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ID:13375085
大小:3.07 MB
页数:103页
时间:2018-07-22
《丁小强-肾小球疾病》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、肾小球疾病GlomerularDiseases丁小强复旦大学附属中山医院Pathologicalchanges--glomerularinjuryClinicalmanifestations--proteinuria/hematuriaAgroupofdiseasesComplicatedcauses&mechanismsVariousclinicalmanifestationsDifferentprognosisMultipletreatmentprimaryglomerulardiseasessecondaryglom
2、erulardiseaseshereditaryglomerulardiseasesImmunemechanismsHumoralCell-mediatedNon-immunemechanismsInflammationGlomerulardiseasesA.Immunemechanisms(A)depositsofCirculatingImmuno-Complex(CIC)circilationantigen+antibodyCICkidneyCIC/depositsantigenextrinsicdrugs--nonh
3、omologousserum,penicillinfoods—xenogenicproteinpathogen—specificserotypesstreptococci,HBV,HCVintrinsicnucleus(SLE)cytoplasm(ANCA)cellularmembraneantigenoftumorantigenofthyroidWhydoesCICdepositintheglomeruli?Largeareaofglomerrularcapillaries--morechancestocontactNe
4、tstructureofCIC--easytodepositandsettledownClearancedysfunctionofmesangialcells,disabilityofmononuclearmacrophage,componentorfunctiondefectofcomplementsDecreaseclearanceofCIC(B)insituImmunocomplex1.Nativerenalantigenglomerularbasementmembrane+anti-glomerularbaseme
5、ntmembraneantibody(anti-glomerularbasementmembraneglomerulonephritis)2.AntigenstrappedorplantedDNA+anti-DNAantibody(LupusNephritis)BalancebetweenthedepositandclearanceofICdeterminesthesituationofthediseasesPersistenceofantigenClearancedysfunctionofmesangialcellsdi
6、sabilityofmononuclearmacrophagecomponentorfunctiondefectofcomplementsICdeposit>clearanceB.Cell-mediatedimmunemechanismsminimalchangeglomerulopathy?C.Non–immunemechanismsglomerularhypertensionhyperlipidemia(LDL-Cho)advancedglycosylationendproducts(protein)glomerulo
7、sclerosisInflammationMediatorsofinflammationAgroupofmoleculeswhichactasmediatorsofinflammationandcomplicatedbiologicalfunctionOriginofinflammationmediatorsinkidneyExtrinsicCellsinkidneyinfiltrativeneutrophil,lymphocyte,mononuclearmacrophage,plateletIntrinsiccellsi
8、nkidneyMesangialcells,tubularcells,endothelialcellsMediatorsofinflammation-activeoxygenandactivenitrogen-lipids-complements-cytokines-chemotaticfact
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