Coris Eric E, Ramirez Arnold M, Van Durme Daniel J
Department of Family Medicine, The University of South Florida College of Medicine, Tampa, Florida 33612, USA.
Sports Med. 2004;34(1):9-16. doi: 10.2165/00007256-200434010-00002.
In 1980, 1700 people died during a prolonged heat wave in a region under-prepared for heat illness prevention. Dramatically underreported, heat-related pathology contributes to significant morbidity as well as occasional mortality in athletic, elderly, paediatric and disabled populations. Among US high school athletes, heat illness is the third leading cause of death. Significant risk factors for heat illness include dehydration, hot and humid climate, obesity, low physical fitness, lack of acclimatisation, previous history of heat stroke, sleep deprivation, medications (especially diuretics or antidepressants), sweat gland dysfunction, and upper respiratory or gastrointestinal illness. Many of these risk factors can be addressed with education and awareness of patients at risk. Dehydration, with fluid loss occasionally as high as 6-10% of bodyweight, appears to be one of the most common risk factors for heat illness in patients exercising in the heat. Core body temperature has been shown to rise an additional 0.15-0.2 degrees C for every 1% of bodyweight lost to dehydration during exercise. Identifying athletes at risk, limiting environmental exposure, and monitoring closely for signs and symptoms are all important components of preventing heat illness. However, monitoring hydration status and early intervention may be the most important factors in preventing severe heat illness.
1980年，在一个对中暑预防准备不足的地区，一场持续的热浪导致1700人死亡。中暑相关病症严重漏报，在运动员、老年人、儿童和残疾人群体中会导致显著的发病率以及偶尔的死亡率。在美国高中运动员中，中暑是第三大死亡原因。中暑的重要风险因素包括脱水、炎热潮湿的气候、肥胖、身体素质差、缺乏适应过程、既往中暑史、睡眠不足、药物（尤其是利尿剂或抗抑郁药）、汗腺功能障碍以及上呼吸道或胃肠道疾病。通过对高危患者进行教育和提高认识，可以解决其中许多风险因素。脱水时，体液流失偶尔高达体重的6 - 10%，这似乎是在炎热环境中锻炼的患者中暑最常见的风险因素之一。研究表明，运动期间因脱水导致体重每下降1%，核心体温会额外升高0.15 - 0.2摄氏度。识别高危运动员、限制环境暴露以及密切监测体征和症状都是预防中暑的重要组成部分。然而，监测水合状态和早期干预可能是预防严重中暑最重要的因素。
