儿科泌尿系统NS英文

儿科泌尿系统NS英文第1页/共20页

Definition

NSisanaccumulationofsymptomsandsignsandischaracterizedbyproteinuria,hypoproteinemia,edema,andhyperlipidemia.

第2页/共20页Thevastmajoritypatients(90%ofcases)withNSofchildhoodareprimary.

Definition

Inchildrenunderage5yearsthediseaseusuallytakestheformofidiopathic(primary)NSofchildhood.

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ConditionsOfAttack

●Secondonlytoacutenephri-

tis

●Incidenceage:atallages,but

mostcommonlybetween3~5

yearsofage第4页/共20页

Type

1.Clinicaltype

SimpletypeNS;

NephriticNS

2.Responsetosteroidtherapy

(P274)

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Type

Theinitialresponsetocortico-

steroidsisaguidetoprognosis

●Steroid-dependentNS

●Steroid-responsiveNS

●Steroid-resistantNS

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Type

▲

Totaleffect

▲

Partialeffect

▲Non-effect

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Type

3.

Pathologictype(P282)

●Minimalchangedisease,

MCD–80%ofallNS,little

changeonlightmicroscopy,

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Type

butelectronmicroscopy

showseffacementoffoot

processes(podocytes)of

epithelialcells

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Type

●Otherforms(Non-MCNS)

MSPGN,FSGN,MGN,

MPGN,etc.

第10页/共20页第11页/共20页第12页/共20页第13页/共20页第14页/共20页第15页/共20页Pathogenesis

◈Theprimarydisorderis

anincreaseinglomerular

permeabilitytoplasma

proteins→lossofproteins,

mainlyalbumininurine

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Pathogenesis

◈

Filtratedbarrier—

Chargebarrier

Molecularbarrier

◈

Thelossofthenegative

chargesontheGBM

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Pathogenesis

◈

Theunderlyingpathogenesis

isunknown,butevidence

stronglysupportstheimpor-

tanceofimmunemechani