您所在的位置:首頁 > 腎內(nèi)科專家課件 > 溶血性尿毒癥綜合癥HUS-武漢大學人民醫(yī)院腎內(nèi)科
溶血性尿毒癥綜合癥HUS-武漢大學人民醫(yī)院腎內(nèi)科 內(nèi)容預覽:
(點擊下圖可對專家課件進行全文預覽)
《溶血性尿毒癥綜合癥HUS-武漢大學人民醫(yī)院腎內(nèi)科》內(nèi)容簡介:
溶血性尿毒癥綜合癥
(Hemolytic Uremic Syndrome,HUS)
武漢大學人民醫(yī)院腎內(nèi)科
劉紅燕
概 念
微血管病 性溶血性貧血(microangiopathic haemolytic anaemia,MAHA)
血小板減少(thrombocytopeania)
急性腎衰竭(acute renal failure)
HUS和TTP
1925年Moschcowitz首先提出TTP
1955年Gasser首先提出HUS,1970年用于成人
兩者同屬血栓性微血管病(TMA),具相似的臨床癥狀和相同的病理表現(xiàn)
HUS分類的進展
腹瀉型(D+)與非腹瀉型(D-)
志賀樣毒素(Shiga-like toxin,Stx)HUS與非志賀樣毒素HUS
HUS的病因
Part 1 etiology advanced
1 Infection induced
(a)Shiga and verocytotoxin(shiga-like toxin)-producing bacteria;
enterohemorrhagic Escherichia coli, Shigella dysenteriaen type 1,Citrobater
(b)Streptococcus pneumoniae,neuraminidase,and T-antigen exposure
2 Disorders of complement regulation
(a)Genetic disorders of complement regulation
(b)Acquired disorders of complement regulation, for example anti-FH antibody
N Besbas, D Karpman et al.Kidney Int 2006vol70:423-431
3 Von Willebrand proteinase, ADAMTS13 deficiency
(a) Genetic disorders of ADAMTS13
(b)Acquired von Willebrand proteinase deficiency;autoimmune, drug induced
4 Defective cobalamine metabolism
5 Quinine induced
Part 2 etiology unknown
1 HIV
2 Malignancy,cancer chemotheray and ionizing radiation
3 Calcineurin inhibitors and transplantation
4 Pregnancy, HELLP syndrome and oral contraceptive pill
5 Systemic lupus erythematosis and antiphospholipid antibody syndrome
6 Glomerulopathy
7 Familial, not included in part 1
8 Unclassified
完善相關輔檢,明確是否存在肺部、尿路感染及進一步評估病情,排除免疫抑制劑治...[詳細]
當機體受到嚴重感染、創(chuàng)傷、燒傷等嚴重打擊后,2個或2個以上器官或系統(tǒng)同時或...[詳細]