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1、,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,LOGO,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Click to edit Master text styles,Second level,Third level,

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8、 to edit Master title style,*,*,單擊此處編輯母版標題樣式,單擊此處編輯母版文本樣式,第二級,第三級,第四級,第五級,The urinary system,Paediatrics of 1,st,hospital affiliated Dalian medical university,馬 路 一,1,The urinary system Paediatrics,2,2,Physiological features,Glomerular filtration rate(GFR):,low in neonate and infant period,Urine con

9、centration and dilution ability,shortage,Renal tubule function,insufficiency,3,Physiological featuresGlomerul,Physiological Features,Normal urinary output:,neonate,:48h 1,3ml/kg.h,3,10d 100,300ml/d,2m 250,400ml/d,1y:400,500 ml/d,3y:500,600 ml/d,5y:600,700 ml/d,8y:600,1000 ml/d,14y:800,1400 ml/d,14y:

10、1000,1600 ml/d,4,Physiological FeaturesNormal u,Physiological features,urinary output,neonate,ml/kg.h,Infant,toddler,ml/d,Preschool age,ml/d,School age,ml/d,oliguria,1.0,200,300,400,urineless,0.5,50,5,Physiological featuresurinary,Urinalysis,Color,:,colorless or light yellow,pH:,5,7,Specific gravity

11、:1.003,1.030,(often 1.011,1.025),Osmotic pressure:,infant:,50,600mmol/L,children:,500,800mmol/L,Physiological features,6,UrinalysisColor:colorless or,Urinalysis,protein,：,negative,：,100mg/m,2.,24h,protein,creatinine,.,positive,：,150mg/d,or,4mg/m,2.,h,or,100mg/L,Urinary cell and cast,：,Urinary sedime

12、nt,:RBC,3/HP,WBC,5/HP,colorless cast occasionally,12h urine Addis count,：,RBC,500000,WBC,1000000,cast,5000,Physiological Features,7,Urinalysisprotein：Physiologica,Serum analysis,The standard indicators of renal function,urea nitrogen,and,creatinine,The ratio,:,10:1.,The ratio increase,:,renal perfus

13、ion,or,urine flow,is decreased,8,Serum analysisThe standard ind,Section 2,Classification of Glomerular Disease,9,Section 2Classification of G,Clinical Classification,一,、,Primary,Glomerular Disease,Glomerulonephritis,acut glomerulonephritis,(,AGN,),(Acute poststreptococcal glomerulonephritis,APSGN),r

14、apidly prograssive,(,RPGN,),persistent,chronic,10,Clinical Classification一、Prima,Clinical Classification,niphrotic syndrome,NS,simple Type NS,nephritic Type NS,steroid-responsive NS,steroid-resistant NS,steroid-dependent NS,relaps and frequently relaps,11,Clinical Classificationniphrot,Clinical Clas

15、sification,Isolated hemarutia or proteinuria,Isolated hematuria,persistent,recurrent,Isolated Proteinuria,orthostatic,non-orthostatic,12,Clinical ClassificationIsolate,Classification Classification,二,、,Secondary glomerular diseases,purpura nephritis,lupus nephritis,HBV-associated glomerulonephritis,

16、others:poison,drug,virus et.al,三,、,Hereditary glomerular diseases,congenital nephrotic syndrome,hereditary progressive nephritis,familial recurrent hematuria,13,Classification Classification,Section 3,Acute glomerulonephritis AG,急性腎小球腎炎,Acute poststreptococcal glomerulonephritis APSGN,急性腎小球腎炎,14,Section 3Acute glomerulone,Etiology,group A-heamolytic streptococcal infection.,upper respiratory tract infection 51%,skin infection 25.8%,acute pharyngtis,，,scarlet fever 1,5%,others,bacteria,Virus,helm