Gorjanc Jurij, Morrison Shawnda A, McDonnell Adam C, Mekjavic Polona Jaki, Blagus Rok, Mekjavic Igor B
Department of Surgery, Hospital of the Brothers of St. John of God, St.Veit/Glan, Austria.
Faculty of Health Sciences, University of Primorska, Izola, Slovenia.
Wilderness Environ Med. 2019 Jun;30(2):141-149. doi: 10.1016/j.wem.2019.01.002. Epub 2019 Apr 9.
We tested the hypothesis that individual susceptibility to freezing cold injury might be reflected in an attenuated cold-induced vasodilatation (CIVD) response by comparing the CIVD responses of an elite alpinist with a history of freezing cold injury in the feet (case alpinist) with those of an age- and ability- matched noninjured alpinists control group (controls). According to this hypothesis, the vasomotor responses to a CIVD test of the case alpinist would represent a pathophysiological response when compared with the normal physiological response of a noninjured cohort.
The case alpinist and the controls in the cohort group conducted a cold water immersion test comprising sequential immersion of a hand and foot for 5 min in 35°C water, followed by a 30-min immersion in 8°C water and a 10-min recovery period in room air. During this test we monitored the finger and toe skin temperatures.
The case alpinist had a significantly attenuated CIVD response and a lower skin temperature in all injured and noninjured digits during immersion (∼2°C lower than in the control group) and an attenuated recovery of finger skin temperatures (∼6°C lower than in the control group).
The attenuated CIVD response of the case alpinist may reflect a previously unrecognized enhanced susceptibility to frostbite. In addition to the poor vasomotor response observed in the injured toes, he also exhibited a poor vasomotor response in his noninjured fingers. The results of the present study indicate that a test of vasomotor activity during thermal stress may identify individuals predisposed to cold injury.
我们通过比较一名有足部冻伤史的精英登山运动员（病例登山运动员）与年龄和能力匹配的未受伤登山运动员对照组（对照组）的冷诱导血管舒张（CIVD）反应，来检验个体对冻伤易感性可能反映在减弱的冷诱导血管舒张反应这一假设。根据这一假设，与未受伤队列的正常生理反应相比，病例登山运动员对CIVD测试的血管运动反应将代表一种病理生理反应。
队列组中的病例登山运动员和对照组进行了冷水浸泡试验，包括将手和脚依次浸入35°C水中5分钟，然后在8°C水中浸泡30分钟，并在室内空气中恢复10分钟。在该测试过程中，我们监测了手指和脚趾的皮肤温度。
病例登山运动员在浸泡期间所有受伤和未受伤手指的CIVD反应明显减弱，皮肤温度较低（比对照组低约2°C），手指皮肤温度恢复减弱（比对照组低约6°C）。
病例登山运动员减弱的CIVD反应可能反映了此前未被认识到的对冻伤的易感性增强。除了在受伤脚趾中观察到的血管运动反应不佳外，他在未受伤的手指中也表现出不佳的血管运动反应。本研究结果表明，热应激期间的血管运动活性测试可能识别出易患冷损伤的个体。
