Fever病理生理学英文课件

hyperthermia
no pyrogen set point no change or damnification T rise a very high level, deadliness physical cooling
treatment eliminate the pyrogens
alcohol bath
Examples: Flu tuberculosis (TB) Malaria
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continued fever
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稽留热
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Salmonella typhimurium . Pneumonia
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Part 1
Introduction
1. normal body temperature and its regulation
normal body temperature : (37 ℃)
axillary temperature: rectal temperature: 36~37.4 ℃ sublingual temperature: 36.7~37.7 ℃ 36.9~37.9 ℃
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Part 2
Etiology & Pathogenesis
1. pyrogenic activator
(1) exogenous pyrogen
① bacterium ② viruses: influenza virus , SARS virus, measles virus, etc.
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Part 2
Etiology & Pathogenesis
2. endogenous pyrogen (EP)
(2) The characters of EP
e. latent period about 15 min.
f. Pyrogenic dose is 30~50ng. g. No toleration.
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ຫໍສະໝຸດ Baidu
间歇热
malaria
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undulant fever
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波状热
Brucella disease
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Stress Physiological elevation Strenuous exercise of body temperature Before menstruation
The elevation of Body temperature Pathological elevation of body temperature
T<37℃
POAH
efferent nerve
37℃
efferent nerve thermogenesis
thermolysis
constant temperature
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Part 1
Introduction
1. normal body temperature and thermoregulation
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physiological
elevated temperature
pathological
fever (regulatory) usually〈42℃
heperthermia
may 〉42℃
42℃: ceiling temperature, fever limitation
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Part 1
Introduction
1. normal body temperature and its regulation
thermoregulatory center
senior center: preoptic anterior hypothalamus (POAH) secondary center:
Fever
Hyperthermia
Fig. Conditions of elevation in body temperature
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Part 1
Introduction
2. Fever and Hyperthermia fever — the hypothalamic set point is reset at a high temperature by pyrogen , result in body temperature being higher than 0.5 ℃. hyperthermia — the body temperature is higher than 0.5 ℃, but the hypothalamic set point had not been changed.
h. The responsive site is POAH.
i. Function: up-regulate the set point of thermostat
center.
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Comparison between pyrogenic activator (ET) and endogenous pyrogens
Part 2
Etiology & Pathogenesis
1. pyrogenic activator
(1) exogenous pyrogen
① bacterium A. gram-positive bacterium: staphylococci, streptococcus , etc. (exotoxin)
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Part 2
Etiology & Pathogenesis
1. pyrogenic activator
pyrogenic activator
exogenous pyrogen products of body
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Part 1
Introduction
2. Fever and Hyperthermia
The comparisons of fever and hyperthermia
items
etiology mechanism effect
Fever
pyrogen set point turned to a high level T reach a high level, febrile ceiling
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irregular fever
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不规则热
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TB, rheumatic fever
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Part 2
Etiology & Pathogenesis
remittent fever
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弛张热
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Sepsis, severe tuberculosis (TB),
rheumatic fever
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intermittent fever
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Part 2
Etiology & Pathogenesis
1. pyrogenic activator
The characters of ET
e. latent period : 20~30 min. f. Pyrogenic dose is 0.1~1.0μg(100~1000ng). g. toleration. h. The responsive site is EP producing cells. i. Function: activate EP-producing cells to produce and release endogenous pyrogen (EP) .
B. gram-negative bacterium: colibacillus, gonococci, etc. (endotoxin, ET )
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The structure of lipopolysaccharide
Part 2
Etiology & Pathogenesis
medulla
spinal cord
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Part 1
Introduction
1. normal body temperature and thermoregulation
the process of thermoregulation
T>37℃ temperature receptor afferent nerve
③ fungi: candida albicans
④ spirochetes: leptospira,
⑤ plasmodium
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different microorganism has different pyrogenic activator and produces different EP, leading to different fever type
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FEVER
Chengwu Liu www.themegallery.com 2015
Outlines
1 2 3 4
Introduction
Etiology & Pathogenesis
Stage & Manifestation
Alterlations of Metabolism and Function Prevention and Treatment
2. endogenous pyrogen (EP)
(1) category of EP
IL-1 monocyte / macrophage / endotheliocyte TNF macrophage / lymphocyte IL-6 monocyte / fibrocyte / endotheliocyte IFN WBC / monocyte
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MIP-1 macrophage
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Part 2
Etiology & Pathogenesis
2. endogenous pyrogen (EP)
(2) The characters of EP
a. The component is protein b. Light molecular weight , easy to cross the BBB. c. Poor stability, Thermolabile. d. species specificity.
1. pyrogenic activator
The characters of ET
a. The venenous component is the lipid A of lipopolysaccharide b. Molecular weight is 1000～2000KD, difficult to cross the blood brain barrier (BBB). c. Strong stability, resist acid and heat, inactivated by 160℃ for 2 hours. d. No species specificity.