湘雅儿科课件measles文档资料.pptxVIP

湘雅儿科课件Measles文档资料会计学第1页/共42页概　述(overview)麻疹是一种由麻疹病毒引起的急性呼吸道传染病(Measles is an acute respiratory contagious disease caused by measles virus )第2页/共42页概　述(overview)临床特征为：发热、上呼吸道炎症、结合膜炎、Koplik斑及全身性斑丘疹(clinical features: fever,upper respiratory inflammation, conjunctivitis, Koplik’s spots and generalized maculopapular rash) 第3页/共42页病　原(ETIOLOGY)麻疹病毒(measles virus)属副粘液病毒，无亚型，仅一种抗原型( RNA-containing virus of the Paramyxovirus family ,only one serotype) 第4页/共42页病　原(ETIOLOGY)麻疹病毒(measles virus)麻疹病毒不耐热，对日光和消毒剂均敏感，但在低温中能长期保存(Measles virus are rapidly inactivated by heat,light , and all kinds of desinfectant,but can be stored indefinitely at low temperature)。第5页/共42页病　原(ETIOLOGY)麻疹病毒(measles virus)存在于患者前驱期和出疹期的眼结膜、鼻、咽、气管等分泌物中(During the prodromal period and eruption period,it is found in sections of conjunctiva, nose , pharynx ,trachea and so on)。第6页/共42页麻疹的发病机制 鼻、咽 短期繁殖病毒 局部粘膜 血流 远处器官单核 眼结膜 （第一次） 巨噬细胞系统 潜伏期大量繁殖 局部症状 血流 （第二次） 前驱期 全身症状 第7页/共42页病理(PATHOGEY)全身淋巴组织增生，有多核巨细胞形成 (Hyperplasia of all lymphoid tissue usually occurs,multinucleated giant cells may be found )第8页/共42页病理(PATHOGEY)多核巨细胞(multinucleated giant cells)：多个巨噬细胞融合形成的具有核内外包涵体的巨细胞网状内皮巨细胞也称华-佛细胞（reticuloendothelial giant cells or Warthin-Finkeldey cells)：存在于全身淋巴组织和肝、脾等脏器中上皮巨细胞（epithelial giant cells）：主要位于皮肤、眼结合膜、呼吸道和消化道粘膜等处 第9页/共42页病理(PATHOGEY)皮肤、眼结合膜、鼻咽部、支气管、肠道粘膜等处可见单核细胞增生及围绕在毛细血管周围的多核巨细胞，淋巴样组织肥大(Prolifieration of mononuclear cells is found in the skin,in the conjunctivae and in the mucous membranes of the nasopharynx, bronchi, and intestinal tract,multinucleated giant cells occur around the capillaries. Hyperplasia of lymphoid tissue occurs.)第10页/共42页病理(PATHOGEY)颊粘膜下层的微小分泌腺发炎，其病变内有浆液渗出及内皮细胞增殖形成Koplik斑 (An inflammatory reaction occurs in the fine secretor of the buccal mucosa, where serous exudate and proliferation of endothelial cells result in Koplik’s spots) 第11页/共42页病理(PATHOGEY)麻疹引起的间质性肺炎为Hecht巨细胞肺炎(Interstitial pneumonitis resulting from measles v