临床医学专业02级七年制《内科学》教案
姓 名
於 强
业务职称
教授
聘任授课职位
教授
授课题目
SLE
学时数
1
授课班级
02级七年制(1)(2)(3)(4)(5)(6)班
授课日期
一、教学目的(掌握、熟悉、了解的具体内容)
1. 掌握SLE累及多系统多脏器损害的临床表现、实验室检查及血清免疫学检测临床意义。
2. 熟悉SLE的诊断依据、治疗原则。
3. 了解SLE疾病的特点、诱发因素及病理学特征。
一 purpose
1. To palmar grasp clinical menifestations of SLE
Immunology laboratory findings are interpreted by laboratorg analysis。
2. To acquaint with criteria for classification and diagnosis of SLE therapeutic principle of SLE
3. To comprehend features of SLE . Pathogenic factors and pathological characteristics of SLE.
二、执行方案:
(一) 内容及时间分配
(3’) 1. SLE疾病的特征 多种自身抗体 病变部位 流行病学特征
(3’) 2. 病因 多种理化环境因素致病(遗传、食物、药物、性激素)
(3’) 3. 发病机理 未明 指出自身免疫参与脏器损害
(3’) 4. 病理 (1)特征性病理改变 苏木紫小体 洋葱皮改变
(2)基本病理改变 血管炎
(3) 肾脏病理改变
(12’) 5. 临床表现
(1)关节病变
(2)皮肤粘膜病变 特征性(蝶形红斑、盘状红斑)
(3)肾损害
(4)心血管病变 全心炎
(5)肺损害 胸膜炎 间质性肺炎
(6)神经系统 中枢神经损害的致死性 周围神经损害
(7)消化系统
(8)血液系统 ITP 溶贫
(9)眼
(5’) 6. 实验室检查
(1)ANA
(2)抗ds—DNA抗体
(3)SM抗体
(4)RNP抗体
(5)抗磷脂抗体
(6)RF
(7)抗血小板抗体
(8)补体
(9)病理 狼疮带及肾活检
(10)器械检查。
(5’) 7. 诊断 按 1982年ARA关于SLE的11条诊断标准
(5’) 8. 治疗
(1)一般及去病因治疗
(2)轻症或皮肤型红斑狼疮治疗 非甾体抗炎药+抗疟药
(3)系统性 中等剂量激素(1mg/kg/d)+细胞毒药
(4)简要介绍SLE治疗进展
(1’) 9. 预后
二 Planning
(一)contents and time distributed
(3’) 1. Characteristic of disease
multi-antibody
Target tissue damage
Predominantly population
morbidity
(3’) 2. etiological factor
Susceptibility gene
Environmental Factors
Sex hormone
Infections agents
(3’) 3. pathogenesis unclear
(3’) 4. Pathology
specific features
vasculitis
lupus nephritis
(12’) 5. Clinical menifestations of SLE
(1)Joint and muscle
(2)Skin and mucosa
specific features malar rashdiscoid rash
(3)Kidney
(4)Heart pericarditis
(5)Lungs pleuritis
acute lupus penumonitis
(6)Neuropsychiatric involvement
CNS
peripheral nervous system mental disorder
(7)Digestive system
(8)Hematologic system
ITP
hemolytic anemia
(9)eye
(5’) 6. Laboratory findings
(1)ANA
(2)anti ds—DNA antibody
(3)SM antibody
(4)RNP antibody
(5)Antiphospholipid antibody
(6)RF
(7)Complement
(8)Pathology
(9)check in device
(5’) 7. Diagnosis
The 1982 Revised Criteria for Classification of SLE
(5’) 8. Management of SLE
(1)remove the cause
(2)Discoid
nonsteroidal anti-inflammatory drugs(NSAIDs
+ antimalarials (chloroquine)
(3)SLEglucocorticoid (GC)
+ cytotoxic drugs(cyclophosphamide)
moderate dose GC 1mg/kg/d
(4)progress of therapy
(1’) 9. Prognosis
(二)重点和难点
重点 SLE的临床表现及诊断标准
难点 血清免疫学检测意义及发病机制
(二)focal point and difficulty
focal point:clinical manifestations of SLE
criteria for classification and diagnosis of SLE
difficulty: immunology laboratory findings are interpreted by
laboratorg analysis
pathogenesis
(三)中文和英文关键词
红斑狼疮 系统性
systemic lupus erythematosus
(四)复习和思维题
1.SLE的临床表现
2.SLE实验室血清学意义
3.SLE的诊断标准
4.SLE的治疗原则
(四) review and thinking
1. Clinical menifestations of SLE
2. immunology laboratory findings are interpreted by
laboratorg analysis。
3. criteria for classification and diagnosis of SLE
4. therapeutic principles of SLE
三、参考书及文献目录
1. Mok CC, Lau CS. Pathogenesis of systemic lupus erythematosus. J Clin pathol. 2003, 56: 481-90.
2. Jimenez S, Cervera R, Font J et.al. The epidemiology of systemic lupus erythematosus. Clin Rev Allerey Immuol. 2003, 25: 3-12.
3. Geboes K, Dalle I. Autoantibodies to ds-DNA Ro/La in systemic lupus erythematosus. Adv Clin chem. 2003; 37: 129-72.
4. Wallace DJ. systemic lupus erythematosus. Druge Today. 2002; 38: 259-63.
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