课件：秋药学慢支、肺心病、肺炎.pptVIP

* Severe Acute Respiratory syndrome, SARS 2003-3-15 WHO SARS is a viral respiratory illness caused by a coronavirus, that has not previously affected humans. SARS was first reported in Asia in February 2003. The SARS global outbreak of 2003 was contained; however, it is possible that the disease could re-emerge. SARS first in November of 2002 Guangdong Province, spread to Hong Kong, Taiwan, Singapore, Vietnam, and Toronto, where large outbreaks also occurred. More than 8,000 cases of SARS, including 774 deaths. Clinical manfestations: incubation period of 2 to 10 days, beginning with a dry cough, malaise, myalgias, fever and chills. Upper respiratory tract symptoms such as sore throat are less commonly. Nearly 10% of patients die from the illness. No specific treatment. 肉眼：肿，实，点状坏死、梗死 镜下：透明膜、胞浆病 毒包涵体，肺泡浆液纤 维素、中性粒细胞，小 血管内微血栓，脱屑性 肺泡炎 Pathological changes SARS: Hyaline membrane SARS: Viral inclusion body 四、支原体肺炎Mycoplasmal pneumonia Also called as primary atypical pneumonia“ characterized by an acute febrile respiratory disease Patchy inflammatory changes in the lungs, largely confined to the alveolar septa and pulmonary interstitium 儿童、青少年 秋冬 飞沫传播，散发 肺间质，节段性 肺泡间隙增高，毛细血管扩张充血，间质水肿，散在慢性炎细胞浸润 重者：肺泡上皮及肺组织坏死 Macrophages and lymphocytes infiltrating the aveolar wall 大、小叶性肺炎和病毒性肺炎的区别 大叶性肺炎 小叶性肺炎 病毒性肺炎 发病人群 青壮年 婴幼儿、老弱 各年龄组 病原体 肺炎双球菌 多种细菌 病毒 病变范围 一或多个肺大叶 散在于双肺 弥漫性分布 病变部位 肺泡 肺小叶：细支气管为中心及周围肺泡 肺间质组织 病变性质 纤维素性炎 化脓性炎 淋巴细胞、单核细胞渗出 预后 完全痊愈 并发症、预后差 差别大 ★ Otherwise pneumonia 真菌性肺炎 吸入性肺炎 免疫抑制相关性肺炎 放射性肺炎 自身免疫性疾病相关性肺炎 特发性间质性肺炎/特发性肺间质纤维化 阻塞性肺炎 过敏性肺炎 二、慢性支气管炎Chronic Bronchitis Introduction Etiology Pathogenesis Pathological changes Clinical relations Chronic non-specific inflammation Common disease, middle-aged and old people (40-65 years old), 15%-20% Clinical characters: Cough, Sputum, Gasp Clinical diagnosis: 3 months per year, 2 years continuously Severity: repeat, persist Pulmonary emphysema,