於强－血管炎病诊断与治疗 .pptVIP

Vasculitides  Fudan university Zhongshan Hospital Yuqiang * The term vasculitis refers to a heterogeneous group of  disorders characterized  pathologically by evidence of  blood vessel inflammation and  clinically by a diverse set of  symptoms and signs. * Pathology three types： 1. necrotize 2. granulomas 3. only inflammatory cellular  infiltration in the vessel wall  * Cause to 1.vessel wall angusty， blunting、 fibrosis， aneurysm  2. tissue ischemia，  functional impaiement * CLASSIFICATION  1. histopathologic  （1）necrotize （2）granulomas （3）leucocytoclasia  （4）giant cell  * 2. clinical classific? infectivity ? un-infectivity * 3. clinical+ histopathologic primarily skin systemic secondary * Lie CLASSIFICATION primarily large-vessel  Takayasu artertis giant cell artertis Medium-vessel polyarteritis nodosa  Churg-Struss syndrom  Wegener’s granulomatosis small-vessel  Microscopic polyangiitis  Schonlein-Henoch syndrom * Secondary infectivity drug connective tissue disease associated with tumer * pathogenesis  1. infectivity 2. immune complex  3. antineutrophil cytoplasmic antibody  ANCA-PR3 ANCA-MPO 4.antibody attack vessel AECA  GBM antibody 5.cell immune 6.understand * clinical manifestation  fever debll  general malaise、 anaemia、 myosalgia、 * Prompt: fever  rash  joint pain  myosalgia  organ impaired  * the Chapel Hill Consensus Conference 1993 * giant cell artertis: Granulomatous a