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Jingdong book

肾脏病实验室检验

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Books Medical Science Surgery

Jingdong book

肾脏病实验室检验

Name: 肾脏病实验室检验
Brand: Jingdong book
SKU: 3117094601
Price: 51.25 USD
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人体的肾脏通过形成尿液来调节和维持体液容量和成分，同时排泄内源性和外源性的代谢产物，以达到维持内环境相对稳定的目的。肾脏病变的早期常常并无明显的形态学变化，也无特异的症状和体征，而只是反映在血和尿液化验检查的改变上。因此，肾脏疾病的临床检验在其诊断、治疗和预后的评价中占有重要地位。随着肾脏病学科的发展日新月异，作为肾脏病学科的一个不可分割的组成部分，肾脏病的实验室检查在肾脏病的诊断和治疗中亦在不断赋予新的内涵，发挥着愈来愈重要的作用。许多临床肾病实验室也开展了多项肾脏疾病的尿液检验，但由于各方面条件限制，开展的工作参差不齐，给临床诊断带来一定的限制。许多临床医生、检验人员，希望能有一本简明、扼要、新颖、实用、规范的参考书，较快地开展各种肾脏疾病的临床检验，更全面地了解肾脏病实验诊断新知识，了解项目的敏感性、特异性及诊断价值，学会更有效的分析利用检测结果完善疾病的诊断，基于这种需求，我们邀请了长期从事临床检验以及肾脏病临床工作的有关专家、教授和检验技师共同编写《肾脏病实验室检验》，期望能对从事临床检验和肾脏病实验室的技术员、临床进修生、实习生和研究生有所裨益，将临床与检验相关知识融会贯通。中国肾脏病的发展已经走过了三十个春秋。古人云：三十而立，已进而立之年的中国肾脏病领域有很多值得夸耀的地方，比如说我们已有拥有庞大的专业队伍，相对健全的组织机构名临床资源十分仿佛，人才培养已具规模，得到愈来愈多的重视等。然而肾脏病实验诊断总是或多或少有些欠缺，愿肾脏病检验专家团队编著的《肾脏病实验室检查》，能为提高中国在国际肾脏病学界所处的地位和影响，为中国肾脏病走入国际肾脏病的舞台贡献自己的微薄之力。

Author Description

张一兵，教授、主任检验师；硕士研究生导师；1988年毕业于锦州医学院，2002年5月获辽宁医学院生物化学与分子生物学研究生学历；2007年10月毕业于加拿大皇家大学医院管理MBA，硕士学位；现为辽宁医学院附属第三医院副院长；锦州市人大常委；辽宁省及锦州市医学会医疗事故技术鉴定专家；中华医学会辽宁分会检验学会常委；中华医学会辽宁省理化检验分会委员；锦州医学会检验分会主任委员。

Catalogue

第一篇总论
第一章肾脏的正常结构与生理功能
第一节肾脏的结构特点和功能解剖
第二节肾脏的生理功能

第二篇尿液理学及有形成分显微镜检验
第二章尿液理学检验
第一节尿液的成分
第二节尿液检验的基本知识
第三节尿液的一般性状检查
第四节尿液渗透量检查
第三章尿液有形成分显微镜检验
第一节尿液沉渣非染色镜检
第二节尿沉渣染色检验
第三节尿中白细胞分类检验
第四节尿中病毒感染细胞包涵体检验
第五节尿沉渣的保存方法
第六节尿沉渣镜检的质量控制
第七节 12小时尿沉渣计数

第三篇尿液化学检验
第四章尿液蛋白质检验
第一节肾脏损伤和蛋白质分类
第二节尿液中蛋白质的检验
第五章尿液中糖类检验
第一节尿中葡萄糖的定性检验
……
第四篇肾脏功能生化检验
第五章血尿的临床及实验室诊断
第六章肾脏病血清标志性抗体检验
第七章肾移植相关检验
第八章尿液自动化检验
第九篇肾组织活检
附
参考文献

Book Abstract

4．鉴别诊断
（1）合并其他肾病损害的糖尿病肾病：糖尿病肾病患者中约27％合并其他类型的肾病，主要有膜性。肾病、膜增殖性肾小球肾炎、毛细血管内增生性肾小球肾炎等，典型的糖尿病肾病占60％因此在诊断糖尿病肾病时，需要对其合并其他肾病的可能性进行排除性诊断。
（2）结节性病变的鉴别诊断：除了糖尿病肾病具有肾小球结节性损害以外，还有5种肾脏疾病存在类似结节性病变，需要鉴别诊断。
①淀粉样肾病：肾小球系膜区出现无定型蛋白物质沉积，偏光显微镜下刚果红染色显示淡黄绿色折光性，电镜下为淀粉样纤维。
②单克隆免疫球蛋白沉积症：无糖尿病史，血清中有异常单克隆免疫球蛋白存在。部分病例呈结节性肾小球硬化改变，免疫组化染色显示K或入轻链阳性，电镜下见细颗粒的电子致密物质。
③膜增殖性肾小球肾炎：慢性肾炎、肾病综合征病史。系膜细胞、基质增生，血管襻双轨样改变；免疫组化染色见免疫复合物在毛细血管襻和系膜区沉积；电镜下见高密度电子致密沉积物。
④纤连蛋白肾病：肾病综合征病史。系膜结节性硬化，免疫组化染色Fironectin强阳性，电镜下为短纤维。
⑤Ⅲ型胶原肾病：肾病综合征病史。系膜结节性硬化，免疫组化染色Ⅲ型胶原阳性，电镜下为胶原纤维。
二、淀粉样变性肾病
淀粉样变性病（amyloidosis）是以细胞外淀粉纤维样蛋白沉积为特点的一组疾病。淀粉样蛋白具有B片层结构，可以与碘作用并被刚果红着色。淀粉样蛋白缓慢沉积于组织中，可造成器官功能损害，最终导致器官结构破坏、功能丧失。患者以男性多见，且多为老年人。系统性淀粉样变性病的首发症状常较严重，常见大量蛋白尿，有或无肾衰竭。
1．显微镜下特征（图31—32）：肾的淀粉样变首先累及肾小球。淀粉样蛋白主要沉积在肾小球、肾动脉壁及肾小管周围，严重时出现在肾问质中，一般不伴有细胞增生，少数情况下沉积物周围可有多核巨细胞反应。肾小球早期病变为系膜区出现无定型团块状蛋白沉积物，进而扩大压迫毛细血管腔。有时淀粉样蛋白沉积在肾小球基底膜外侧。淀粉样蛋白沉积物在HE染色下呈嗜伊红的均质无结构的团块状沉积物，PAS染色下呈淡红色，PAS—M染色下呈浅黑色，刚果红染色下呈砖红色。刚果红染色是最特异的淀粉样物质染色，应用切片厚度以8um为好。
……

Introduction

人体的肾脏通过形成尿液来调节和维持体液容量和成分，同时排泄内源性和外源性的代谢产物，以达到维持内环境相对稳定的目的。肾脏病变的早期常常并无明显的形态学变化，也无特异的症状和体征，而只是反映在血和尿液化验检查的改变上。因此，肾脏疾病的临床检验在其诊断、治疗和预后的评价中占有重要地位。随着肾脏病学科的发展日新月异，作为肾脏病学科的一个不可分割的组成部分，肾脏病的实验室检验在肾脏病的诊断和治疗中亦在不断赋予新的内涵，发挥着愈来愈重要的作用。
许多临床肾病实验室也开展了多项肾脏疾病的尿液检验，但由于各方面条件限制，开展的工作参差不齐，给临床诊断带来一定的限制。许多临床医生、检验人员，希望能有一本简明、扼要、新颖、实用、规范的参考书，较快地开展各种肾脏疾病的临床检验，更全面地了解肾脏病实验诊断新知识，了解项目的敏感性、特异性及诊断价值，学会更有效地分析利用检测结果，完善疾病的诊断，基于这种需求，我们邀请了长期从事临床检验以及肾脏病临床工作的有关专家、教授和检验技师共同编写此书，期望能对从事临床检验和肾脏病实验室的技术员、临床进修生、实习生和研究生有所裨益，将临床与检验相关知识融会贯通。
中国肾脏病的发展已经走过了30个春秋。古人云：三十而立。已进而立之年的中国肾脏病领域有很多值得夸耀的地方，比如说，我们已拥有庞大的专业队伍，相对健全的组织机构，临床资源十分丰富，人才培养已具规模，得到愈来愈多的重视等。然而，肾脏病实验诊断总是或多或少有些欠缺，愿肾脏病检验专家团队编著的《肾脏病实验室检验》这本书，能为提高中国在国际肾脏病学界的地位和影响。
……

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