肾小球疾病概述ppt课件.pptVIP

特征 无症状蛋白尿(1.0克/24h) 或单纯肾小球性血尿(持续或间隙镜下血尿) 无水肿、高血压及肾功能损害 病理 肾小球轻微病变 轻度系膜增生型肾炎(IgAN/非IgAN) 局灶节段增生性肾炎 FSGS(个别) 治疗 无须特殊治疗 定期随访：尿常规、肾功能、血压 保护肾功能、避免肾损因素 IgA肾病 发病率 亚太地区 20-40% 西欧地区 10-20% IgA肾病的临床进程 罕见的IgA肾病消退(5%) 良性进程的持续性IgA肾病 (50%) 迅速进展型的IgA肾病 (10%) 缓慢进展型的IgA肾病 (30-40%) 提示预后差的临床标志 高血压 肾病综合征 肾功能减退 无肉眼血尿史 临床特点 反复发作性肉眼血尿或持续性镜下血尿 与感染尤呼吸道感染关系密切 临床表现多样，可肾炎综合征表现或肾病综合征表现，或急进性肾炎表现 病理特点 免疫荧光：IgA系膜区弥漫沉积 光镜：各种表现 治疗--根据临床、病理综合治疗 单纯性血尿或蛋白尿：同隐匿性肾炎 肾病综合征：同原发性肾病综合征 慢性肾炎：参照慢性肾炎+鱼油+低抗原饮食 急进性肾炎：激素冲击+CTX+抗凝或血浆置换 * * Diabetic Nephropathy (DN)is increasingly becoming the most important cause of end stage renal disease The pathological characteristics of DN are glomerular hypertrophy, glomerular extracellular matrix (ECM) accumulation,glomerular basement membrane thickening, and final glomerulosclerosis. Evidence suggests that local alterations in the production of growth factors such as TGF-? are crucial to increase the synthesis of matrix and decrease of the degradation of matrix in diabetes. However, that effective treatment of diabetes and prevention of diabetic nephropathy remain elusive goals * * Effect of AM on glycemia,HbA1C,kidney/body weight, microalbuminuria, the expression of TGF-?1 and Collagen IV mRNA and proteins in renal cortex of diabetic rats induced by STZ Expression of TGF-?1 and Collagen IV mRNA and proteins in mesangial cell grown in high glucose Cell differentiation, Expression of TGF-?1 and Collagen IV , and PAI mRNA or proteins in renal fibroblasts grown in high glucose * Effect of AM on glycemia,HbA1C,kidney/body weight, microalbuminuria, the expression of TGF-?1 and Collagen IV mRNA and proteins in renal cortex of diabetic rats induced by STZ Expression of TGF-?1 and Collagen IV mRNA and proteins in mesangial cell grown in high glucose Cell differentiation, Expression of TGF-?1 and Collagen IV , and PAI mRNA or proteins in renal fibroblasts grown in high glucose * * Diabetic Nephropathy (DN)is increasingly becoming the most important cause of end stage renal d