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页数:28页
时间:2018-10-02
《医学课件myasthenia 》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、myastheniagravis(MG)Speaker:LiXianzheMembers:WangFuhai,WangDefeng,GuoXiuquan,WangZhuqing,ChenWeiwei,ZhuYoukang,YuanMingzhenWhatisMG?DEFINITIONMyastheniagravisisanautoimmunediseasethataffectsthetransmissionofsignalsfromnervestomuscles.AChRisonekindmultifunctionaltransmembraneglycoprot
2、ein,becomposedof5subunits,subalphaunitamongthemisthemainantigenthatbindswithanti-AchR.SubalphaunitofAchRisalsoantigendeterminantthatbindswithTcells.communicationsbreakdownbetweennervesandmuscles.WhatcauseMG?MechanismofMGHICMIAbnormalThymusHI1.antibodiesblockordestroymanyreceptorsitesf
3、oracetylcholineinmuscles.2.Destructionofthemusclemembraneasaresultofcomplementactivationbyautoantibodies3、OpsonizationofAnti-AChR4、OthersCMIAChRisakindofTD-AgInMGpatientsTcellskilltheAChRofThymusandmusclesdirectly.AbnormalThymusImmunetoleranceisbrokenbyabnormalthymuspositiveandnegativ
4、eselectionSymptoms?WeaknessoftheeyemusclesChangeinfacialexpressionDifficultyinswallowingandshortnessofbreathWeaknessinarms,hands,fingers,legs,andneckTreatmentTreatmentofMGMedicationscholinesteraseinhibitorssuchasneostigmine(新斯的明)andpyridostigmine(吡啶斯的明).Immunosuppressivedrugssuchaspre
5、dnisone(强的松)cyclosporine(环孢菌素),andazathioprine(硫唑嘌呤)Thymectomythesurgicalremovalofthethymusgland(abnormalinmostpersonswithMG).Plasmapheresisorplasmaexchange.High-doseintravenousimmuneglobulin.王军,男,45岁,2000年患甲亢,随后出现眼睑下垂,一直以来当作甲亢症状治疗,经过治疗,甲亢的其他症状消失,检查也正常,但眼部症状却未能缓解。患者于2001年出现复视,挣眼无力,劳累后
6、加重,一次偶然的机会,他从网上发现,他眼睛的症状与重症肌无力的首发症状很相似,他立即上当地医院检查,果然诊断为眼肌型重症肌无力,睑裂明显减小,在采用嗅化吡啶斯的明治疗后病情有所好转,但一感冒病情就加重,继而出现了胸闷气短、双上肢抬举费力,腰膝酸软等症状。THANKYOU!
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