解剖組織学5 造血器

ゎ๗⤌⧊Ꮫ䠑 㐀⾑ჾ
⾑ᾮ䛿
ே㛫䛾య䛾⣙13ศ䛾1䠄5䝸䝑䝖䝹䠅⛬ᗘ䛒䜛䚹
ேయ䜢ᚠ⎔䛧䚸⏕࿨⥔ᣢ䛻㔜せ䛺ᙺ๭䜢ᣢ䛴䚹
1. ⾑ᾮ䛾䛹䜣䛺ᙺ๭䜢▱䛳䛶䛔䜎䛩䛛䠛
2. 䛹䜣䛺≀㉁䜔⣽⬊䛜䛒䜛䛾䛷䛩䛛䠛
3. 䛺䛬㉥䛔䛾䛷䛩䛛䠛
㓟⣲䚸Ⅳ㓟䜺䝇䚸ᰤ㣴䚸⪁ᗫ≀䚸య 䚸䜲䜸䞁
䝩䝹䝰䞁䛺䛹䛾㐠ᦙ䛸ᜏᖖᛶ䛾⥔ᣢ䚹
⣽⬊ᡂศ䠖㉥⾑⌫45%䚸ⓑ⾑⌫䚸⾑ᑠᯈ1%
ᾮయᡂศ䠄⾑₢䠅55%䠄䝦䝬䝖䜽䝸䝖䛸䛿䠛䠅
䝦䝰䜾䝻䝡䞁䛿㕲䜢ྵ䜐㉥䛔Ⰽ⣲䠄㓟⣲㐠ᦙ䠅
⾑ᾮ䛾ὶ䜜䜛㐨䚸䝇䝨䞊䝇䚸⤒㊰䜢
⾑⟶䛸࿧䜃䚸ື⬦䛸㟼⬦䛜䛒䜛䚹
ື⬦䛸㟼⬦䛿䛹䛾䜘䛖䛺㐪䛔䛜䛒䜚䜎䛩䛛䠛
⾑ᾮ䜢ᚠ⎔䛥䛫䜛௙⤌䜏䛸⤒㊰䜢ྜ䜟䛫
ᚠ⎔ჾ䚸ᚠ⎔⣔䛸࿧䜆䚹
ᚰ⮚䛸䚸኱⾑⟶䚸⫵⮚䛺䛹䛜䛣䜜䛻ᒓ䛧䜎䛩䚹
ᚠ⎔ჾ⣔䛿㛢㙐⣔䛸࿧䜀䜜䜎䛩䚹
䝸䞁䝟⣔䛿㛤ᨺ⣔䛸࿧䜀䜜䜎䛩䚹
㐪䛔䛿䛺䜣䛷䛩䛛䠛
⾑₢䛻䛿100✀㢮௨ୖ䛾⾑₢ᡂศ䛜ྵ䜎䜜䛶䛔䜛䚹
䝍䞁䝟䜽㉁ 䐟䜰䝹䝤䝭䞁䠄⫢⮚䠅䠖⾑₢ᾐ㏱ᅽ䜢ᢸ䛖
䐠จᅛ䝍䞁䝟䜽䠖⾑ᾮจᅛ䛻㛵୚䛩䜛
䐡ච␿䜾䝻䝤䝸䞁
㟁ゎ㉁䠄䝘䝖䝸䜴䝮䚸䜹䝸䜴䝮䚸䜹䝹䝅䜴䝮䚸䜽䝻䝹䠅
䠖⾑ᾮ䛾㓟ሷᇶᖹ⾮䚸pH7.35-7.45䛾⥔ᣢ
ᰤ㣴⣲䠖䜰䝭䝜㓟䚸䜾䝹䝁䞊䝇䠄䝤䝗䜴⢾䠅䚸
⬡⫫㓟䚸䝡䝍䝭䞁䛺䛹䛾㐠ᦙ䚹
䜺䝇஺᥮䠖⣽⬊࿧྾䠖㓟⣲䚸Ⅳ㓟䜺䝇䛾㐠ᦙ䚹
䝩䝹䝰䞁
⾑⟶ෆ
Ỉ䚸⺮ⓑ䚸⢾䚸⬡㉁䚸䝡䝍䝭䞁䚸䝭䝛䝷䝹䛺䛹
⾑₢䠙ᾮయᡂศ䠄จᅛᅉᏊྵ䜐䠅
⾑⌫䠙⣽⬊ᡂศ
⾑
ᾮ
㉥⾑⌫
ⓑ⾑⌫
⾑ᑠᯈ
⾑Ύ䠙⾑₢䠉จᅛᅉᏊ䠄Fibrinogen䛺䛹䠅
⾑⟶እ
จ⾑
⾑㣰䠙⾑⌫䠇จᅛᅉᏊ䠄䠢䡅䠾䡎䡅䡊䠅
䠄จ⾑ሢ䠅
㉥⾑⌫䠖
㦵㝶䛷㉥ⱆ⌫䛛䜙ศ໬䛧䚸
᰾䛾䛺䛔⣽⬊䚹
䝦䝰䜾䝻䝡䞁䜢ධ䜜䜛䚹
䝗䞊䝘䝒≧䚸෇┙≧䛾≉␗䛺ᙧ䜢䛩䜛䚹
⾑ᾮ1mm3䛻500୓ಶ䛒䜛䚹
䝦䝰䜾䝻䝡䞁䛿㓟⣲䛸⤖ྜ䛩䜛䚹
㈋⾑䛿
㓟⣲㐠ᦙ⬟䛜పୗ䠄㉥⾑⌫୙㊊䛺䛹䠅≧ែ䛷䚸
ṇᖖ䛷䛿
㉥⾑⌫䛾ᩘ: 400-500
䝦䝬䝖䜽䝸䝑䝖䠄ᅛᙧᡂศ%䠅: 40-48
䝦䝰䜾䝻䝡䞁䠄g/dl䠅: ⏨ᛶ䠖13-18 ዪᛶ䠖12-16
䛺䛹䛷᳨ᰝ䛥䜜䜛䚹
㕲Ḟஈᛶ䚸⁐⾑ᛶ䚸෌⏕୙Ⰻᛶ䠄㦵㝶㞀ᐖ䠅
ฟ⾑ᛶ䠄⫶₽⒆䚸Ꮚᐑ➽⭘䛺䛹䠅
␗ᖖ䝦䝰䜾䝻䝡䞁⑕
䠄௦⾲ⓗ䛺⑌ᝈ䛿㙊≧㉥⾑⌫㈋⾑䠅䠖
㉥⾑⌫ Erythrocytes, Red blood cells
䞉 ┤ᚄ⣙7μm䚸ཌ䛥⣙2-3μm䚸↓᰾
䞉 ୰ኸ㒊䛜䜔䜔พ䜣䛰෇┙≧䚸ᙎຊᛶ䚸ఙ䜃⦰䜏
䞉 ⣙400-450䠄䗠䠅 450-500䠄䗢䠅㽢104 / μl
䞉 ෆ㒊䛻䝦䝰䜾䝻䝡䞁䠄Hemoglobin䠖H䠾䠅䜢ྵ䜐
䝦䝰䜾䝻䝡䞁䠖
Fe++䜢ྵ䜐⺮ⓑ㉁
㓟⣲䛾㐠ᦙ
oxyhemoglobin 㓟⣲䛻⤖ྜ䠙㓟໬
㉥Ⰽ
deoxyhemoglobin
ⓑ⾑⌫
⾑ᾮ䛾᭷ᙧᡂศ䛾1%௨ୗ䛷䚸
4000-10000/1mm3䛒䜛䚹
㈎㣗⬟䚸㐟㉮⬟䜢ᣢ䛴ዲ୰⌫䚸
ᢠయ䜢⏘⏕䛩䜛䝸䞁䝟⌫䛺䛹䛜䛒䜛䚹
⏕య㜵ᚚ䛾ᙺ๭䜢ᣢ䛴䚹
ⓑ⾑⌫ቑከ⑕䚸ⓑ⾑⌫ῶᑡ⑕
⾑ᾮ䛾⒴䠖ⓑ⾑⑓
ⓑ⾑⌫䛾✀㢮
㢛⢏⌫
ዲ୰⌫䠖㈎㣗⬟䠄⣽⳦䚸┿⳦䠅
ዲ㓟⌫䠖䜰䝺䝹䜼䞊
ዲሷᇶ⌫䠖䝠䝇䝍䝭䞁䚸⾑⟶㏱㐣ᛶ
䝸䞁䝟⌫䠄↓㢛⢏⌫䠅䠖T⣽⬊䚸B⣽⬊
༢⌫䠖⤌⧊䛻⛣⾜䛩䜛䛸䝬䜽䝻䝣䜯䞊䝆䛸
䛸䛺䜛䚹㈎㣗⬟䜢ᣢ䛴䚹
⾑ᑠᯈ䠖㦵㝶ᕧ᰾⌫䛾⣽⬊㉁䛾୍㒊䚹
ฟ⾑ḟ㞟䜎䜚Ṇ⾑䛻㛵୚䛩䜛䚹
䠆䡚 † ㉥⾑⌫䛾୍⏕䠄⣙120᪥䠅
ฟ⾑䠄ኻ⾑䠅
䠆㐀⾑
† ⁐⾑
⬺᰾
⣽⬊ศ⿣
㉥⾑⌫
Erythrocytes
ᚰ䞉⾑⟶䠙ᚠ⎔
ቑ
ῶ
Hemoglobin
ᖿ⣽⬊
Stem cell
㉥ⱆ⌫
Erythroblast
㦵㧊
䠄㉥Ⰽ㦵㧊䠅
Bone marrow
Billirubin
෌⏕୙Ⰻᛶ㈋⾑
⭁⮚
⁐⾑ᛶ㈋⾑
䠄㉥⭁㧊䠅
Spleen
ⓑ⾑⌫ Leucocytes, White blood cell
ዲ㓟⌫
䜰䝺䝹䜼䞊䞉ᐤ⏕⹸
2䡚
ዲ୰⌫
3䠂
⅖⑕䞉⣽⳦ឤᰁ
Eosinophil
ⓑ⾑⌫
㐟㉮⬟䜢᭷䛧䚸
㈎㣗䞉䜰䝺䝹䜼䞊䞉ච␿
䛺䛹⏕య㜵ᚚ䛻㛵୚
㢛⢏⌫
Granulocytes
Neutrophil
60ዲሷᇶ⌫
70䠂
㈎㣗
䜰䝺䝹䜼䞊
Basophil
1䠂
䠞⣽⬊
䝸䞁䝟⌫
䠰⣽⬊
ᾮᛶච␿
⣽⬊ᛶච␿
Lymphocytes
20䡚
30䠂
༢⌫
Monocytes
5䡚
8䠂
䛭䛾௚䠄䠪䠧⣽⬊䛺䛹䠅
㈎㣗
ᢠయ
⾑ᑠᯈ
Platelets
䞉 2-3μm䜋䛹䛾ᑠ∦
15-20 㽢104 / μl
䞉 㦵㧊ᕧ᰾⌫䛾⣽⬊㉁䛜ศ㞳 ⾑୰䜈
䞉 ⢓╔⬟䜢䜒䛴 Ṇ⾑䠄ฟ⾑᫬䠅
⾑ᰦ䠄⾑⟶ෆจᅛ䠅
௚䛻䚸⾑ᾮ䛾⢓ᗘ䜢㧗䜑䜛
⾑ᾮจᅛಁ㐍
⾑⟶཰⦰
⾑⟶ቑṪ 䛺䛹
⾑ᾮ䛿䛹䛣䛷䠛
䛹䛾䜘䛖䛻䛴䜙䜜䜛䛾䛰䜝䛖?
⾑⌫ᡂศ䠖㦵㧊䚸䝸䞁䝟⠇䚸⬚⭢
⾑₢ᡂศ䠖⫢⮚䜰䝹䝤䝭䞁䚸จᅛᅉᏊ
䝸䞁䝟⠇䠖ච␿䜾䝻䝤䝸䞁
⟶㦵
㛗⟶㦵
▷⟶㦵
ᡥᖹ㦵
㐀⾑㒊఩䛾ኚ㑄
⫾ඣ⫢䛷䛾㐀⾑
㧊እ㐀⾑
ฟ⏕ᚋ䚸㦵㧊௨እ䛾⮚ჾ䜔⤌⧊䛷㐀⾑䛜⾜䜟䜜䜛䛣䛸
⭁⮚
㦵㧊䠄㐀⾑⤌⧊䠅Bone marrow
⬺᰾㏵୰䛾㉥ⱆ⌫
⬡⫫⣽⬊
ዲ୰⌫
㉥⾑⌫
⣽⥙⣽⬊
㉥ⱆ⌫
㦵㧊ⱆ⌫
䠤䠡ᰁⰍ 400ಸ
㦵ᰕ
㦵㧊
䠤䠡ᰁⰍ 100ಸ
㐀⾑䛾┒䜣䛺㉥Ⰽ㦵㧊
⬡⫫⤌⧊䛻⨨᥮䛥䜜䛯㯤Ⰽ㦵㧊
㐀⾑⤌⧊䚸⾑⌫䛾⑓Ẽ䛿䠛
Ⓨ⏕␗ᖖ䛿䠛
⅖⑕䛿?
ᶵ⬟୙඲䛿?
㈋⾑䚸ῶᑡ⑕䚸㢛⢏⌫ῶᑡ⑕䚸⾑ᑠᯈῶᑡ⑕
㐀⾑⤌⧊䚸⾑⌫䛾⭘⒆䛿䠛
ⓑ⾑⑓䚸ᝏᛶ䝸䞁䝟⭘
䛹䜣䛺✀㢮䛜䛒䜛䛾䠛
㦵㧊ᛶ䠄㢛⢏⌫䠅⣔䚸䝸䞁䝟ᛶ⣔
ᛴᛶ䚸៏ᛶ䚸T䝸䞁䝟⌫䚸B䝸䞁䝟⌫
㦵㧊䠖 ៏ᛶ㦵㧊ᛶⓑ⾑⑓䛾ᛴᛶ㌿໬
䠄䠏䠑ṓ䚸ዪᛶ䠅
䝸䞁䝟⣔䛾≉ᚩ䛷ṇ䛧䛔䛾䛿䛹䜜䛛?
1. 㐣๫䛺⤌⧊ᾮ䜢ᅇ཰䛩䜛䚹
2. 䝸䞁䝟⟶䛾ቨ䛿ཌ䛔ᖹ⁥➽䛛䜙䛷䛝
䛶䛔䜛䚹
3. ⬚⟶䛻㞟䜎䜚ື⬦䛻㑏ὶ䛩䜛䚹
4. 䝸䞁䝟ᾮ䛻⬡⫫ᡂศ䛿ྵ䜎䜜䛺䛔䚹
5. ೺ᖖᡂே䛾୍᪥䛾䝸䞁䝟ὶ㔞䛿⣙
10䝸䝑䝖䝹䛷䛒䜛䚹
ṇゎ䠖䠍
⬚⭢ Thymus
䞉 ⬚㦵䛾⫼㠃䛻Ꮡᅾ 䞉 ᛮ᫓ᮇ௨㝆㏥⦰⬡⫫䛷⨨᥮
㦵 㧊
ᮍ⇍䛺䝸䞁䝟⌫
⬚ ⭢
䠰⣽⬊
඲㌟䛾䝸䞁䝟⤌⧊
⮬ᕫ䛸㠀⮬ᕫ䛾༊ู䜢ㄆ㆑
㧊㉁
⓶㉁
⬚⭢䛾⤌⧊ീ 䠤䠡ᰁⰍ
⣽⥙⣽⬊
⬚⭢ᑠయ
䝸䞁䝟⌫ 䠄䝝䝑䝃䝹ᑠయ Hassall’s body䠅
ᕥ䠖100ಸ䚸ྑ䠖400ಸ
⏕ᚋ䠍᪥
䠏䠑ṓ䠊
⬚⭢䠖⬚㦵䛾ᚋ䜝䚸ᚰ⮚䛾๓䚸⬚㒌ෆ䛻䛒䜛䚹ᕥྑ2ⴥ䛻ศ䛛䜜䚸⫾ඣᮇ䚸ᑠඣᮇ䛷
⬚⭢䛿ᛮ᫓ᮇ┤๓䛻᭱኱䛸䛺䜚䚸௨ᚋⴎ⦰䛩䜛 䠄⬚⭢䛾㏥⦰䠅
䛿Ⰻ䛟Ⓨ㐩䛧䚸ᛮ᫓ᮇ䜢㐣䛞䜛䛸㏥⦰䛩䜛䚹
⏕ᚋ䠍᪥
㧊㉁䠖䝝䝑䝃䝹ᑠయ
䠏䠑ṓ
⓶㉁䠖䝸䞁䝟⌫䠄䠰䝸䞁䝟⌫䠅