基础医学北大病理学课件泌尿系统疾病总论.ppt

泌尿系统疾病 一、肾脏的正常功能和结构 Nephron=glomerulus +proximal tubule +thin loop of Henle +distal tubule CONCLUSION NEPHRON It consists of glomerulus, proximal tubule, thin loop of Henle and distal tubule. It is basic anatomic and functional unit of kidney. CONCLUSION GLOMERULUS The production of primary urine by filtrated is its important function. Bowman’s space is lined on parietal and visceral epithelial cells. Glomerular capillary tuft consists of endothelial cells, basement membrane, epithelial cells, and mesangium. Endothelial cells, basement membrane and epithelial cells is called filtrated barrier. Filtrated barrier carried negative charge, so is called charge barrier. CONCLUSION TBULE It is including proximal tubule, thin loop of Henle, distal tubule and collecting duct, production of urine by absorption and secretion is its important function.. INTERSTITIUM and VASCULAR SYSTEM They can support to the nephron. 二、肾小球肾炎 (Glomerulonephritis,GN) 概 念： 本病是变态反应(allergic reaction, hyper- sensitive reaction)引起的非化脓性炎症 (non- suppurative inflammation),主要侵犯肾小球， 主要的临床表现包括蛋白尿、血尿、水肿、 高血压及轻重不等的肾功能障碍。 1.病因发病机制: III型变态反应 ? 抗原(antigen)： 外源性：a.药物和食物 b.细菌 c.支原体 d.寄生虫 e.真菌 f.病毒 内源性：a.细胞核、胞浆、包膜 b.红细胞抗原 c.甲状腺抗原 d.免疫球蛋白和补体 e. 肿瘤抗原 f. 肾小管抗原 ?抗体(antibody)： IgG、IgA、IgM ? 抗原+抗体=免疫复合物(immune complex) 循环免疫复合物，原位免疫复合物，(植入性抗原，GBM抗原、肾小球上皮细胞膜抗原gp330，系膜细胞抗原Th1，内皮抗原ACE等) ?炎症介质 激活的补体，炎症细胞和受损伤的及增生的肾小球固有细胞释放的细胞因子和血管活性物质。 ?细胞免疫 GN病因发病机制 原位IC 循环IC 原位IC （抗GBM等） （抗植入抗原） 肾小球 炎症细胞 激活炎症介质 凝血系统 血管活性物质 激活补体 细胞因子