《病理生理学》课件：08发热fever.ppt

《《病理生理学》课件：08发热fever.ppt》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、发热Fever周文华WenhuaZhouPh.DSchoolofMedicine,NingboUniversityContact:whzhou@vip.163.com病案CaseA36-year-oldman,Onedaypriortoadmissionhewasmadeworsebyheadache,dizzy(头昏）,achingpainofmuscleandjoint(肌肉和关节酸痛）andfever.Check:T39℃,Ｐ100/min,R20/min,Bp100/70mmHg,congestionofthroat（咽喉充血）,swellingoftonsil（扁桃体肿大）,res

2、piratoryrudeness,nobubblingsoundLabfindings:WBC：13.3×109/L,lymphocyte16%,neutrophil83%。Treatment:Hewasgivenantibiotic（抗生素）.Duringtransfusion,thepatientsufferfromchilly,shake,dysphoriaandtempetaturerosetoＴ41.3℃,Ｐ120/min,R24/min,DexamethasoneintravenousinjectionQuestions1.Whatpathogenicmechanismaccou

3、ntforthispatient`sfever?2.Whythepatientshownchilly,shake,dysphoriaandtempreturerosemore?3.Howtotreatandgivemedicalorderofnursing?正常体温NormalAxillarytemperature（腋温）36~37.0CSublingualtemperature（舌下温度）36.7~37.7Crectaltemperature（肛温）36.9~37.9C37℃37℃37℃SetpointBTnormalPyrogenaffectedbodyFeverhappenedF

4、ever：调定点setpointDefinitionFeverisdefinedasaregulatorybodytemperatureelevationresponsetothepyrogen,itisinducedbyanupwardshiftoftheset-pointinthermoregulatorycenter.Anelevationofbodytemperatureisfever?36℃40℃PhysiologicelevationofbodytemperatureApathologicelevationofbodytemperatureisfever?HeatstrokeHy

5、perthyroidism甲状腺机能亢进Centralnervoussystemdamagehyperthermia非调节性体温升高，过热TemperaturehomeostasisCentralthermo-receptorsPeripheralthermo-receptorsPOAHEffectorgansHeatproductionHeatdissipation36℃40℃下丘脑视前区PhysiologictemperatureelevationPathologictemperatureelevationTemperatureelevationFeverHyperthermiaClas

6、sificationHyperthermiaisanunregulatorytemperaturerisingItisapassiveprocessThereisnochangeofthesetpointFeverisaregulatorytemperaturerisingItisanactiveprocessItisthebody’sactivereactiontopyrogenPathogenesisPyrogenicActivator发热激活物Activator:thesubstancecanactivatethecellsthatcanproducethepyrogen.pyroge

7、n:thesubstancecancausefeverMicrobialagents:G+,G-,exotoxins，TB,etc病毒，真菌，螺旋体，疟原虫Non-microbialagents:steroid,antigen-antibodycomplex,uratecrystal，体内组织破坏，ectPyrogenicactivatorEP-producingcellsEP（内生致热原）Endogenou