《基础医学各论II》课件：生理学-发热.pdf

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1、Fever发热ShenJDepartmentofPathophysiology,ZhejiangUniversitySchoolofMedicine1Introduction2Causes&Mechanism3Febrilephases&Thermo-metabolism4Functional&Metabolicchanges5Prevention&Treatment21Introduction2Causes&Mechanism3Febrilephases&Thermo-metabolism4Functional

2、&Metabolicchanges5Prevention&Treatment3IntroductionNormalbodytemperature~37℃withavariation~1C•Axillary36.2-37.2C•Oral36.7-37.7C•Rectal36.9-37.9CRegulationofnormalbodytemperature•Thermoregulatorycenter•Setpoint4ElevationofbodytemperatureAnelevationofbod

3、ytemperatureabovethenormalamplitudeofdailyvariation(>0.5℃)Anelevationofbodytemperatureisfever?40℃36℃Physiologicelevationofbodytemperature5Apathologicelevationofbodytemperatureisfever?HeatstrokeHyperthyroidismCentralnervoussystemdamagehyperthermia6Elevationof

4、bodytemperatureAnelevationofbodytemperatureabovethenormalamplitudeofdailyvariation(>0.5℃)TypesofbodytemperatureelevationPhysiologicalelevation•Beforemenstruation•Severeexercise•StressPathologicalelevation•Fever（发热）•Hyperthermia（过热）7FeverFeverFever,orpyrexia,

5、isacomplicatedpathologicalprocesscharacterizedbyaregulatedelevationofcorebodytemperaturethatexceedsthenormaldailyvariation(>0.5℃),inwhichpyrogens(致热原)causeatemporaryupwardresettingofthehypothalamicthermostaticsetpoint,inducingacomplexphysiologicandpathophysio

6、logicfebrileresponse.•Regulatedincreaseofbodytemperatureabove37.5℃•Causedbypyrogens•Bodytemperature=thechangedsetpoint8HyperthermiaHyperthermiaAnunregulatedriseinbodytemperaturebeyondtheunchangedhypothalamicthermostaticsetpointresultingfromthedysfunctionofbod

7、ytemperaturecenterorimpairmentofheatproductionand/orheatlossmechanisms.Causes:•Overproductionofheat•Impedimentinheatloss•DysfunctionofbodytemperaturecenterFeatures:•Passiveincreaseofbodytemperature>0.5℃•Bodytemperaturebeyondtheunchangedsetpoint9Comparisonbetw

8、eenhyperthermiaandfeverHyperthermiaFeverArisingfromchangeswithinthebodyorbyResultingfrompyrogenchangesinenvironmentSetpointremainsunchangedordamaged,Abilitytoregulatesetpointremainsoreffe