大学课件 内科学 SLE.ppt

系统性红斑狼疮(SLE)SystemicLupusErythematosus遵义医学院第二临床学院张祥贵SystemicLupusErythematosus(SLE)ManyDifferentAuto-antibodiesMultipleSystemInvolvementSLEonsetbysexandageEtiologyandpathogenesispathology★ClinicalfindingsLaboratoryfindings★Diagnosis★TreatmentprognosisEtiologygeneticfactorsenvironmentalfactorsSexhormonalfactorsPathogenesisExcessive,abnormalproductionof“self”antibodiesandformationofIC.Autoantibodiesagainstnuclear,cytoplasmicandmembranecomponentsofmultiplecelltypesinmultipleorgans.Etiologyandpathogenesispathology★ClinicalfindingsLaboratoryfindings★Diagnosis★TreatmentprognosisPathology光镜:1.结缔组织的纤维蛋白样变性2.基质黏液性水肿3.坏死性血管炎★特征性:疣状心内膜炎苏木紫小体“洋葱皮样”病变临床应用：皮肤狼疮带试验肾活检Etiologyandpathogenesispathology★ClinicalfindingsLaboratoryfindings★Diagnosis★TreatmentprognosisSystemicfeaturesFeverWeakWeightloss★skinandmucosa光敏感photosensitivity脱发alopecia雷诺现象Raynaud’sphenomenon口腔溃疡oralulcer皮疹rashskinandmucosaskinandmucosaskinandmucosaskinandmucosaskinandmucosaskinandmucosaMuscleandJointarthritis--Jaccoud’sarthropathyMusclepain、myositis股骨头坏死femoralheadnecrosisMuscleandJointJaccoud’sarthropathy★RenallesionProteinuriahematuriacylindruriaNephriticsyndromeRenalinsufficiencylupusnephritisClassI正常ClassII系膜增殖性mesangialClassIII局灶增殖性focalproliferativeClassIV弥漫增殖性diffuseproliferativeClassV膜性membranousClassVI肾小球硬化性glomerulosclerosis★Nervoussystemclinicalmanifestation:-headache、vomiting-psychogenia-epilepsy-convulsionpathology-vasculitiscerebrospinalfluid-nospecial(intracranialpressure↑protein↑cellpopulation↑glucose↓)Identifywithothercentralnervoussystemdisease★Hematologysystemleukopeniathrombocytopeniaanemias:hemolyticanemiasanemiasofchronicdiseaselymphadenectasissplenectasis★Respiratorysystem胸膜炎pleurisyPulmonaryinterstitialfibrosisLupuspneumoniaPulmonaryhypertensionRespiratoryfailurelung★Circulatorysystemheart-心包炎pericarditis-myocarditis-endocarditisLibman-Sackendocarditis-心率失常cardiacarrhythmias-cardiacfailurevessel-vasculitisDigestivesystemClinicalfeatures-食欲不振anepithymia-nauseaandvomiting-abdominalpain、di