fever病理生理 发热课件

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1、Chapter6Fever赵赫男PhDhttp://www.pmph.com本章主要内容Summarization1EtiologyandPathogenesis2AlterationsofMetabolismandFunction3PathophysiologicalBasisofPreventionandTreatment4Normalbodytemperature(BT)BodyTemperatureiskeptconstantinaverysmallrange.TheaveragenormalBTis37ºC,coreBTismaintainedwithinarangeof36.2

2、-37.8ºC.Thetemperaturevariesdependingonindividualdifferences,timeofday.BTNormalrangeofBTRoutinemeasurements:oral,axillary,rectalsettingsLethaltemperature:<26ºC,>43ºC37.135.8Ear36.735.2Axillary37.335.7Orally(sublingually)37.135.5Orally(buccally)37.536.0Vagina37.836.2RectumupperlimitT/(oC)lowerlimit

3、T/(oC)Whereused:ThermoregulationThermoregulatorycenter:视前区下丘脑前部(Preopticanteriorhypothalamus,POAH)ThermostatSetpointhypothesis调定点(Setpoint,SP)是指体温调节的参考信号。SPisconstant,butsometimesshifts.ThermoregulationThermoregulationisthebalancebetweenheatgainandlossmechanismsunderthecontrolofhypothalamushttp://

4、www.pmph.comSectiononeSummarization一、ConceptofFeverNormaloraltemperatureofhuman:37℃，Variationsofapproximately1℃TheelevationofBTQuestion?TheelevationofBT>0.5ºCPhysiologicalPathologicalFeverBT=SetpointHyperthermiaBT>SetpointStressWhenexercisemenstruation病理性生理性http://www.pmph.comConceptofFeverPyrogen

5、sHypothalamicSetpoint↑regulatedelevation（>0.5℃）???http://www.pmph.comHyperthermia癫痫大发作，甲亢某些全麻药中暑，汗腺缺乏症下丘脑损伤出血，炎症Heat-productionHeat-lossThermoregulatorycenter被动性体温升高BodyT>SPhttp://www.pmph.comSection2EtiologyandPathogensisPyrogenicactivatorsEPcellsEPsSP↑Heat-production↑heat-loss↓CorebodyT↑http://w

6、ww.pmph.com一、PyrogenicactivatorsFevercanbecausedbyanumberofmicroorganismsandnon-microbialpyreticsubstancesthatarecollectivelycalledpyrogenicactivators,includingexogenouspyrogensandnon-microbialpyreticsubstances.http://www.pmph.comExogenouspyrogenGenerallyspeaking,exogenouspyrogensinvolvevariouskin

7、dsofinfectiousmicroorganisms细菌(bacterium)：G+、G-病毒(virus)真菌(fungus)螺旋体(spirochete)疟原虫(plasmodium)http://www.pmph.comStaphylococcusStreptococcusDiphtheriabacilliPyrogeniccomponents：wholecell，exotoxinexotoxin（1）G+Ba