急性链球菌感染后肾小球肾炎ppt课件

1、.1，acute poststructoccal glomerulonephritis(AP SGN)，2，Apsgn follows infection of the throat or skin by certain nephitogrenic strains of group a-hemolymtic structocci throars，3，Diagrams depicting the ultra structural features of a normal glomerular capillary loop(a)，and the ultra structural features，

2、4，immune complex es antigens，Activation of compliments recruitment of leukocytes，GBM damage，blood ingredients leakage，5，Hematuria : gross Hematuria(30-50%)，Microscopic Hematuria are more common . edema(90%): typicia，6，laboratory findings (1)，Urinalysis hematuria is nearaly always present in AP SGN。o

3、ther findings on microscopy are those of leuk ocytes，red blood cell casts，And granular casts。macroscopic hetmaturia typically has a rusty or tea-color . protei nuria is nearaly always present but typically in the su B- nephrotic rananythe urine contains large amounts of fibrin degradation products，a

4、nd fibrinopeptides。7，laboratory findings (2)，GFR And blood chemi story the bun concentration is elevated in 75% of patients，And serum creentshyperkalemia、Hypocalcaemia、hyponatremia、And metabolic acidosis are seen only in severe patients。a mild normalic aneemia may be present from hemo dilution and l

5、ow-grade hemo lysis。8，Laboratory findings (3)，evidices of streptooccal infection throoat or skinnetures。antireptolysin o(aso)titer . pharyngitis(80%)，Skin infections (50%)。anti-deoxyribonuclease(dnase)b level。pharyngitis (98%)、Skin infections (80%)。its the best single antibody titer to document cuta

6、neous Streep tococcal infection。activation of complements serum C3 level，Decrease (90%)，return to normal within 4-8wk . serum C4 levels are typically normal，9，Treatment of AP SGN is large ly that of supportive care . usually，Patients under sgo a spontaneous diu resistance within 7 to 10 days aftsman

7、agement is directed at treating the acute effects of Renal insufficency and hyperension，treatment s，10，bed rest is indicated as long as there are clinical manifestation of active disease，Such as edema，hypertension，Or grossthe acute phase generally resolves within 2-3wk。children could go back school after ESR returns to normal . but，Exhausting and competive activatites are prohibited until the Addis count retures、diet protenein、Sodium and water intake