Clinical Thiab Pathological Nta Ntawm Cov Neeg Laus Raum Kab Mob
Oct 14, 2022
Raws li cov lus pom zoo ntawm Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Ntiaj Teb (WHO), "cov neeg laus" txhais tau tias yog cov neeg muaj hnub nyoog siab dua lossis sib npaug li 60 xyoo hauv Asia-Pacific thiab cov tebchaws tsim kho, thiab Ntau dua lossis sib npaug rau 65 xyoo hauv lwm cheeb tsam. Ib lub tebchaws, ntau dua 7 feem pua ntawm cov neeg muaj hnub nyoog tshaj 65 xyoo lossis ntau dua 10 feem pua ntawm cov neeg muaj hnub nyoog tshaj 60 xyoo yog cov neeg laus. Nrog rau kev txhim kho ntawm kuv lub teb chaws txoj kev ua neej nyob thiab kev txhim kho kev kho mob maj mam, lub neej expectancy ntawm cov neeg Suav tau ntev heev, thiab cov neeg laus cov neeg laus tau nce xyoo los ntawm xyoo. Raws li kev suav pej xeem thib 5 hauv xyoo 1999, 10.2 feem pua ntawm cov neeg muaj hnub nyoog Loj dua lossis sib npaug li 60 thiab 6.96 feem pua ntawm cov neeg laus dua lossis sib npaug li 65 Yog li ntawd, peb lub tebchaws tau nkag mus rau cov neeg laus.
Nyem rau cistanche tshuaj xyuas kab mob raum
Nrog rau kev loj hlob ntawm lub hnub nyoog, cov qauv thiab kev ua haujlwm ntawm tib neeg cov ntaub so ntswg thiab lub cev tau txais kev hloov pauv. Yog li ntawd, cov kab mob senile, nrog rau kab mob raum, tau txais kev saib xyuas.
Vim muaj qhov sib txawv ntawm kev laus ntawm ntau lub cev thiab cov khoom nruab nrog cev, kev laus ntawm cov hlab plawv, kev laus ntawm lub cev tsis muaj zog, kev laus ntawm cov zis, thiab qhov tshwm sim ntawm cov qog muaj feem cuam tshuam rau cov neeg laus cov kab mob hauv lub raum. Nyob rau hauv luv luv, etiology, pathogenesis, thiab kev faib tawm ntawm cov kab mob ntawm cov neeg laus cov kab mob raum muaj lawv cov yam ntxwv. Cov kab mob hauv lub raum hauv cov neeg laus muaj raws li hauv qab no.
Asymptomatic proteinuria thiab hematuria
ischemic mob raum
Glomerulosclerosis thiab ischemic shrinkage tuaj yeem pom nyob rau hauv lub raum cov ntaub so ntswg ntawm tus neeg mob, thiab cov kev hloov ischemic kuj tuaj yeem pom nyob rau hauv peripheral lub raum tubules thiab interstitium. Qee lub sij hawm qhov chaw puas tuaj yeem pom nyob rau hauv ib qho band zoo li kev faib tawm, uas yog vim muaj cov kab mob vascular loj dua ntawm qhov chaw. Ua rau. Cov neeg mob tuaj yeem muaj ischemic raum puas vim yog atherosclerosis nrog lossis tsis muaj ntshav siab.
Kev rog rog ntsig txog nephropathy
Ntau tus neeg laus muaj ntau lub cev qhov hnyav, uas tuaj yeem ua rau me me ntawm cov proteinuria vim kev hloov pauv hemodynamic. Pathological manifestations yog glomerular hypertrophy thiab lub raum stenosis.
Macroalbuminuria thiab Nephrotic Syndrome (NS)
Membranous Nephropathy (MN)
MN suav rau 25 feem pua -54 feem pua ntawm cov neeg laus NS cov neeg mob, thiab thawj cov membranous nephropathy (pMN) suav txog 76.3 feem pua. Txawm hais tias kev kho mob thiab kev tshwm sim ntawm cov neeg laus MN yog tib yam li cov neeg laus hauv nruab nrab, kev saib xyuas tshwj xeeb yuav tsum tau them rau nws txoj kev sib raug zoo nrog cov qog. Cov neeg laus yog ib pab pawg uas muaj kev pheej hmoo siab rau ntau yam qog, thiab cov ntawv ceeb toom ntawm cov neeg laus MN ua ke nrog lossis lwm yam qog nqaij hlav (uas yog, cov antigens uas ua rau MN yog muab los ntawm cov qog antigens). Ntxiv nrog rau PSA ntawm lub raum mob qog noj ntshav, CD10 ntawm lub raum mob qog noj ntshav, thiab lwm yam), tsis muaj cov cim tshwj xeeb rau ntau lwm cov qog nqaij hlav, thiab nws yog ib qho nyuaj rau kev daws qhov teeb meem no los ntawm kev kuaj mob ntawm lub raum biopsy. Yog li ntawd, lub npe hu ua pMN tseem muaj qee yam ntawm cov theem nrab membranous nephropathy (saib). Ntxiv nrog rau ntau yam qog, cov neeg laus sMN tuaj yeem tshwm sim los ntawm kab mob siab B lossis C thiab tshuaj.
Yam tsawg kawg nkaus Hloov Nephropathy (MCD)
Qhov tshwm sim ntawm MCD muaj ob qhov siab tshaj plaws hauv cov menyuam yaus thiab cov neeg laus. MCD suav txog 15 feem pua mus rau 20 feem pua ntawm cov neeg laus NS, thiab cov kab mob tshwm sim zoo ib yam li cov menyuam yaus uas muaj MCD, thiab qee zaum nws tuaj yeem cuam tshuam nrog cov qog.
Focal segmental glomerulosclerosis (FSGS) FSGS suav txog 7 feem pua rau 10 feem pua ntawm cov neeg laus NS, thiab tshwj xeeb yuav tsum tau them nyiaj tshwj xeeb rau kev tshem tawm cov xwm txheej ntawm ischemic raum raug mob hauv kev kuaj mob pathological.
Mob ntshav qab zib nephropathy (DN)
Cov neeg laus yog cov hnub nyoog uas muaj ntshav qab zib ntau, thiab ntshav qab zib hom 2 yog qhov ua rau cov neeg laus DN. Nws tsis yog qhov nyuaj rau kev kuaj pom tseeb nrog cov keeb kwm kho mob tiav thiab kuaj kab mob ntawm lub teeb microscopy, immunofluorescence, thiab electron microscopy.
Cov protein tshwj xeeb lossis paraproteinemia nephropathy
Vim yog B cell hyperplasia lossis qog, ntau lub teeb saw protein lossis lwm cov protein tshwj xeeb tshwm sim hauv lub cev thiab tom qab ntawd tso rau hauv glomerulus thaj chaw mesangial thiab hauv qab daus, uas ua rau muaj proteinuria loj lossis NS kuj tshwm sim hauv cov neeg laus mob raum. Xws li lub raum amyloidosis, kab mob teeb pom kev zoo, macroglobulinemia nephropathy, fibronectin glomerulopathy, thiab lwm yam, cov yam ntxwv ntawm cov kab mob nodular sclerosis nyob rau hauv thaj tsam mesangial, thickening ntawm lub hauv paus membrane, thiab auxiliary tsis yooj yim rau kev kuaj mob los ntawm immunofluorescence thiab electron microscopy.
Mob raum mob (AKI) thiab mob raum tsis ua haujlwm (ARF)
Crescentic glomerulonephritis tuaj yeem ua rau kev puas tsuaj ntawm glomerular capillary loops rau ntau yam, ua rau glomerular capillary voj necrosis thiab crescent tsim, cuam tshuam rau lub raum ua haujlwm thiab txawm lub raum tsis ua haujlwm. Anti-neutrophil cytoplasmic antibody (ANCA)-associated polyangiitis yog ib qho ua rau muaj hom III crescentic glomerulonephritis, thiab ANCA-associated polyangiitis muaj ntau dua rau cov neeg laus, thiab txog 40 feem pua ntawm cov neeg muaj hnub nyoog 60 xyoo. feem pua. Kev kuaj mob yuav tsum yog raws li kev kho mob tshwm sim, ntshav ANCA titers, thiab kuaj kab mob. Hom I crescentic glomerulonephritis thiab IgA nephropathy tshwm sim los ntawm kev tiv thaiv hauv qab daus daim nyias nyias, thiab hom II crescentic glomerulonephritis tshwm sim los ntawm hom IV lupus nephritis kuj pom hauv cov neeg laus, tab sis tsawg dua.
mob tubulointerstitial nephropathy
Mob hnyav tubular raug mob thiab mob tubular necrosis ob qho tib si qhia AKI lossis ARF, yog li lawv koom rau hauv qeb ntawm cov kab mob hnyav. Lub pathological morphology ntawm yav dhau los yog nthuav tawm ntawm cov ciam teb ntawm lub raum tubular epithelial hlwb, dilation ntawm lub lumen, edema ntawm lub raum interstitium, thiab lub tso zis thiab disintegrated cell khib nyiab yog ntxuav mus rau hauv lub tob tubules los ntawm cov zis; yaj cell khib nyiab. Kev raug mob ntawm tubular thiab necrosis tuaj yeem tshwm sim los ntawm mob raum ischemia thiab nephrotoxic tshuaj thiab yog ib qho ua rau AKI hauv cov neeg laus.
Acute Interstitial Nephritis Acute allergic interstitial nephritis feem ntau tshwm sim los ntawm cov tshuaj (xws li cov tshuaj uas tsis yog-steroidal anti-inflammatory tshuaj, tshuaj tua kab mob, tshuaj suav tshuaj ntsuab, thiab lwm yam), thiab nws yog ib qho yooj yim kom pom qhov infiltration ntawm eosinophils hauv interstitium. Idiopathic mob interstitial nephritis lossis tubulointerstitial nephritis-uveitis (TINU) syndrome kuj tuaj yeem pom hauv cov neeg laus. Sjögren's syndrome kuj tuaj yeem ua rau muaj kev cuam tshuam nephritis.
mob ntshav qab zib nephropathy
Cov qe ntshav liab loj loj los ntawm hematuria (feem ntau hauv IgA nephropathy), cam khwb cia nephropathy tshwm sim los ntawm myeloma, myoglobin casts tshwm sim los ntawm cov leeg nqaij necrolysis, hemoglobin casts los ntawm hemolysis, cov kua tsib los ntawm cov bilirubin ncaj qha, Uric acid casts tshwm sim los ntawm oncolytic syndrome tuaj yeem ua rau mob hnyav. puas raum tubules, ua rau AKI lossis ARF.
mob raum vascular kab mob los yog kab mob
mob raum ischemia
Cov neeg laus feem ntau raug kev txom nyem los ntawm atherosclerosis lossis lwm yam kab mob vascular. Yog li ntawd, lub raum hlab ntsha los yog nws cov ceg yog nquag mus rau thrombosis. Nws yog ib qho nyuaj rau tsim kom muaj kev sib koom ua ke, uas yuav ua rau muaj kev cuam tshuam rau lub raum ischemia thiab txawm tias lub raum infarction. Tus neeg mob tau mob raum, hematuria, thiab ARF.
cov roj cholesterol embolism
Nyob rau hauv xyoo tas los no, txhawm rau txhim kho cov ntshav ncig, arterial catheter interventional kho feem ntau ua. Thaum lub sijhawm ua haujlwm, atherosclerotic plaques tuaj yeem raug kov kom ua rau lawv poob, thiab embolized nyob rau hauv cov ceg ntawm lub raum cov hlab ntsha nrog cov ntshav khiav, ua rau spasms ntawm lub raum hlab ntsha thiab ua rau ARF. . Nyob rau tib lub sijhawm, cov neeg mob feem ntau muaj cov ntiv taw mob, ntiv taw ntawm daim tawv nqaij liab qab tshwm sim, hu ua ntshav ntiv taw syndrome.
thrombotic microangiopathy
Nws suav nrog ib pawg loj ntawm cov kab mob. Cov neeg laus uas ua rau ARF muaj ntau dua nyob rau hauv malignant hypertension, thiab lawv feem ntau ua ke nrog IgA nephropathy thiab qee zaus hauv cov kab mob sclerosis.
Loj thiab nruab nrab vasculitis ntawm lub raum
Polyarteritis nodosa tuaj yeem ua rau ARF hauv cov neeg laus, thiab Takayasu arteritis thiab lwm yam Takayasu arteritis qee zaus koom nrog rau cov hlab ntsha.
Lub raum tsis ua haujlwm (CRF)
Cov theem ntev ntawm ntau cov kab mob hauv lub raum laus tau hais los saum toj no tuaj yeem txhim kho mus rau CRF. geriatric nephritic syndrome
Qhov kev faib ua feem ntawm tus mob intracapillary proliferative glomerulonephritis nyob rau hauv senile nephritic syndrome yog me me, tab sis ntau hom IgA nephropathy yog. Lwm cov kab mob hauv lub raum, xws li lupus nephritis, tsis txawv ntau ntawm kev kho mob thiab kev tshwm sim ntawm cov hluas.
Hauv kev xaus, thaum kuaj pom cov neeg laus mob raum, tsis yog tsuas yog kev kho mob tshwm sim thiab kev hloov pauv pathological yuav tsum tau them rau, tab sis kuj tseem muaj lub xeev ntawm cov neeg laus, kev hloov hauv lub cev, thiab cov yam ntxwv ntawm lub raum muaj hnub nyoog.
Yog xav paub ntxiv:ali.ma@wecistanche.com
