儿科学精品课件：AGN2015.pdfVIP

Acute Acute Glomerulonephritis Glomerulonephritis (AGN) (AGN) Definition Definition 一组不同病因的急性肾小球肾炎– acute 一组不同病因的急性肾小球肾炎– acute nephritic syndrome. nephritic syndrome. Acute poststreptococcal glomerulonephritis, Acute poststreptococcal glomerulonephritis, (APSGN) (APSGN) Non-poststreptococcal glomerulonephritis Non-poststreptococcal glomerulonephritis Definition Definition ●Incidence age: in 5 ~14 years old ●Incidence age: in 5 ~14 years old ●peak age: 3~7 years old ●peak age: 3~7 years old ● ● ●Incidence peak: Jan. Feb. Sep. ●Incidence peak: Jan. Feb. Sep. and Oct. and Oct. Etiology Pathogenesis Etiology Pathogenesis ●Bacterial: ●Bacterial: Group A β- hemolytic streptococci (20%) Group A β- hemolytic streptococci (20%) Staphylococci, Staphylococci, Pneumococci, Pneumococci, G ˉbacilli G ˉbacilli ●Viral: influenza virus, mumps virus , ●Viral: influenza virus, mumps virus , Coxsackie virus, ECHO virus and EBV Coxsackie virus, ECHO virus and EBV ●Other pathogens: fungi etc. ●Other pathogens: fungi etc. Etiology Pathogenesis Etiology Pathogenesis 免疫复合物→肾小球毛细血管炎症 免疫复合物→肾小球毛细血管炎症 致肾炎菌株 （nephritogenic strans ） 致肾炎菌株 （ ——致肾炎抗原性 ——致肾炎抗原性 Etiology Pathogenesis Etiology Pathogenesis Circulating immunecomplexes Circulating immunecomplexes (CIC) (CIC) Antigens+antibodies Antigens+antibodies In situs immunecomplexes In situs immunecomplexes Etiology Pathogenesis Etiology Pathogenesis →deposited on glomerular capillari