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【医学课件】肾病总论（英语）张玖强【医学课件】肾病总论（英语）张玖强11.ReviewsofAnatomyandPhysiologyof
UrinarySystem1.ReviewsofAnatomyand(1)kidneyLT11~L2RT12~L3(1)kidney10cminlength5cminwidth4cminthickness134~148ginweight(1)kidney10cminlength(1)kidney(2)RenalCortexrenalcortex
80~90%ofglomerulusGlomerularcapsule
renalmedulla
renaltubule(2)RenalCortexrenalcortex(3)GlomerulusGlomerularFiltrationMembraneendothelialcellsbasementepithelialcells(3)GlomerulusGlomerularFiltr(4)Renaltubuleproximalconvolute
reabsorption
distalconvolute
regulatingofacid-basebalance
(4)RenaltubuleproximalconvoRenaltubulardiseases(renal,tubular,acidosis)ⅠType(dRTA)ⅡType(pRTA)Ⅰ+ⅡRenaltubulardiseases(renal,(5)RenalInterstitiumInterstitialcellsFibrocyteExtracelluarmatrixPathogenicmicroorganism
immunoreactionAcuteinterstitialnephritis
ChronicinterstitialnephritisInterstitium(5)RenalInterstitiumIntersti(6)RenalPelvis,UreterRenalpelvisureterPathogenicmicroorganismpyelonephritis(upperurinarytract)(6)RenalPelvis,UreterRenal(7)UrinaryBladder,UrethraUrinarybladderUrethra(Lowerurinarytract)Pathogenicmicroorganismcystourethritis(7)UrinaryBladder,UrethraUri2.SymptomsofGlomerularDisease2.SymptomsofGlomerularDiProteinuriahematuriaedemahypertension
nephritissyndromeProteinurianephritissyndrome(proteinuria>3.5g/day)Proteinuria>+++nephroticsyndrome(proteinuria>3.5g/day)nephrotiproteinuria>150mg/24hrProteinuriaanalysisglomerulartubularoverflowsecretoryor>1.5g/24hr<1.5g/24hrimmunoglobulinhisticΒ2-microglobulinInfectiontoxicityBenceJonesproteinmyelomaSelective(albumin)NonSelective(mixture)proteinuria>150mg/24hrProteinuhematuriaDysmorphicRbcHemogeneousRbcCalculus,tumor,TB,infectionGlomerulardiseasehematuriaDysmorphicHemogehypertensionrenalparenchymaRenalvessel——Arleriaerenalisstenosisvolumedependent
renindependenthypertensionrenalparenchymaReEdemaGlomerularFiltrateRate(GFR)
↓Plasmacolloidosmoticpressure↓
AnasarcaLocaledemaLowerextremityedemaEdemaGlomerularFiltrateRatePCommonClinicalLaboratoryAssessmentofRenalDiseaseCellproteincastglomerulartubularIVPCTrenalbiopsyMRI
CrCcrGFRPSPMosthsRenaldiseaseurinalysisRenalfunctionSpecialexaminationCommonClinicalLaboratoryAss3.TreatmentofGlomerularDisease3.TreatmentofGlomerularDRemovalcausesCorticosteroidImmunosuppressiveSymptomaticandsupportingPrimaryGlomerularnephritisAnti-inflammatoryChineseherbsRemovalcausesCorticosteroidImRenalfailuredialysisHDPDRenalfailuredialysisRenaltransplantationRenaltransplantationThanks!Thanks!【医学课件】肾病总论（英语）张玖强【医学课件】肾病总论（英语）张玖强251.ReviewsofAnatomyandPhysiologyof
UrinarySystem1.ReviewsofAnatomyand(1)kidneyLT11~L2RT12~L3(1)kidney10cminlength5cminwidth4cminthickness134~148ginweight(1)kidney10cminlength(1)kidney(2)RenalCortexrenalcortex
80~90%ofglomerulusGlomerularcapsule
renalmedulla
renaltubule(2)RenalCortexrenalcortex(3)GlomerulusGlomerularFiltrationMembraneendothelialcellsbasementepithelialcells(3)GlomerulusGlomerularFiltr(4)Renaltubuleproximalconvolute
reabsorption
distalconvolute
regulatingofacid-basebalance
(4)RenaltubuleproximalconvoRenaltubulardiseases(renal,tubular,acidosis)ⅠType(dRTA)ⅡType(pRTA)Ⅰ+ⅡRenaltubulardiseases(renal,(5)RenalInterstitiumInterstitialcellsFibrocyteExtracelluarmatrixPathogenicmicroorganism
immunoreactionAcuteinterstitialnephritis
ChronicinterstitialnephritisInterstitium(5)RenalInterstitiumIntersti(6)RenalPelvis,UreterRenalpelvisureterPathogenicmicroorganismpyelonephritis(upperurinarytract)(6)RenalPelvis,UreterRenal(7)UrinaryBladder,UrethraUrinarybladderUrethra(Lowerurinarytract)Pathogenicmicroorganismcystourethritis(7)UrinaryBladder,UrethraUri2.SymptomsofGlomerularDisease2.SymptomsofGlomerularDiProteinuriahematuriaedemahypertension
nephritissyndromeProteinurianephritissyndrome(proteinuria>3.5g/day)Proteinuria>+++nephroticsyndrome(proteinuria>3.5g/day)nephrotiproteinuria>150mg/24hrProteinuriaanalysisglomerulartubularoverflowsecretoryor>1.5g/24hr<1.5g/24hrimmunoglobulinhisticΒ2-microglobulinInfectiontoxicityBenceJonesproteinmyelomaSelective(albumin)NonSelective(mixture)proteinuria>150mg/24hrProteinuhematuriaDysmorphicRbcHemogeneousRbcCalculus,tumor,TB,infectionGlomerulardiseasehematuriaDysmorphicHemogehypertensionrenalparenchymaRenalvessel——Arleriaerenalisstenosisvolumedependent
renindependenthypertensionrenalparenchymaReEdemaGlomerularFiltrateRate(GFR)
↓Plasmacolloidosmoticpressure↓
AnasarcaLocaledemaLowerextremityedemaEdemaGlomerularFiltrateRatePCommonClinicalLaboratoryAssessmentofRenalDiseaseCellproteincastglomerulartubularIVPCTrenal
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