$n%r*'l.

36


36/64

Pembentukan . pematangan seldarah merah

Pr%eri#r%l'(# "he*'(i#%l'(#+ "0 '*+ eri#r%l'(# '(%phili$ "0 '*+ H*ul'i &ien#u$ eri#r%l'(#p%li$r%*'#%phili$ "06 '*+ eri#r%l'(#%r#%$r%*'#%phili$ n%r*%l'(# "3 '*+ H (ele('i &ien#u$ re#i$ul%(i# "(&*

*u&'+ "?0 '*+

(el &'r'h *er'h "10h'ri+ #el'h *en'l'n$'n #u-'((ep'n'n- ? *il

3=


37/64

Ke#i$' eri#r%(i# *enu', (el ini '$'n r'puh pe2'h. H #erlep'( *enin--'l$'n*e*r'n (el )- $%(%(n-, (el ini $e*u&i'n'$'n &i/'-%(i#%(i( %leh *'$r%/'- &l* h'#i,li*p', n%&u( li*/' (u*(u* #ul'n-. H

'$'n &ipe2'h *en'&i He*e -l%in. Be(i pe2'h'n he*e '$'n $e*'li $e h'#i,li*p', (u*(u* #ul'n- u#$ *e*en#u$ul'n- H. Se&'n-$'n h'#i '$'n *en-u'h

p%rrin "pe2'h'n &'ri he*e+ *en'&iiliruin )- '$'n &ie$($re(i$'n &'ri #uuhle5'# /e2e( urin.

3?


38/64

SEL DARAH PUTIH "LEUKOSIT+ u*l'h 6 J 1 (elF&L

Ber&'('r$'n'&'F#i&'$ '&'n)'-r'nulFp'r#i$el

Gr'nul%(i#:NEUTROPHIL,EOSINOPHIL"ASIDOPHIL+,

BASOPHILA-r'nul%(i#:

LIMPHOSIT, MONOSIT

Ber&'('r$'n'n)'$n)' in#i

P%linu$leu(FP%li*%rp

hi:NEUTROPHIL,

EOSINOPHIL"ASIDOPHIL+,

BASOPHIL, MONOSITM%n%nuleu(F*%n%*

%rphi: LIMPHOSIT

3@


39/64

3


40/64

Si/'#!(i/'# (el &'r'h pu#ih

1. '*%e%i& &'p'# *eru'hen#u$

0. /'-%(i#%(i# &'p'# *e*'$'n#eru#'*' '$#eri, >iru(, p'r'(i#l'inn)'

3. &i'pe&e(i( &'p'# $elu'r *'(u$ 'rin-'n &'n pe*uluh &'r'h

4


41/64

Gr'nul%(i#'. Neu#r%l

Neu#r%l "P%li*%r/+, (el ini er&i'*e#er 10J16 * *e*illi$i in#i )'n- $h'( p'&'##er&iri '#'( (i#%pl'(*' pu2'# &i 'n#'r' 0hin--' 6 l%u( &en-'n r'n-$' #i&'$

#er'#ur. Merup'$'n (el )- per#'*' $'li erper'n

p& pr%(e( in;'*'(i '$u#.

neu#r%l *'#ur er'&' &i (u*0

#ul'n-, (ehin--' *e*un-$in$'n re(p%n(e-er' $e#i$' #uuh *e*u#uh$'n(eu*l'h (el e('r $e#i$' #er'&i in;'*'(i.

W'$#u hi&up : 1 '* J 3 h'ri41


42/64

. E%(in%l

Men-'n&un- eer'p' -r'nul' e('r )-er5'rn' %r'n-e.

P'&' $%n&i(i n%r*'l, e%(in%l *'#ur #$er'&' p'&' (u*(u* #ul'n-, #e#'pi *ere$'

#er&'p'# &l* u*l'h $e2il p'&' &'r'h #epi.Sel ini '$'n $elu'r &'ri pe*uluh &'r'h #epi*enuu 'rin-'$ e$(#r'>'($ul'r er'$u*ul'(i &i &e$'# per*u$''n epi#el.

D'ri (ini *ere$' '$'n *elin&un-i #uuh&'ri in/e$(i p'r'(i# *e*%&ul'(i re(p%ni*un 'ler-i er('*' I-E.

W'$#u hi&up : 1 '* J 3 h'ri40


43/64

. B'(%lB'(%l er5'rn' un-u &'n *e*ili$i -r'nul' )-

e('r.

un-(i n%r*'l &l* #uuh #&$ &i$e#'hui (e2'r'*en&'l'*.

B'(%l *e*ili$i 'n)'$ -r'nul' (i#%pl'(*' )'n-*enu#upi in#i &'n *en-'n&un- hep'rin &'nhi(#'*in.

D'l'* 'rin-'n , '(%l *en'&i 8*'(# 2ell(9.B'(%l *e*ili$i #e*p'#!#e*p'# perle$'#'n I-G&'n &e-r'nul'(in)' &i$'i#'n &en-'n pelep'('nhi(#'*in. un-(in)' erper'n &'l'* re(p%n'ler-i

43


44/64

A-r'nul%(i#

'. M%n%(i# M%n%(i# &ilep'($'n (u*(u* #ul'n- $e &'l'*

(ir$ul'(i &l* $%n&i(i (el /'-%(i# hip%'$#i/.Se#el'h *ene*pel p& en&%#el li*p', (u*(u*#ul'n- h'#i '#'u (e#el'h erpin&'h &'ri

&'r'h *enuu p'ru, 'rin-'n i$'# '#'u 'rin-'n li*/%i&, (el ini '$'n eru'h *en'&iMAKROAG &-n /un-(i /'-%(i#%(i( penuh.

Sel ini *erup'$'n '-i'n &'ri RES

"re#i$ul%en&%#eli'l ()(#e*+ er#'n--un- 5 &l* *en-h'n2ur$'n (u(#'n(i '(in- )-*e*'(u$i #uuh.

44


45/64

. Li*/%(i#

Ber&'('r /un-(in)' #er'-i *en'&i 3 : li*/%(i# T, li*/%(i# B, &'n (el NK "n'#ur'l $iller+

un-(i (el B p'&' re(p%n i*un &i*e&i'(i'n#i%&i )- *e*'n#u u#$ *e*per#'h'n$'n#h &'ri in/e$(i '$#eri, #%$(in '$#eri eer'p' eni( >iru(.

Sel T, *erup'$'n &'('r &'ri re(p%n i*un )-&i*e&i'(i $%*p%nen i*un (eluler )- er/un-(iu#$ *e*per#'h'n$'n #uuh &'ri (er'n-'n

p'#%-en in#r'(eluler /'$ul#'#i/ %li-'#, '*ur,(er#' >iru(.

Sel NK *en)u(un 6!1 li*/%(i# &l* (ir$ul'(i. Terli'# &l* pen-h'n2ur'n eer'p' (el #u*%r

(el )- #erin/e$(i >iru(.46


46/64

4=


47/64

PLATELETFTROMBOSIT

Me*ili$i 0 per'n'n pen#in- &l*h%*e%(#'(i( )'i#u : 1+. Menu#up lu$' $e2ilp& pe*uluh &'r'h "/un-(i he*%(#'(i(+ 0+.K%*p%nen )- &iu#uh$'n &l* pr%(e(

$%'-ul'(i "/un-(i #r%*%l'(#i$+.Se#i'p pl'#ele# &ipr%&u$(i &'ri pe*e2'h'n

#ul'n- )- &i(eu# *e-'$'ri%(i# erin#i'n)'$ &i (u*(u* #ul'n- )- &i(eu#

*e-'$'ri%(i#.Pe*en#u$'n pl'#ele# p& *'nu(i'

*e*u#uh$'n 5'$#u 6 h'ri.

4?


48/64

Su*(u* #ul'n- n%r*'l *'nu(i'*en-'n&un- hin--' = u#'

*e-'$'ri%(i#F$- BB, &'n (e#i'p*e-'$'ri%(i# *e*pr%&u$(i leih &'ri1 pl'#ele#.

Pr%&u$(i pl'#ele# p& *'nu(i' n%r*'ler'&' p& $%n#r%l $e#'# h%r*%n h'#i)'i#u, #r%*%p%ie#in erl'n-(un-(e2'r' $%n(i(#en &-n u*l'h rel'#i/ ('*'

(ep'n'n- #'hun.Dl'* he*%(#'(i( &iperlu$'n 'n#'r'

16.!4.F**3.

4@


49/64

He*%(#'(i(Merup'$'n pr%(e( per'i$'n pe*uluh

&'r'h u#$ *en-ur'n-i hil'n-n)' &'r'h &'ripe*uluh &'r'h.

Ter'&i &l* 3 #'h'p'n :

'.'(%$%n(#ri$(i pe*uluh &'r'h.Pe*en#u$'n (u*'# pl'#ele#

2.K%'-ul'(i '#'u pe*en#u$'n -u*p'l'nrin

4


50/64

Pr%(e( He*%(#'(i(

Pembuluh darahPembuluh darah TrombositTrombositFaktor Pembekuan

darah

Faktor Pembekuandarah

'(%$%n(#ri$(i pen-ur'n-'n'lir'n &'r'h

p'&' &'er'h)'n- lu$'

A$#i>'(i#r%*%(i#

'&he(i'--re-'(i

(u*'##r%*%(i#"l* (#'il+

A$#i>'(i/'$#%rpe*e$u'n

pe*en#u$'n rin" (u*'##r%*%(i#(&h (#'il+

L'KA PADA P&"$'L'/ DA%A/

6


51/64

Vasokonstriksi lokal

Spasme lokal ototpolos

Dapat di’maintained’ olehplatelet

vasokonstriktor

61


52/64

Pembentukan Agregatplatelet

Pembuluh darah yangterluka melepaskan ADP, yang menarik (attracts)platelet (PL)

PL selan!utnya kontakdengan collagen yangterekspos dan melepaskan"serotonin, ADP, #A$, yangmemperkuat vasokonstriksidan menyebabkan PLmengembang dan men!adilebih lengket (sticky)

60


53/64

Pembentukanbekuan darah (blood clot)

Dalam prosespembentukan clot,en%im yang disebutthrombin mengubah

&ibrinogen men!adiinsoluble protein,&ibrin

'ibrin beragregasi

membentuk meshlikenetork* pada tempatter!adinya kerusakanpembuluh darah

63


54/64

AKTOR KOAGULASI

N%r*'l &'l'* $e'&''n in!'$#i/,&i(eu# (e'-'i QMOGEN

i$' '&' r'n-('n-'n)*%-en eru'h (e'-'i

en#u$'n en


55/64

N%*en$l'#ur '$#%r K%'-ul'(i"Pe*e$u'n+Faktor Nama Sinonim

I irin%-en !

II Pr%#hr%*in !III Ti((ue '2#%r Ti((ue Thr%*%pl'(#in

I I%n K'l(iu* !

Pr%'22elerin L'ile '2#%r

II Pr%2%n>er#in S#'le '2#%r

III An#i He*%phili2 '2#%r "AH+ An#i He*%phili2 Gl%ulin "AHG+

I Pl'(*' Thr%*%pl'(#in%*p%nen# "PT+

hri(#*'( '2#%r

S#u'r# '2#%r Pr%5er '2#%r

I Pl'(*' Thr%*%pl'(#inAn#e2e&en#

An#i he*%phili2 '2#%r

II H'-e*'n '2#%r %n#'2# '2#%r

III irin S#'ili


56/64

dd" !alur ekstrinsik danintrinsik, lalu bergabungmen!adi satu (!alur

bersama)

Sistem !alur intrinsiklebih kompleks

Proses pembentukan&ibrin, terbagi atas +

tahap

ekanisme -oagulasi

6=


57/64

.ntrinsic pathay"

/ollagen yg terekspos

mengakti&kan 0ageman&actor (' #..)1 ' #.. amengakti&kan plasmaen%yme 2 plasmathromboplastin

antecedent (PA3 ' #.,bersama /a $4 mengakti&kan /hristma&actor (' .#)1 ' .#berinteraksi dengan

antihemophilic &actor ('V...), 5 /a $4 membentukompleks yangmengakti&kan Stuart&actor (' #)1

Stage ." 'ormationo& prothrombin

activator

*a12

/hristmas&actor

Anti6hemophilic&actor

Stuart &actor

6?


58/64

ahap ."pembentukanprothrombin

activator

+1 /ommon pathay"

' # a bersama /a$4

membentuk kompleksdengan accelerin (' V) untuk membentukprothrombin activator

*a1

/hristmas&actor

Anti6

hemophilic&actor

Stuart &actor

6@


59/64

ahap .." -onversi prothrombin men!adi thrombin

Prothrombin 2 prekursor inakti& dari en%im thrombinDengan adanya prothrombin activator dan /a$4,

prothrombin diubah men!adi thrombinhrombin meningkatkan la!u pembentukannya sendiri

(positive &eedback mechanism)

*a1

6


60/64

ahap ..." -onversi &ibrinogen men!adi &ibrin

'ibrinogen 2 protein plasma yang diproduksi oleh heparhrombin mengubah &ibrinogen men!adi &ibrinhrombin !uga mengakti&kan &ibrin6stabili%ing &actor ('

#...), bersama dgn /a$4, menstabilisasi &ibrin polymer dgncara mengikat &ibrin monomers secara kovalen

&ibrin6stabili%ing&actor

=


61/64

=1


62/64

INTERAKSI ALUR INTRINSIK EKSTRINSIK

1. Ke&u' (i(#i* &iperlu$'n &'l'* pr%(e( he*%(#'(i(

"'$#i>'(i 'lur in#rin(i$ rel'#i/ l'*'# 'lure$(#rin(i$ erl'n-(un- 2ep'#+

0. A$#i>'(i (i(#i* in#rin(i$ #er'&i il' &'r'her(en#uh'n &en-'n $%l'-en "'r.(uen&%#el+ '$#i>'(i 'lur e$(#rin(i$ #er'&i il' &'r'her(en#uh'n &en-'n e$(#r'$ 2'ir'n 'rin-'nF#i((ue#hr%*%pl'(#in.

3. Tr%*in )'n- &ih'(il$'n 'lur e$(#rin(i$ '$'n leih*e*'2u '$#i>'(i 'lur in#rin(i$ *el'lui '$#i>'(i

#r%*in p'&' /'$#%r III4. Tr%*in )'n- &ih'(il$'n u-' *er'n-('n- '-re-'(i

#r%*%(i#

6. '$#%r II )'n- #er'$#i>'(i %leh #r%*%pl'(#in 'rin-'n i$u# *en-'$#i>'(i /'$#%r I.

=0

IBRINOLISIS


63/64

IBRINOLISIS ANTIKOAGULANSi(#e* $%'-ul'(i &i$en&'li$'n %leh er'-'i

*e$'ni(*e u#$ *en-'#ur 'lir'n &'r'h *el'luip.&'r'h.

D'r'h *e*ili$i 'n#i$%'-ul'n n'#ur'l "hep'rin,

'n#i#r%*in, 'n#i#r%*%pl'(#in+ )- e$er' u#$*en-h'*'# $%'-ul'(i.

Pe*uluh &'r'h (e2'r' $%n#inu *en-'l'*i$eru('$'n per'i$'n. In#er'$(i $%*ple$( erul'n- 'n#'r' pe*en#u$'n -u*p'l'n, li(i(

-u*p'l'n 'n#i$%'-ul'n *e*un-$in$'nper'i$'n p. &'r'h #'np' '&'n)' pe*en#u$'n-u*p'l'n )- e('r &'l'* p. &'r'h.

=3


64/64

Documents

Sistem Imun-kp 1