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1、自体免疫疾病许秉宁台大医学院免疫学研究所台大医院内科部器官特异性非器官特异性自体免疫疾病肌肉肾脏皮肤关节PathologicalFactorsinRheumaticDisordersRheumaticdiseasesaremultisystemdisorderscausedbytissuedamageresultingfromautoantibodies,cytotoxicTlymphocytes,complement-fixingimmunecomplexdeposition,andinflammatorymediatorsI
2、nflammatoryParametersESRAcutephasereactantsImmunoglobulinsComplementcomponentsInflammatorymediators:cytokines,prostanoidsESRaredeterminedbythethreeforcesSurfacefreeenergy(VandeWaal＇sforce):cohesiveforceElectricalchargeassociatedwithRBC:repulsiveforceDielectricconstan
3、tofthemedium:dissipatestheforceCalculationEquationforESRVs=2/9x(Ps-PL)R2/nxgVs=thelimitingvelocityofthesphereR=theradiusofthespherePsandPL=thedensitiesofthesphereandoftheliquidg=theaccelerationduetogravityn=theviscosityoftheliquidSerumProteinsandDrugsThatAffecttheESR
4、RateESRincreaseESRdecreaseFibrinogenACTHImmunoglobulinsCortisoneDextranEthambutolMethyldopaQuinineProcainamideSalicylateOralcontraceptivesPenicillamineMethylsergideTheophyllineTrifluperidolVitamineAAcutePhaseReactantsTheAcutePhaseResponseFollowsCellInjuryandTissueDam
5、ageCausedby:Acuteinfections:i.e.,bacterialorparasiticTrauma:i.e.,blunt,surgery,andburnsIschemicnecrosis:i.e.,acutemyocardialinfarctionMalignantdisease:I.e.,tumorgrowthandmetastasisConnectivetissuedisease:i.e.,rheumatoidarthritis,rheumaticfeverandothersAcuteabdominali
6、nflammation:i.e.cholecystitisandpancreatitisVaccination:I.e.,typhoidFunctionalPropertiesofHumanAcutePhaseProteinsFunctionalGroupProteinFunctionHostdefenseproteinsC-reactiveprotein(CRP)Complementactivation,opsonicationMannan-bindingprotein(MBP)Complementactivation,ops
7、onizationComplementproteinsC3,C4,C5FactorB,C9FactorH,C4bpIncreasedvascularpermeability,opsonization,bacterialkillingFibrinogenFormationofhemostaticplugs,woundhealingProteinaseinhibitors1-Proteinaseinhibitor(1-PI)Controlofextracellularmatrixdegradation1-Antichymotryps
8、in(1-Achy)Controlofextracellularmatrixdegradation2-Antiplasmin(2-AP)ControlofplasminC1inhibitor(C1INH)Controlofcomplementandcontace
