???????(Systemic lupus erythematosus, SLE)??????????????????,????????????????????????????,?????????????SLE?????????????? - PowerPoint PPT Presentation

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Title:

???????(Systemic lupus erythematosus, SLE)??????????????????,????????????????????????????,?????????????SLE??????????????

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Title: Author: aaa Last modified by: sk Created Date: 11/20/1999 9:11:38 AM Document presentation format: Other titles – PowerPoint PPT presentation

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Title: ???????(Systemic lupus erythematosus, SLE)??????????????????,????????????????????????????,?????????????SLE??????????????


1
???????
?????????? ???
2
???????
  • ???????(Systemic lupus erythematosus,
    SLE)??????????????????,???????????????????????????
    ?,?????????????SLE??????????????

3
???????
  • ???????
  • (Systemic Lupus Erythematosus SLE)
  • ??????
  • (Discoid Lupus Erythematosus DLE)
  • Lupus-Wolf

4
????
  • 1845? Hebra(Vienna)????????????
  • 1851? Cazenave(Paris)????????(??)
  • 1895? Osler(Baltimore)?????????
  • 1848? Hargraves(Rochester)LE??

5
SLE
  • ?????,????,????
  • ??????
  • ??????????????,???????????????

6
????
  • ???4-250/10??,??70/10??,????113/10??
  • ?? 17-10,??????
  • ???????????????????????

7
??? ?
  • ???? ???????? ?????????
    ???????????? SLE??HLA-DR2?DR3??
    ???????

8
??? ?
  • ??????? ?????????? ??
    ?? ?? ???? ????? ???????
  • ??? ??? ???

9
??????
  • ???????????SLE??????,????????????SLE????????
    T????????????T?????? B????????,????????
    ?????????? ??????? ??????

10
? ?
  • ?????????????????,???????????????????
  • ???????(????????)????????
  • ???????TH?TS,????

11
??????
  • ?? ??????????? ???????????
    ??????
  • ?SLE???????????? ?????????????
    ????????????????? ??????

12
??????
  • ???? ?????????? ????? ?????????? ????
    ????????? ???????????
    ????? ???? ?????????

13
??????
  • ?????? ?????????????
    ????????????? ????
  • ?????? ?????????????
    ?????????????
  • ????? ????????????? ??????????

14
??????
  • ??? ??????????????? ?????????
  • ?????? ???????????? ?????????????
  • ??? ???????????????? ???????
  • ???????? ???????????? ?SSA??SSB??

15
???????
  • ???????????
  • ?????? ????(ANA)?????????, ?SLE????????
    ???DNA(ds-DNA)????????????,?SLE??????????????????
    ?????? ?Sm??????,????,???????,????????????

16
???????
  • ?RNP??
  • ?SLE?????,???????????
  • ?SSA(Ro)??
  • ????,?????????,SLE??????,ANA? ??SLE???????
  • ?SSB(La)??
  • ????,??????????? ?Rib- (rRNP)??????P????,????,??S
    LE??????????

17
???????
  • ?????
  • ??????????????????????????
  • ????
  • ???????????????? ?? ???????????????C3?C4??
    ,CH50??,?????,?SLE?????,???SLE??

18
???????
  • ????
  • ?????????????? ???????????,?
    ???????????????X???????CT

19
?????????
  • ??1997???????????SLE????,11?
  • ?4??????
  • ??????????? ?????????????
    ??????? ?????

20
?????????
??????????SLE???? 1????? ????,?????,??????? 2?
???? ??????????,?????????????????????? 3????
?????????,????,???????????? 4?????
???????????????,????? 5???? ???????,??2????????
,???,?????
21
??????????SLE????
  • 6???? ???????7????? ?????0.5/24???,?(????
    ???????????)8????? ????????,????????????9????
    ?? ?????,??????,???????,??????10??????
    ?ds-DNA????,?Sm????,????????(?????????????????????
    ?????6??????????????????????)11?????
    ????????????????????,????????

22
??SLE???????
  • ?????(???????)
  • ????
  • ???????????????????
  • ?????
  • ?????
  • DNA??????
  • ???????
  • ??(?????)
  • ??????(????????????)
  • ?????
  • ??(???)
  • ???,??,?????
  • ???????(???????????)

23
????
  • 1?????,
  • 2???SLE??????????,
  • 3???SLE??????,
  • 4?????????,
  • 5???SLE???,
  • 6???????????,
  • 7???SLE?????????,???????

24
? ??
  • ????????????
  • ????????????

25
??? ?
  • ?????????????
  • ????
  • (a) ??SLE?????????????
  • (b) ?????????????? ?? 1mg/kg/d
    ????1000 mg/d,?3? ???????

26
??? ?
  • ?????
  • ????(CTX)????10-16mg/kg
    ??2mg/kg/d??? ??????
  • ????2mg/kg/d ?????????????
  • ????10-15mg ???? ?????????????
    ????????????????

27
??? ?
  • ?????
  • ???3-5mg/kg ?2-3??? ????????
  • ? ?10-30mg/kg ?2-3???
  • ???10-20mg/d
  • ?????10-20mg ???? ????????????????
  • ??????????0.4g/kg,3-5??

28
? ?
  • (c)???????SLE????CTX????,????
  • (d)???SLE?????????????

29
??
  • ????
  • ?????????????????????????

30
SLE??
  • ????,??????
  • ????(??????)NSAIDS????????????(???)
  • ???????????
  • ???????

31
????
  • ??
  • ??????????????,??????????????????????????????
  • ???????????????????
  • ?SS-A?/??SS-B?????,????????????????

32
????
  • ????????????????,?????,??????????
  • ???

33
? ?
  • ????,??????
  • 5????90
  • 10????75
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