Sagui Emmanuel, Beighau Sophie, Jouvion Arnaud, Trichereau Julie, Cornet Delphine, Berthelot René Charles, Canini Frédéric, Grélot Laurent
French Military Teaching Hospital Laveran, CS 50004, 13384 Marseille Cedex 13, France.
Armed Forces Biomedical Research Institute, BP 73, 91223 Bretigny Sur Orge Cedex, France.
Mil Med. 2017 Jul;182(7):e1842-e1850. doi: 10.7205/MILMED-D-16-00251.
After one episode of exertional heat stroke (EHS), risk factors must be identified to determine the potential for subsequent episodes. One of these risk factors, core body temperature (T) kinetics during strenuous exercise, may be a surrogate marker suggestive of impaired thermoregulation. This study aimed to determine the kinetics of increases in T among military subjects who had a history of EHS.
Forty subjects (38 males, mean age 28.4 ± 4.9 years, mean body mass index 24.9 ± 2.4) who had a history of EHS ran 8 km in full combat gear with continuous monitoring of T and heart rate. The run was a qualifying event for military service. T was assessed using an ingestible sensor (Cortemp HQ Inc., Palmetto, Florida). Maximum oxygen uptake (VO) was measured on the day before the run.
The mean performance time for the run was 44.6 ± 6.6 minutes achieved under mild climatic conditions. No neurological impairment was observed. The mean maximum T was 39.9 ± 0.5°C. On the basis of T during the last 10 minutes of running, two T profiles were identified: increased T (T increase > 0.5°C) and plateaued T. Neither profile depended on initial, mid-run, or maximal T, VO, speed running, body surface area or body fat mass.
Subjects who had a history of EHS exhibited different T profiles at the end of an 8-km run. Laboratory studies will be necessary to identify the mechanisms underlying these profiles; future longitudinal studies can determine whether a T increase >0.5°C during the last 10 minutes is a risk factor for EHS recurrence.
在发生一次劳力性热射病（EHS）后，必须确定危险因素以判断后续发作的可能性。这些危险因素之一，即剧烈运动期间的核心体温（T）动力学，可能是提示体温调节受损的替代标志物。本研究旨在确定有EHS病史的军事人员中T升高的动力学情况。
40名有EHS病史的受试者（38名男性，平均年龄28.4±4.9岁，平均体重指数24.9±2.4）身着全套作战装备跑8公里，同时持续监测T和心率。此次跑步是军事服役的一项资格赛。使用可摄入式传感器（佛罗里达州棕榈滩的Cortemp HQ公司）评估T。在跑步前一天测量最大摄氧量（VO）。
在温和气候条件下，跑步的平均完成时间为44.6±6.6分钟。未观察到神经功能损害。平均最高T为39.9±0.5°C。根据跑步最后10分钟的T，确定了两种T曲线：T升高（T升高>0.5°C）和平稳T。两种曲线均不取决于初始、跑步中途或最高T、VO、跑步速度、体表面积或体脂量。
有EHS病史的受试者在8公里跑步结束时表现出不同的T曲线。需要进行实验室研究以确定这些曲线背后的机制；未来的纵向研究可以确定在最后10分钟内T升高>0.5°C是否是EHS复发的危险因素。
