发热(国际医学系2014.4).ppt

(4)NO Has been described as a member of a new class of neurotransmitters in the modulation of neuronal activity Is a kind of pyrogenic mediator in OVLT and POAH (5)CRH (corticotrophin releasing hormone) Is synthesized and released from the hypothalamus a potent releaser of adrenocorticotrophic hormone (ACTH) Synthesized in hypothalamus Is responsible for endogenous antipyresis (1)AVP (arginine vasopressin) 2.The negative regulation mediator AVP VSA, MAN suppresses febrile response induced by EPS AVP antagonist VSA Fever Experimental evidence An endogenous neuropeptide (2)α-MSH Fever inducer cells endogenous pyrogens IL-1 TNF IFN produce release Thermo-regulating center (POAH) Set point ? Etiology and pathogenesis of fever PGE cAMP Na+/Ca2+ AVP α-MSH ?heat production ?heat loss Fever shivering Vasoconstriction ?sweat Fervescence period Persistent febrile period Defervescence period Shivering vasoconstriction sweat vasodilation Alteration of metabolism and function Rise of set point Fall of Set point * Fever 国际学院医学系2014 temperature – regulating center (POAH) thermoreceptor heat loss Temperature regulating control system heat production the preoptic area of anterior hypothalamus (POAH) The skin is endued with both cold and warmth receptors (peripheral thermoreceptors) Deep body thermoreceptors are also found in spinal cord , abdominal organs and hypothalamus (central thermoreceptors). Detection of temperature by receptors in the skin and deep body tissues These thermoreceptors provide the hypothalamus with information about skin and core temperature during maximum shivering , body heat production can rise to four to five times normal Basal rate of metabolism Shivering (rhythmic contraction of skeletal muscle) heat production Heat is a by-product of metabolism heat is lost from the core body and skin surfa