泌尿系统疾病总论_上海交大《内科学-泌尿系统疾病》.pptVIP

第五篇 泌尿系统疾病Part 5. Renal and Urinary System Diseases 第一章 总论Chapter 1. General Overview 第一节 肾脏的结构与功能特点 Section 1. Normal structure and function of the kidneys 第一节 肾脏的结构与功能特点 Section 1. Normal structure and function of the kidneys 第二节 肾脏疾病的诊查 病史、体格检查及必要的一些实验室检查 Testing the serology 肾脏疾病的评估 估计疾病程； 仔细的尿液检查 尿液评估 Testing the urine 蛋白尿测定 Assessment of proteinuria a. 功能性蛋白尿 (Functional proteinuria) b. 肾小球性蛋白尿 (Glomerular proteinuria) c. 肾小管性蛋白尿 (Tubular proteinuria) d. 溢出性蛋白尿 (Overflow proteinuria) 尿液分析 Urine analysis : 血尿 hematuria; 管型尿 cast (hyaline casts granular casts); 白细胞尿leukocyte 、脓尿 pyuria和菌尿 bacteriuria 尿液测定 Measure of urine Proteinuria Proteinuria can be caused by systemic overproduction, tubular dysfunction, or glomerular dysfunction. It is important to identify patients in whom the proteinuria is a manifestation of substantial glomerular disease as opposed to those patients who have benign transient or postural (orthostatic) proteinuria. 多年来已知白蛋白尿是预示糖尿病患者预后差的一个指标。 另外, 也有资料提示通过治疗减少白蛋白尿可导致患者危险情况改善 在美国，第III次NHNES调查显示糖尿病患者29％有白蛋白尿。 微量白蛋白尿是早期心、肾、血管、视网膜结构和功能变化的指标 第二节 肾脏疾病的诊查 影像学检查 Imaging and other Investigations 第二节 肾脏疾病的诊查 肾活检 Renal biopsy 常见综合征 The most common syndrome of kidney disease Nephrotic syndrome Nephritic syndrome Asymptomatic urinary abnormalities Acute renal failure or Rapidly progressive renal failure Chronic kidney disease(Table 1) The most common syndrome of kidney disease Nephrotic syndrome Nephritic syndrome Asymptomatic urinary abnormalities Acute renal failure or Rapidly progressive renal failure Chronic kidney disease(Table 1) The most common syndrome of kidney disease Nephrotic syndrome Nephritic syndrome Asymptomatic urinary abnormalities Acute renal failure or Rapidly progressive renal failure Chronic kidney disease(Table 1) The most common syndrome of kidney disease Nephrotic syndrome Nephritic syndrome Asympto