Lim Chin Leong, Byrne Chris, Lee Jason Kw
Military Physiology Laboratory, Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore.
Ann Acad Med Singap. 2008 Apr;37(4):347-53.
This review discusses human thermoregulation during exercise and the measurement of body temperature in clinical and exercise settings. The thermoregulatory mechanisms play important roles in maintaining physiological homeostasis during rest and physical exercise. Physical exertion poses a challenge to thermoregulation by causing a substantial increase in metabolic heat production. However, within a non-thermolytic range, the thermoregulatory mechanisms are capable of adapting to sustain physiological functions under these conditions. The central nervous system may also rely on hyperthermia to protect the body from "overheating." Hyperthermia may serve as a self-limiting signal that triggers central inhibition of exercise performance when a temperature threshold is achieved. Exposure to sub-lethal heat stress may also confer tolerance against higher doses of heat stress by inducing the production of heat shock proteins, which protect cells against the thermolytic effects of heat. Advances in body temperature measurement also contribute to research in thermoregulation. Current evidence supports the use of oral temperature measurement in the clinical setting, although it may not be as convenient as tympanic temperature measurement using the infrared temperature scanner. Rectal and oesophagus temperatures are widely accepted surrogate measurements of core temperature (Tc), but they cause discomfort and are less likely to be accepted by users. Gastrointestinal temperature measurement using the ingestible temperature sensor provides an acceptable level of accuracy as a surrogate measure of Tc without causing discomfort to the user. This form of Tc measurement also allows Tc to be measured continuously in the field and has gained wider acceptance in the last decade.
本综述讨论了运动过程中的人体体温调节以及临床和运动环境中体温的测量。体温调节机制在休息和体育锻炼期间维持生理稳态方面发挥着重要作用。体力活动通过导致代谢产热大幅增加,对体温调节构成挑战。然而,在非热解范围内,体温调节机制能够适应,以在这些条件下维持生理功能。中枢神经系统也可能依靠体温过高来保护身体免受“过热”影响。体温过高可能作为一种自我限制信号,当达到温度阈值时触发对运动表现的中枢抑制。暴露于亚致死热应激也可能通过诱导热休克蛋白的产生,赋予对更高剂量热应激的耐受性,热休克蛋白可保护细胞免受热的热解作用。体温测量技术的进步也有助于体温调节研究。目前的证据支持在临床环境中使用口腔温度测量,尽管它可能不如使用红外温度扫描仪进行鼓膜温度测量那么方便。直肠温度和食管温度是广泛接受的核心体温(Tc)替代测量方法,但它们会带来不适,不太可能被使用者接受。使用可摄入温度传感器进行胃肠道温度测量作为Tc的替代测量方法,提供了可接受的准确度水平,且不会给使用者带来不适。这种形式的Tc测量还允许在现场连续测量Tc,并且在过去十年中得到了更广泛的接受。