11、疟原虫详解.pptVIP

(九)先天性疟疾和儿童疟疾 先天性疟疾的疟原虫来自母体，经胎盘传播，新生儿出生 后4 -12周开始发病。 先天性疟疾还可致早产、流产、死胎、低出生体重儿等。 儿童疟疾主要发生在热带的疟疾流行区，出生一个月后多见， 死亡率高。 (十)生活史与致病的关系 潜伏期 发作 再燃 复发 Pathogenesis The pathogenic effects of a malarial infection have been considered to be directly related to hemolysis of infected uninfected erythrocytes, liberation of the metabolites antigens or toxin of the parasite the immunologic response of the host to antigenic material. In falciparum malaria the phenomenon of cytoadherence is basic to the locally diminished tissue profession seen in its more sever complication. 1. Primary attack Recrudescence Relapse Incubation period Pv—11-25 d ( 6-12 m) Pf—7-27 d Pm—18-35 d typical clinical manifestation of malarial paroxysm chill ( 20 min-1 hr) fever (1-4 hrs) sweating (2-3 hrs) Definite amount of parasites required for paroxysm Pv 10-500/mm3 Pf 500-1300/ mm3 Pm 140/mm3 Periodicity of paroxysm coincides with time of release of merozoites Pv: 48 hrs Pf: 72 hrs Pm: 36-48 hrs Anemia Splenomegaly Pernicious malaria cerebral type, gastrointestinal type, algid type and so on Parasite develop in RBC Pf Surface change in Metabolism of hemoglobin lysis of cells infected RBC hemozoin formation stroma hemoglobin antigen Adherence to endothelium Fe store depletion splenomegaly fever hemoglobinemia dissemi