内科学结缔组织疾病讲稿（notes on connective tissue diseases in internal medicine）

《内科学结缔组织疾病讲稿（notes on connective tissue diseases in internal medicine）》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、内科学结缔组织疾病讲稿（Notesonconnectivetissuediseasesininternalmedicine）SystemiclupuserythematosusI.conceptSystemiclupuserythematosus(systemiclupus,erythematosus,SLE)withantinuclearantibody.Alargenumberofautoantibodiesandimmuneresponsestoselfantigens,anautoimmunediseasecausedbymultipleorganandtis

2、suedamage.Thisdiseaseisahighincidenceareainourcountry.Two.Etiology1.isrelatedtogeneticfactors2.geneticsusceptibilitygenesaremorepositivegenes:HLAclassIIIC2liveC4defect;HLAclassIIDR2andDR3frequencyabnormalities.Multiplegenepolymorphismsareassociatedwithlupus.General:SLEisamultigenediseas

3、e;multiplegenesundercertainconditionsinteracttoalterthenormalimmunetoleranceanddisease;geneabnormalitieshaveacertainrelationshipwiththeclinicalsubtypesandautoantibodies;experimentalanimalgenesexisttoprotecttheissue.3.environmentalfactors,sunlight,drugs4.estrogenThree,thepathogenesisandi

4、mmuneabnormalitiesTheexternalantigenstimulatestheactivationoftheimmunesystem,producingantibodiesandproducinganimmuneresponsetothetissues.1.pathogenicautoantibodies1.1IgGtype;1.2antiplateletantibodiesandantiredcellantibodies;1.3antiSSA(Ro)antibody;1.4antiphospholipidantibodysyndrome(thro

5、mbosis,thrombocytopenia,habitualspontaneousabortion);1.5antiribosomalantibodies2.theimmunecompleximmunecomplexiscomposedofautoantibodiesanditsowntissues.Itisdepositedinorgansandtissues,activatescomplementandstimulatesautoimmunedamage.3.TcellandNKcelldysfunctionandNKcellfunctionofCD8+Bce

6、llsactivatedbycontinuousdisorder.Four、pathologyThemainpathologicalchangesoftheinvolvedorgansareinflammatoryreactionandvascularabnormality.Characteristicchange:hematoxylinbodies,nucleibyantibodiestoeosinophilicmasses;onionskinlesions,hyperplasiaoffibroustissuearoundtheradialarteries.Path

7、ologicalcharacteristicsoflupusnephritisactivityandchronicity:AcuteindexChronicindexProliferativechangesGlomerulosclerosisFibrinousnecrosis/nuclearrupturefibrouscrescentcellularcrescentRenaltubularatrophyLeukocyteinfiltrationInterstitialfibrosisHyalinethrombusInterstitialinflamm