内毒素致热的热型和热限研究  

Fever Pattern and Limits Induced by Endotoxin

作　　者：刘瑞东 崔颖[2] 高颖[2] 刘庆增[2] 王金兰[2] 

机构地区：[1]衡水市药检所,河北衡水053000 [2]武警医学院药剂教研室,天津300162

出　　处：《中华医院感染学杂志》2003年第5期421-423,共3页Chinese Journal of Nosocomiology

摘　　要：目的　研究内毒素对机体致热的规律 ,掌握不同剂量内毒素致热的热型和热限。方法　按照药典规定的热原检查方法 ,对家兔耳缘静脉注入大、中、小不同剂量的内毒素 ,记录并绘制升温曲线图 ,确定其热型 ;对分次注入和 1次大量注入内毒素形成的耐受性的家兔 ,再次注入内毒素及染菌葡萄糖溶液 ,记录并绘制升温曲线图 ,确定其热限。结果　在一定剂量范围内 ,内毒素剂量大小与体温升高程度及维持时间有量效关系 ;小剂量引起单相热 ,大剂量引起双相热 ,中剂量引起中间型 ;加大内毒素剂量不可能使体温无限上升 ;当体内内毒素超过一定剂量时 ,体温不再上升 ,而产生热限。结论　机体疾病与热型相关 ,病变性质不同决定了致热原吸收入血的速度和浓度 ,血中致热原浓度决定了热型 ,对于反复细菌感染而内毒素集聚的机体可形成热限 ,体温不再升高 ;过量的内毒素反而因微循环障碍而体温下降 ;热限形成或体温下降有可能掩盖临床症状而延误治疗 ,导致更严重后果 ,应引起重视。OBJECTIVE To understand fever pattern and limits, induced by endotoxin of different doses and study the fever regularity. METHODS According to the method of pyrogen test in pharmacopoeia, endotoxin was injected into rabbit ear margin vein in high, middle or low doses, data were recorded, diagram of curve was drawed with which the fever pattern was definited. Endotoxin or glucose solution contaminated with germs was injected into rabbits, after tolerance formed which the repeated injection was done in higher dose, temperature time cure was drawed, formed fever limits were recorded. RESULTS In a defined range of dose, there is dose dependent relationship between endotoxin and fever characteristics including degree of temperature increase and time of fever. The fever pattern of single phase fever, double phase fever or transition type separately corresponded with endotoxin of low, high and middle doses. The phenomena of fever limits that temperature shift isn′t increased occur when endotoxin in body exceeds some fixed concentration. CONCLUSIONS There is a relationship between human disease and fever pattern, speed of entering into blood of pyrogen and concentration of endotoxin are determinated by lesion nature, and the later is important reason for pattern of fever. Limit of fever occurs in body contaminated by germs repeatedly or with accumulation of endotoxin, in which temperature shift isn′t increased, overdose endotoxin decreases temperature with the reason of microcirculation disorder instead. Formation of fever limits or temperature descent, which should be thought highly of, can cover clinic symptom and delay therapy, even lead to severe consequence.

关 键 词：内毒素 热限 热型 单相热 双相热 

分 类 号：R136.4[医药卫生—劳动卫生]