於强2SLE教案

1、临床医学专业02级七年制内科学教案姓名於强业务职称教授聘任授课职位教授授课题目SLE学时数1授课班级02 级七年制(1)(2)(3)(4)(5)(6)班授课日期一、教学目的(掌握、熟悉、了解的具体内容)1. 掌握SLE累及多系统多脏器损害的临床表现、实验室检查及血清免疫学检测临床意义。2. 熟悉SLE的诊断依据、治疗原则。3. 了解SLE疾病的特点、诱发因素及病理学特征。一 purpose1. To palmar grasp cli nical meni festati ons of SLEImmuno logy laboratory findings are in terpreted by

2、laboratorg an alysis 。2. To acqua int with criteria for classificati on and diag no sis of SLE therapeutic prin ciple of SLE3. To comprehe nd features of SLE . Pathoge nic factors and pathological characteristics of SLE.一、执仃方案：(一)内容及时间分配(3 1. SLE疾病的特征多种自身抗体病变部位流行病学特征(3 2.病因多种理化环境因素致病(遗传、食物、药物、性激素)(3

3、 3.发病机理 未明 指出自身免疫参与脏器损害(3 4.病理(1)特征性病理改变苏木紫小体 洋葱皮改变(2 )基本病理改变血管炎(3) 肾脏病理改变(12 5.临床表现(1) 关节病变(2) 皮肤粘膜病变特征性(蝶形红斑、盘状红斑)(3) 肾损害(4) 心血管病变全心炎(5 )肺损害胸膜炎间质性肺炎(6 )神经系统中枢神经损害的致死性周围神经损害(7) 消化系统(8) 血液系统ITP 溶贫(9) 眼(5 6.实验室检杳(1) ANA(2 )抗ds DNA抗体(3 ) SM抗体(4 ) RNP抗体(5) 抗磷脂抗体(6) RF(7) 抗血小板抗体(8) 补体(9) 病理狼疮带及肾活检(10) 器

4、械检查。(57.诊断 按1982年ARA关于SLE的11条诊断标准(58.治疗(1) 一般及去病因治疗(2)轻症或皮肤型红斑狼疮治疗非甾体抗炎药+抗疟药(3)系统性 中等剂量激素(1mg/kg/d ) +细胞毒药(4 )简要介绍SLE治疗进展(19.预后二 Planning() contents and time distributed(31. Characteristic of diseasemulti-a ntibodyTarget tissue damagePredo minan tlypopulatio nmorbidity(3)2. etiological factorSuscept

5、ibility geneEnvironmen tal FactorsSex horm oneInfections age nts(3 3. pathoge nesisun clear(3 4. Pathologyspecific featuresvasculitislupus n ephritis(12 5. Cli nical me nifestatio ns of SLE(1) Joint and muscle(2) Skin and mucosaspecific featuresmalar rashdiscoid rash(3 ) Kidney(4 ) Heartpericarditis

6、(5 ) Lungspleuritisacute lupus penumon itis(6 ) Neuropsychiatric in volveme ntCNSperipheral n ervous systemmen tai disorder(7) Digestive system(8 )HematologicsystemITPhemolytic an emia(9 )eye(5 6. Laboratoryfindings(1)ANA(2 )anti dsDNA antibody(3 )SM an tibody(4)RNP an tibody(5 )An tiphospholipidan

7、tibody(6 )RF(7)Compleme nt(8 )Pathology(9) check in device(5 7.Diag no sisThe 1982 Revised Criteria for Classificati on of SLE(58.Man ageme nt of SLE(1) remove the cause(2) Discoidnon steroidal an ti-i nflammatory drugs(NSAIDs+ antimalarials (chloroquine )(3) SLEglucocorticoid (GC)+ cytotoxic drugs(

8、cyclophosphamide)moderate dose GC 1mg/kg/d(4 ) progress of therapy(1 9. Prog nosis(二) 重点和难点重点 SLE的临床表现及诊断标准难点血清免疫学检测意义及发病机制(二)focal point and difficultyfocal point : clinical manifestations of SLEcriteria for classificati on and diag no sis of SLEdifficulty :immuno logy laboratory findings are in te

9、rpreted bylaboratorg an alysis pathoge nesis（三）中文和英文关键词红斑狼疮 系统性systemic lupus erythematosus（四）复习和思维题1. SLE的临床表现2. SLE实验室血清学意义3. SLE的诊断标准4. SLE的治疗原则（四） review and thi nking1. Cli nicalmeni festati ons of SLE2. im mun ologylaboratory findings are in terpreted bylaboratorg an alysis。3. criteria for cla

10、ssificati on and diag no sis of SLE4. therapeutic prin ciples of SLE三、参考书及文献目录1. Mok CC, Lau CS. Pathoge nesis of systemic lupus erythematosus. JClin pathol. 2003,56: 481-90.2. Jime nez S, CerveraR, Font J et.al. The epidemiology of systemiclupus erythematosus. Clin Rev Allerey Immuol. 2003,25: 3-12.3. Geboes K,Dalle I. Autoantibodies