Department of Health, Exercise and Sport Sciences, University of New Mexico, Albuquerque, NM, USA.
Department of Health and Human Performance, Northwestern State University, Natchitoches, LA, USA.
Sports Med. 2021 May;51(5):863-872. doi: 10.1007/s40279-021-01427-8. Epub 2021 Feb 2.
Exertional heat stroke (EHS) is a life-threatening condition that affects mainly athletes, military personnel, firefighters, and occupational workers. EHS is frequently observed in non-compensable conditions (where the body is unable to maintain a steady thermal balance) as a result of heavy heat stress and muscle contraction associated with prolonged and strenuous physical and occupational activities, resulting in central nervous system dysfunction followed by multi-organ damage and failure. Since the pathophysiology of EHS is complex and involves multiple organs and systems, any condition that changes the interrelated systems may increase the risk for EHS. It has been suggested that exercise-induced muscle damage (EIMD) can lead to thermoregulatory impairment and systemic inflammation, which could be a potential predisposing factor for EHS. In this review article, we aim to (1) address the evidence of EIMD as a predisposing factor for EHS and (2) propose a possible mechanism of how performing muscle-damaging exercise in the heat may aggravate muscle damage and subsequent risk of EHS and acute kidney injury (AKI). Such an understanding could be meaningful to minimize the risks of EHS and AKI for individuals with muscle damage due to engaging in physical work in hot environments.
运动性热射病（EHS）是一种危及生命的疾病，主要影响运动员、军人、消防员和职业工人。EHS 经常发生在非补偿条件下（身体无法维持稳定的热平衡），由于剧烈的热应激和肌肉收缩与长时间剧烈的体力和职业活动有关，导致中枢神经系统功能障碍，随后发生多器官损伤和衰竭。由于 EHS 的病理生理学复杂，涉及多个器官和系统，任何改变相关系统的情况都可能增加 EHS 的风险。有人认为，运动引起的肌肉损伤（EIMD）可导致体温调节障碍和全身炎症，这可能是 EHS 的一个潜在诱发因素。在这篇综述文章中，我们旨在（1）阐述 EIMD 作为 EHS 的诱发因素的证据，（2）提出在热环境中进行肌肉损伤运动可能加重肌肉损伤以及随后发生 EHS 和急性肾损伤（AKI）的潜在机制。这种理解对于减少因在炎热环境中进行体力劳动而导致肌肉损伤的个体发生 EHS 和 AKI 的风险具有重要意义。
