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IgA肾病(第2版)
$63.81
近年来,IgA肾病的诊断及治疗有很多进展,尤其是关于IgA肾病治疗的随机对照试验研究结果,给IgA肾病的规范治疗提供了更多依据。
本书亮点:
★IgA肾病领域的经典学术专著,在第1版的基础上,更新内容、总结经验。
★全书共23章,从基础到临床,对IgA肾病做了全面介绍。
★图文并茂,内容较为凝练。
★为肾内科医护人员,尤其是高年资肾脏病专科医生提供重要参考,对于相关基础研究人员、临床药师也有一定参考价值。
全书主要内容包括IgA肾病的基础和临床知识及其进展。基础部分讲述IgA肾病的发展史、遗传学、分子生物学、细胞生物学、实验动物模型、病理生理学及病理学等;临床部分 阐述IgA肾病的流行病学、症状学、诊断学、治疗学、指南、预后,以及儿童、妊娠和肾移植与IgA肾病相关的问题。
史伟 主任医师、教授、博士生导师; 国务院政府特殊津贴专家;广东省人民医院肾内科主任(1998—2016年);广东省人民医院内科主任(1998—2013年);广东省医学会血液净化分会主任委员;广东省血液净化医疗质量控制中心主任;中华医学会肾脏病分会常务委员(第8~10届);中国医师协会肾脏内科医师分会常务委员(第1~3届);中国医院协会血液净化中心分会副主任委员(3届)。
章IgA肾病的概述/1节IgA肾病的流行病学特征/2第二节IgA肾病的临床、病理特征和治疗/3第三节IgA肾病的预后/4第四节目前研究热点及存在的问题/4第二章IgA肾病的遗传学特征/9节IgA肾病的遗传学证据/10第二节IgA肾病的遗传学研究/11第三章IgA分子与IgA肾病的发生/17节人类IgA和IgA系统/18第二节IgA1在系膜区的沉积/29第三节人类IgA肾病发生的分子机制/35第四章IgA肾病的细胞生物学/44节系膜细胞/45第二节足细胞/52第三节肾小管上皮细胞/54第四节内皮细胞/60第五节淋巴细胞/62第六节中性粒细胞/68第七节巨噬细胞/70第八节血小板/73第九节成纤维细胞/75第十节树突细胞/76第十一节系膜细胞、内皮细胞与炎症细胞之间的作用/77第五章足细胞在IgA肾病中的意义/80节IgA肾病与足细胞概述/81第二节足细胞损伤影响IgA肾病蛋白尿的发生和发展/81第三节足细胞损伤与IgA肾病中的节段性硬化/82第四节IgA肾病新生物标志/83第五节IgA肾病足细胞致病机制/84第六章补体激活在IgA肾病中的意义/87节IgA肾病患者中的补体成分/88第二节补体系统在IgA肾病发病中的作用机制/89第三节补体在IgA肾病中作为生物标志物的可能性/92第四节补体系统对IgA肾病治疗的可能作用/93第七章黏膜免疫和IgA肾病/96节黏膜免疫屏障系统构成/97第二节扁桃体黏膜免疫/97第三节肠黏膜屏障/98第四节肠黏膜免疫与IgA肾病可能关联的机制/100第五节肠道黏膜与IgA肾病关联的证据/101第六节IgA肾病肠道黏膜免疫展望/102第八章IgA肾病的动物模型/104节免疫诱导型及继发病变型/105第二节两种经典的IgA肾病动物模型的制作方法/108第三节自发病变型及转基因小鼠模型/111第四节小结/116第九章IgA肾病的病理生理/118节IgA肾病病理表现/119第二节IgA1分子的结构及正常糖基化过程/119第三节糖基化异常IgA1分子的形成与来源/120第四节IgA1分子与T淋巴细胞免疫功能紊乱的关系/121第五节IgA1免疫复合物形成/121第六节IgA1免疫复合物在系膜区沉积/123第七节肾损伤机制/124第十章IgA肾病的病理及其评估系统/127节基本病理改变/128第二节病理评价系统/140第三节继发性IgA肾病的病理改变/149第四节过敏性紫癜性肾炎病理改变及其病理评价系统/151第十一章IgA肾病的诊断及疾病活动性评估/157节IgA肾病的诊断/158第二节IgA肾病的疾病活动性评估/168第十二章IgA肾病的检查方法/172节病史和体检/173第二节实验室检查/176第三节肾脏活体组织病理检查/189第四节肾脏超声检查/194第五节X线和磁共振检查/196第六节放射性核素检查/205第十三章治疗IgA肾病的药物/215节血管紧张素转换酶抑制剂及血管紧张素Ⅱ受体拮抗剂/217第二节糖皮质激素/224第三节环磷酰胺/234第四节硫唑嘌呤/238第五节吗替麦考酚酯/241第六节环孢素A/245第七节他克莫司/249第八节咪唑立宾/252第九节来氟米特/255第十节利妥昔单抗/258第十一节其他药物/262第十四章IgA肾病的治疗/264节IgA肾病的治疗概况/265第二节IgA肾病的治疗/268第三节不同临床及病理表现的IgA肾病治疗方案/276第十五章IgA肾病的预后/304节IgA肾病病理类型和预后/305第二节IgA肾病临床表现和预后/307第三节IgA肾病遗传因素和预后/309第四节判断预后的生物学标志物/310第五节IgA肾病预后评估存在的问题和展望/311第十六章IgA肾病和妊娠/313节妊娠期肾脏生理功能变化/314第二节妊娠对IgA肾病的影响/315第三节IgA肾病对妊娠的影响/316第四节IgA肾病患者的妊娠/318第五节IgA肾病患者围生期用药/320第六节IgA肾病患者妊娠的预后/322第十七章过敏性紫癜性肾炎/324节流行病学特征/325第二节病因及发病机制/325第三节临床表现/328第四节实验室检查/329第五节病理表现/330第六节临床诊断与鉴别诊断/330第七节治疗/332第八节预后/335第十八章儿童及青少年IgA肾病/338节儿童IgA肾病的流行病学/339第二节病因及发病机制/339第三节临床表现及其分型/342第四节病理分型及病理学特征/343第五节实验室检查/345第六节诊断与鉴别诊断/346第七节治疗/347第八节儿童IgA肾病的肾移植问题/350第九节预后及随访/353第十九章IgA肾病肾移植的相关问题/356节IgA肾病患者肾移植前的准备/357第二节IgA肾病患者肾移植后的处理/360第二十章继发性IgA肾病/369节概述/370第二节肝硬化相关的IgA肾病/373第三节类风湿关节炎相关的肾损害/375三、类风湿关节炎相关肾损害病理类型/375第四节原发性干燥综合征相关肾损害/376第五节强直性脊柱炎相关肾损害/378第六节继发于炎症性肠病的IgA肾病/379第七节银屑病相关的肾损害/380第八节人类免疫缺陷病毒相关性IgA肾病/382第九节白塞病肾损伤/385第二十一章IgA肾病指南及述评/388节改善全球肾脏病预后组织(KDIGO)临床实践指南:IgA肾病/389第二节日本IgA肾病的循证临床实践指南(2014)/392第三节儿童原发性IgA肾病诊治循证指南(2016)/400第二十二章中医治疗/405节概述/406第二节单方成药/407第三节专方验方/409第四节辨证论治/412第五节名医经验/415第六节食疗/421第二十三章IgA肾病的预防控制与健康教育/426节IgA肾病的预防原则/427第二节IgA肾病患者的日常护理指导/428第三节IgA肾病患者的专科护理指导/431参考文献/437
IgA 肾病是世界范围内常见的原发性肾小球肾炎,是导致慢性肾衰竭的重要病因。我国是IgA 肾病的高发地区,是世界上IgA 肾病患者数量多的国家。在原发性肾小球疾病中,IgA 肾病占位,是导致慢性肾衰竭的首位病因。IgA 肾病及其导致的慢性肾衰竭给国民带来了严重的健康问题和沉重的经济负担,如何预防和治疗IgA 肾病是肾内科医生面临的重大临床问题。10 年前我们出版了国内本关于IgA 肾病的专著,受到众多肾内科专业医生的欢迎及好评,这给了我们很大的鼓励。近年来,IgA 肾病的诊断及治疗有很多进展,尤其是近发表了众多关于IgA 肾病治疗的随机对照试验研究结果,给IgA 肾病规范治疗提供了更多的依据。为此,我们在版的基础上,更新内容、总结经验,修订出版《IgA 肾病(第2 版)》。IgA 肾病的诊断目前基本没有争议。IgA 肾病病理的牛津分型也被越来越多的肾脏病理工作者及肾脏科医生所采用。但IgA 肾病的治疗仍然是复杂且存在争议的领域。多数IgA 肾病早期给予恰当的治疗可以改善预后。然而,由于IgA 肾病临床表现呈多样性,可以从单纯镜下血尿到肾病综合征、从肾功能正常到急性肾衰竭,因此,用一个治疗方案去覆盖所有的IgA 肾病是不可能的。此外,IgA 肾病肾脏病理损伤的多样性及不同的病理表现对糖皮质激素和/ 或免疫抑制剂的反应不同,因此,用一个临床研究去覆盖各种病理类型的IgA 肾病并由此判断糖皮质激素和/ 或免疫抑制剂能否获益是不妥的。一些IgA 肾病临床研究没有进行病理类型分层且病例数有限,因此得出的结论对临床指导意义有限。我们在相应的章节对此进行了评述。由于IgA 肾病临床研究设计不一致所导致的结论不一致,不同地区与国家、同一地区不同医生对该病的认知和治疗方案不尽相同,甚至有很大争议。我们认为,IgA 肾病的正确治疗应该是针对每一位患者临床表现并结合肾脏病理损伤的不同,给予个体化治疗。本书再版综合了近年来国内外IgA 肾病的基础及临床研究进展,并总结了我们自己的研究和经验,对IgA 肾病作了全面介绍。本书主要内容包括IgA 肾病的基础和临床知识及其进展。基础部分讲述IgA 肾病的发展史、遗传学、分子生物学、细胞生物学、实验动物模型、病理生理学及病理学等;临床部分包括IgA 肾病的流行病学、症状学、诊断学、治疗学、指南、预后,以及儿童、妊娠和肾移植与IgA 肾病相关的问题。本书适合肾内科专科的医护人员阅读,尤其是高年资的肾脏病专科医生,对于肾病的基础研究人员也有一定的参考价值,在IgA 肾病的遗传研究方面、IgA 分子机制方面、IgA 肾病动物模型及黏膜免疫方面均有详细的介绍。对于肾脏病的临床药师,本书也有一定的参考价值,本书专设一个章节讨论IgA 肾病药物治疗方面的新进展。对于IgA 肾病患者,本书也有一些章节给予相关内容介绍,如中医药在IgA 肾病中的应用及IgA 肾病护理方面需要注意的事项。鉴于目前IgA 肾病研究水平所限,本书内容可能达不到对IgA 肾病完全透彻的认识,甚至有些内容可能被将来的研究结果修正。我们欢迎同行专家批评指正,以便再版时得到修正。在本书顺利出版发行之际,我深深感谢我的同事们及合作者在本书撰写和出版过程中的付出,由于他们的努力,才使本书得以付梓。史 伟于广东省人民医院2021 年12 月1 日
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