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Jingdong book

哈里森风湿病学

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Books Medical Science Internal Medicine

Jingdong book

哈里森风湿病学

Name: 哈里森风湿病学
Brand: Jingdong book
SKU: 3117046591
Price: 43.80 USD
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Content Description

《哈里森风湿病学》系名著哈里森内科学16版的风湿病分册，涵盖了从概论、症状学、常见疾病的诊断和治疗等部分。秉承了哈里森一贯的权威性、科学性和实用性的风格。加入了更多新的内容，配以大量图片和表格，并提供了复习和自测题，便于读者自我评估。

Catalogue

第一部分免疫系统健康与疾病
第一章免疫系统简介
第二章主要组织相容性基因复合体
第三章自身免疫和自身免疫疾病

第二部分免疫介导损伤性疾病
第四章系统性红斑狼疮
第五章类风湿关节炎
第六章风湿热
第七章系统性硬化症（硬皮病）及相关疾病
第八章干燥综合征
第九章脊柱关节病
第十章血管炎综合征
第十一章白塞综合征
第十二章复发性多软骨炎
第十三章结节病
第十四章淀粉样变性
第十五章多发性肌炎、皮肌炎与包涵体肌炎

第三部分关节和周围组织疾病
第十六章关节及肌肉骨骼系统疾病的诊治思路
第十七章骨关节炎
第十八章痛风和其他晶体性关节病
第十九章感染性关节炎
第二十章纤维肌痛症、系统性疾病相关的关节炎及其他关节炎
第二十一章肢体关节周围软组织疾病
复习和自测题

Book Abstract

定义
韦格纳肉芽肿是一种有着特殊临床病理表现的疾病，其特点为上呼吸道、下呼吸道的肉芽肿性血管炎和合并存在的肾小球肾炎。此外，还可能出现累及小动脉和小静脉的不同程度的播散性血管炎。发病率和患病率
韦格纳肉芽肿是一种不常见的疾病，其估测患病率为3／100000。与白人相比，黑人发病非常罕见；男女比为1：1。该病可见于任何年龄；大约15％的患者年龄<19岁，但该病在青春期前发生的情况很少见；发病的平均年龄大约是40岁。病理和发病机制
韦格纳肉芽肿的组织病理学标志是小动脉和小静脉的坏死性血管炎伴肉芽肿形成，肉芽肿可发生于血管内或血管外（图10—2）。肺部受累典型表现为多发的、双侧的、结节样空洞浸润（图10—3），其活检结果几乎都表现为典型的坏死性肉芽肿性血管炎。上呼吸道病变，尤其是鼻窦和鼻咽病变的典型表现为炎症、坏死和肉芽肿形成，伴或不伴有血管炎。
肾脏受累的早期特征为局灶性节段性肾小球肾炎，可能进展至快速进展型新月体肾小球肾炎。肾脏活检很少能看到肉芽肿形成。与其他类型的肾小球肾炎相反，韦格纳肉芽肿肾脏病变没有免疫复合物沉积的证据。事实上，除了该病经典的上呼吸道、下呼吸道和肾脏病变三联征，任何器官都可以受累，表现为血管炎、肉芽肿或两者兼有。
尽管上呼吸道和肺部的肉芽肿性血管炎提示存在有针对经上呼吸道进入或留驻于上呼吸道的外源甚至内源抗原的异常细胞介导的免疫反应，但该病的免疫发病机制还不清楚。已有报道称鼻部慢性携带金黄色葡萄球菌与较高的韦格纳肉芽肿复发率相关；然而，还没有证据表明该微生物在本病发病机制中的作用。

Introduction

肌肉骨骼症状是风湿病患者就医的主要原因。关节和肌肉疼痛不仅会影响生活质量，造成残疾，影响社会劳动力，而且也是一些严重的炎症性疾病、感染或肿瘤的先驱症状。鉴于其常见性和所引起的后果，肌肉骨骼系统和结缔组织疾病会影响到所有内科医生的临床工作，因此也是风湿病的重点。
风湿病是一个重要的专科疾病，在很多方面都体现了内科疾病的多样性和复杂性。虽然结缔组织的健康与否是风湿病的基础，但风湿病专业本身涵盖了很多内科疾病，从以单关节疾病为特点的疾病到以肌肉骨骼疼痛为症状之一的、可以引起不同程度病残的多系统疾病，都在风湿病的范畴内。因此，从事风湿病专业需要有广泛的诊断技巧、对内科基础知识的深刻理解、早期识别可能威胁生命的疾病的能力和如何很好地选择和利用繁多的治疗方案并对之进行监测的能力，因为必须权衡这些治疗给患者带来的益处和发生药物毒性的危险。解决这些诊断和治疗难题也为更好地改善患者的状况提供了机遇，正是这些因素使得风湿病专业成为内科学中重要的而且也是回报巨大的领域。
风湿病学另一个吸引临床医生和生物医学研究人员的方面是它与免疫学和生物医学的关系。在风湿病学的早期研究中，炎症的临床和组织学证据都支持在许多风湿病中所发生的关节和组织损伤是由免疫机制介导的。近些年来，实验室研究不仅为这些疾病的免疫学基础提供了确凿的证据，而且还发现了单一疾病的特异发病机制。对疾病发病机制中致病通路的发现和以特异免疫效应通路为靶向的治疗为风湿病的革命性治疗提供了很多机会。这种具有针对性的靶向治疗使类风湿关节炎和强直性脊柱炎的治疗取得了重要的进展，严谨的研究对将这些治疗扩展到其他疾病和指导治疗决策的制订都是非常必须的。这些研究将继续为许多结缔组织疾病的病因学和发病机制提供线索，并将继续为我们带来痛苦更小、能更大程度减少关节和器官损伤、改善整体临床转归、具有划时代意义的治疗方法。

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Jingdong book

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