Esiri M M
Department of Neuropathology and Clinical Neurology, Radcliffe Infirmary, Oxford, UK.
Brain Pathol. 1997 Jan;7(1):695-709. doi: 10.1111/j.1750-3639.1997.tb01084.x.
In this review I shall try to provide a brief, up-to-date, account of the neuropathology of those viral and rickettsial diseases that are particularly prevalent in tropical regions. These diseases are not, however, exclusive to the tropics. Some, such as AIDS, are common in temperate regions as well, though others are closer to being exclusively tropical, such as some of the arthropod-borne (ARBO) virus encephalides. The latter are dependent for their dissemination on an existence during part of their infectious cycle in insects which are, in turn, climatically and seasonally sensitive. This necessarily limits their geographical distribution. Factors that influence some of the other diseases are less closely dependent on climate and geography and reflect more the social or cultural conditions under which people live. Thus, diseases that depend for their spread on forms of human behavior such as promiscuity or drug abuse (AIDS), or poor hygiene and living conditions (polio, rickettsial diseases) or on contact with domestic and other animals (rabies) may occur in a more widespread distribution, for the tropics are not the only places that afford opportunities for these diseases to flourish. I shall select for discussion aspects of the pathology of these diseases that are currently undergoing investigation but will aim to present these against the backdrop of more established aspects of their pathology. Recent reviews of the pathology of viral encephalitis can be found in Hamilton and Wiley (33) and Esiri and Kennedy (20) and of HIV-1 infection in Price & Sidtis (78) and Scaravilli (85).
在这篇综述中,我将尝试简要介绍热带地区特别常见的病毒性和立克次体病的神经病理学最新情况。然而,这些疾病并非热带地区所特有。有些疾病,如艾滋病,在温带地区也很常见,不过其他一些疾病则更接近于热带地区特有,比如某些节肢动物传播(虫媒)病毒脑炎。后者的传播依赖于它们在昆虫体内感染周期的一部分时间内存在,而昆虫又对气候和季节敏感。这必然限制了它们的地理分布。影响其他一些疾病的因素对气候和地理的依赖程度较低,更多地反映了人们生活的社会或文化条件。因此,那些传播依赖于滥交或药物滥用(艾滋病)、卫生条件差和生活环境恶劣(脊髓灰质炎、立克次体病)或与家畜及其他动物接触(狂犬病)等人类行为形式的疾病,可能分布更为广泛,因为热带地区并非这些疾病能够肆虐的唯一地方。我将选择讨论这些疾病病理学中目前正在研究的方面,但会以其病理学中更成熟的方面为背景来呈现。关于病毒性脑炎病理学的近期综述可参考汉密尔顿和威利(33)以及埃西里和肯尼迪(20)的文章,关于HIV - 1感染的综述可参考普赖斯和西迪斯(78)以及斯卡拉维利(85)的文章。