高职病解--第17章-泌尿系统.pptVIP

郧阳医学院病理学教研室 * 1. The kidney excretes the waste products of metabolism A patient with any sort of impaired kidney function will have increased creatinine and urea nitrogen in the blood, or azotemia. If the kidney is adequately perfused, itself normal, and its outflow not obstructed, blood urea nitrogen levels will remain within normal limits. 2. The kidney regulates the bodys content of water, sodium, and potassium. Hypertension, edema, and/or hyperkalemia may develop in renal disease. Renal edema is first visible around the patients eyes. 3. The kidney maintains the appropriate acid-base balance of plasma Metabolic acidosis is characteristic of severe renal failure, because you cannot get rid of the sulfate and phosphate ions that you generate from burning your food. The kidney also makes renin (REE-nin, please) and erythropoietin, and activates vitamin D. High blood pressure, anemia, and bone demineralization are common in serious kidney disease The functional reserve is large, much damage may occur before functional impairment is evident.thus the early signs and symptoms are particularly important to the clinician. 内分泌功能。 　　① 分泌肾素、前列腺素、激肽。通过肾素—血管紧张素—醛固酮系统和激肽—缓激肽—前列腺素系  　　统来调节血压。 　　② 促红细胞生成素。刺激骨髓造血。 　　③ 活性VitD3 。调节钙磷代谢。 　　④ 许多内分泌激素降解场所——如胰岛素、胃肠激素等。当肾功能不全时这些激素T1/2明显延长， 　　从而引起代谢紊乱。 　　⑤ 肾外激素的靶器官。如甲状旁腺素、降钙素等。可影响及调节肾脏功能。 郧阳医学院病理学教研室 * 郧阳医学院病理学教研室 * 快速进行性肾炎综合征 起病急，进展快，出现水肿、血尿、蛋白尿后，迅速发生少尿、无尿伴氮质血症，并发生急性肾衰竭。 郧阳医学院病理学教研室 * * * 血源性（下行性）感染：败血症或感染性心内膜炎时，细菌随血 肾栓塞肾小球或肾小管周围毛细血管，引起化脓性多为金葡菌引起 上行性感染：主要感染途径，下尿路感染（尿道炎、膀胱炎）时，细菌沿输尿管和周围淋巴管上行至肾盂和肾间质引起病变。当有膀胱输尿管尿液返流时，更容易发生上行性感染。病原菌大多为大肠杆菌。由于女性尿道短，特别是当各种原因引起机体抵抗力降低时，易发生肾盂肾炎。 郧阳医学院病理学教研室 * 很少累及肾小球，一般不出现高血压、氮质血症和肾功能衰竭。 郧阳医学院病理学教研室 * 郧阳医学院病理学教研室 * 切面淡黄色，可见灶状出血、坏死、软化及钙化。 郧阳医学院病理学教研室 * 切面淡黄色，可见灶状出血、坏死、软化及钙化。 郧阳医学院病理学教研室 * 类型：尿路上皮乳头状瘤、低恶性潜能的尿路上皮瘤、低级别尿路上皮乳头癌和高级别尿路上皮乳头癌。 郧阳医学院病理学教研室 * 郧阳医学院病理学教研室 * The proximal convoluted tubule reabsorbs substances from the glomerular filtrate, including ions, glucose, phosphate, bicarbonate,