病理生理学精品课件（复旦大学）03 inflammation1.pptVIP

Complications in cutaneous wound healing （并发症）： Deficient scar formation瘢痕形成不足 Wound dehiscence(伤口裂开) Ulceration（溃疡） Excessive formation of the repair components瘢痕形成过度 keloid（瘢痕疙瘩） aggressive fibromatoses （侵袭性纤维瘤病） Formation of contractures挛缩 Deformities of the wound and the surrounding tissue keloid（瘢痕疙瘩） Ⅴ. Factors that influence wound healing影响修复的因素 Systemic factors： nutrition(营养) Metabolic sttus(代谢状况) Circulatory sttus(循环状况) Hormones(激素) Local factors： Infection(感染) Mechanical factors(机械磨擦) Foreign bodies(异物) Size, location and type of wound (大小、部位、伤口类型） Fibrosis of organs 器官纤维化 2.器官内某些细胞活化、增 生（Fb） 如肝星状细胞，肾小球系膜细胞， 肺原始间叶细胞 伴有ECM沉积 1.慢性炎症持续存在、剌激 3.器官结构改变，功能异常 1 2 3 ECM ①慢性持续性损伤（启动） 上皮、内皮损伤， 间质水肿， 组织支架结构损伤 （氧自由基、弹性蛋白酶、MMP-2） ②间叶增生和细胞介质分泌(调节) 上皮细胞增生， 间叶细胞增生 肾系膜细胞增生 功能活化（ TGF-β ↑，胶原↑， FN↑ ，） （巨噬细胞TGF-β，HGF、KGF、EGF） 系膜细胞增生 TGF-?1表达增加 ③系膜细胞增生和ECM合成(效应) ECM合成增多、降解减少 PAS C-IV FN ④ECM沉积和分解(持续或消退) 器官结构改变，功能异常 （病因持续、MMP-2↓、TIMP↑） question What is granulation tissue ? please summarize the effects of granulation tissue in benefits and disadvantages for patients. * * * * * * * * * * * * Pyemia It is caused by pyogenic bacteria which form localized abscess in site of injury. Then the bloodstream invasion by bacteria results in septicemia, and followed by formation of multiple pyemic abscesses in distant metastatic sites (brain, kidney, bone ). Spread播散 Ⅷ. Clinical Features 炎症的临床表现 Local: redness(rubor, 红) swelling(tumor, 肿) warmth(calor, 热) pain(dolor, 痛) lost of function(功能障碍) Systemic manifestation Fever （发热） Exogenous pyrogens (外源性致热原) Leukocytes release cytokines(IL-1, TNF) Cyclooxygenases inhibit aspirin PGE2 cAMP Reset the temperature set-point at a higher level 产热 ? 散热 体温 ? Helpful: Fever may induce heat shock proteins, enhance lymphocyte responses to