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黄疸型钩端螺旋体病患者肝脏、肾脏和肺部的病理形态发生

[Pathomorphogenesis of the liver, kidneys, and lungs in patients with icteric leptospirosis].

作者信息

Mel'nik G V, Zhukova L I

机构信息

Kuban State Medical Academy, 350000, Krasnodar.

出版信息

Arkh Patol. 2004 Jan-Feb;66(1):3-7.

Abstract

Postmortem and biopsies pathomorphological studies of the liver, kidneys and lungs of patients with leptospirosis were carried out. The content of myoglobin in these organs, blood and urine was investigated. Dystrophy and infiltration of the liver in leptospirosis are moderate and do not correlate with the intensity of icterus. In pathogenesis of hepatorenal and respiratory disturbances in leptospirosis the important role in leptospirosis belongs to rhabdomyolysis resulting in accumulation of blood myoglobin. Its elimination occurs through the liver, kidneys and lungs and this promotes development of such complications as shock, acute renal failure, respiratory distress syndrome. The inclusion in pathogenetic therapy of efferent methods of detoxication effectively eliminates endotoxicosis and hypermyoglobinemia and solves the problem of complications.

摘要

对钩端螺旋体病患者的肝脏、肾脏和肺进行了尸检及活检病理形态学研究。对这些器官、血液和尿液中的肌红蛋白含量进行了调查。钩端螺旋体病时肝脏的营养不良和浸润程度中等,且与黄疸强度无关。在钩端螺旋体病肝肾和呼吸功能障碍的发病机制中,横纹肌溶解导致血液中肌红蛋白蓄积起重要作用。其清除通过肝脏、肾脏和肺进行,这促进了休克、急性肾衰竭、呼吸窘迫综合征等并发症的发生。在病因治疗中采用传出性解毒方法可有效消除内毒素血症和高肌红蛋白血症,解决并发症问题。

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