急性肾小球肾炎-最新的-20090212.pptVIP

毛建华 In some patients 1. Hypervolemia 2. Encephalopathy 3. Oilguric acute renal failure LABORATORY FEATURE ■ Complement：C3, CH50 ■ Blood ■ Renal function examination ■ ESR ■ urinalysis ■ ASO, ADNase-B, Ahase, et al. * * Acute Glomerular Nephritis Mao Jianhua, Department of Nephrology, The Children’s Hospital of Zhejiang University School of Medicine DEFINITION EPIDEMIOLOGY APSGN is a disease that affects primarily children, with the peak incidence being between ages of 2 and 6 years, Males are more likely than females to have overt nephritis. ETIOLOGY Nephritogenic strains of β–hemolytic streptococci PATHOGENESIS 1. Immune complex glomerulonephritis caused by deposition of circulating antigen-antibody complexes. 2. Autoimmune glomerulonephritis caused by deposited IgA being directed against a mesangial antigen or neo-antigen. 3. Immune complexes are formed in situ in the mesangium in response to a planted antigen. PATHOLOGY Endocapillary proliferative nephritis Light microscopy the glomeruli are found to be swollen and filled with cells obscuring much of the delicate network of the normal glomerular tugt. 正常肾小球，用PAS染色以突出基底膜。肾小球血管袢薄而清晰。 Immunofluorescence microscopy Glomerular deposits of IgG and C3 in capillary and mesangium Electron microscopy 1.The proliferation of cells is seen to involve primarily endothelial cells and the mesangium. 2.Electron-dense humps on the epithelial side of the basement membrane. Clinical Features Classically: 1. Edema and oliguria 2. hematuria 3. hypertension * * * 肾小球疾病 *