1、 内容:一、尿液检查二、肾功能检查三、免疫学检查四、影像学检查五、肾活组织检查肾小球功能 1.血尿素氮(BUN)、血肌酐(Scr)2.内生肌酐清除率(Ccr)肾小管功能 1.酚红排泄试验 2.浓缩功能试验二、肾功能检查二、肾功能检查三、免疫学检查四、影像学检查五、肾活组织检查第三节 肾小球疾病的临床分类第三节第三节 肾小球疾病的临床分类肾小球疾病的临床分类第三节第三节 肾小球疾病的临床分类肾小球疾病的临床分类第三节第三节 肾小球疾病的临床分类肾小球疾病的临床分类目的要求掌握急性肾小球肾炎的病因及发病机制、临床表现、重症病例的处理熟悉急性肾小球肾炎的鉴别诊断etiology pathogenes
2、ispathology clinical manifestationlaboratory examinationdiagnosis and diff.diagtherapyprognosisetiology pathogenesispathology clinical manifestationlaboratory examinationdiagnosis and diff.diagtherapyprognosisetiologypathogenesisAPSGN免疫机制的几种学说循环免疫复合物学说原位免疫复合物学说自身免疫机制学说交叉抗原学说pathogenesisRBCpathologyp
3、athologyetiology pathogenesispathology clinical manifestationlaboratory examinationdiagnosis and diff.diagtherapyprognosisclinical manifestationClinical manifestation1.起病时几乎都有血尿,50-70%为肉眼血尿2.血尿的颜色与尿的酸碱度有关3.肉眼血尿1-2周消失转为镜下血尿,镜下血尿一般持续1-3个月。4.血尿明显不影响预后5.与感染 活动有关6.可伴有不同程度的蛋白尿,20%可达肾病水平 clinical manifesta
4、tionclinical manifestationclinical manifestationclinical manifestationclinical manifestationetiology pathogenesispathology clinical manifestationlaboratory examinationdiagnosis and diff.diagtherapyprognosislaboratory examinationlaboratory examinationdiagnosis and diff.diagdiagnosis and diff.diag 系病毒直接损伤肾小球所致。前驱期短(35天),症状轻,以血尿为主,无水肿和高血压,C3正常,ASO正常。无明显前驱期,贫血、高血压、肾功能不全持续不好转,尿比重低,且固定。diagnosis and diff.diagdiagnosis and diff.diagetiology pathogenesispathology clinical manifestationlaboratory examinationdiagnosis and diff.diagtherapyprognosistherapytherapytherapytherapytherapytherapytherapy