系统性红斑狼疮sle课件

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1、系统性红斑狼疮(SLE)SystemicLupusErythematosusSystemicLupusErythematosusManyDifferentAuto-antibodiesMultipleSystemInvolvementSLEonsetbysexandageEtiologyandpathogenesispathologyClinicalfindingsLaboratoryfindingsDiagnosisTreatmentprognosisEtiologygeneticfactorsenvironmen

2、talfactorsSexhormonalfactorsPathogenesisExcessive,abnormalproductionof“self”antibodiesandformationofIC.Autoantibodiesagainstnuclear,cytoplasmicandmembranecomponentsofmultiplecelltypesinmultipleorgans.EtiologyandpathogenesispathologyClinicalfindingsLaboratoryfin

3、dingsDiagnosisTreatmentprognosisPathology光镜:1.结缔组织的纤维蛋白样变性2.基质黏液性水肿3.坏死性血管炎特征性:疣状心内膜炎苏木紫小体“洋葱皮样”病变临床应用：皮肤狼疮带试验肾活检EtiologyandpathogenesispathologyClinicalfindingsLaboratoryfindingsDiagnosisTreatmentprognosisSystemicfeaturesFeverWeakWeightlossskinandmucosa光敏感phot

4、osensitivity脱发alopecia雷诺现象Raynaud’sphenomenon口腔溃疡oralulcer皮疹rashskinandmucosaskinandmucosaskinandmucosaskinandmucosaskinandmucosaskinandmucosaMuscleandJointarthritis--Jaccoud’sarthropathyMusclepain、myositisfemoralheadnecrosisMuscleandJointRenallesionProteinuria

5、hematuriacylindruriaNephriticsyndromeRenalinsufficiencylupusnephritisClassI正常ClassII系膜增殖性mesangialClassIII局灶增殖性focalproliferativeClassIV弥漫增殖性diffuseproliferativeClassV膜性membranousClassVI肾小球硬化性glomerulosclerosisNervoussystemclinicalmanifestation:-headache、vomiti

6、ng-psychogenia-epilepsy-convulsion、consciousdisturbance-comapathology-vasculitiscerebrospinalfluid-nospecial(intracranialpressure↑protein↑cellpopulation↑glucose↓)IdentifywithothercentralnervoussystemdiseaseHematologysystemleukopeniathrombocytopeniaanemias:hemol

7、yticanemiasanemiasofchronicdiseaselymphadenectasissplenectasisRespiratorysystempleurisyPleuraleffusionPulmonaryinterstitialfibrosisLupuspneumoniaPulmonaryhypertensionRespiratoryfailurelungCirculatorysystemheart-pericarditis-myocarditis-endocarditisLibman-Sacken

8、docarditis-cardiacarrhythmias-cardiacfailurevessel-vasculitisDigestivesystemClinicalfeatures-anepithymia-nauseaandvomiting-abdominalpain、diarrhea-peritonealeffusion-acuteabd