Kluger M J, VanDeKerkhove K M, Eiger S M, Port F K
Am J Kidney Dis. 1987 Aug;10(2):89-91. doi: 10.1016/s0272-6386(87)80037-9.
Uremic patients tend to have a lower than normal deep-body temperature. In addition, there is a clinical impression that uremic patients are also more thermolabile than healthy people; that is, in a warm environment, body temperature tends to be higher, and in a cold environment, body temperature tends to be lower than in healthy subjects. To test the hypothesis that uremia results in enhanced thermolability, nonoperated control (NO), nephrectomized (NX), and sham-nephrectomized (SHAM) rabbits were subjected to mild cold (5 degrees C) and heat (30 degrees C) stresses. At 48 hours postsurgery, the core temperature of NX rabbits was significantly lower than that of the NO or SHAM rabbits (P less than .01). Exposure to 5 degrees C resulted in a significant fall in body temperature of the NX (from 39.1 degrees C to 38.3 degrees C; P less than .05) rabbits compared to the NO rabbits. There was a tendency for body temperature of the SHAM rabbits to fall, and as a result, there was no significant difference in the change in body temperature between the SHAM and NX rabbits. Exposure to 30 degrees C resulted in virtually no change in the core temperature of the NO or SHAM rabbits, but did result in a significant rise in core temperature of the NX rabbits (P less than .02 and P less than .01 for respective comparisons), as well as a significant increase in mortality rate (P less than .02). Based on these data, we conclude that anephric animals are more thermolabile, and are less able to tolerate exposure to a warm environment, than are normal animals.
尿毒症患者的深部体温往往低于正常水平。此外,临床观察发现,尿毒症患者比健康人对温度变化更敏感;即在温暖环境中,体温往往较高,而在寒冷环境中,体温往往比健康受试者更低。为了验证尿毒症会导致温度敏感性增强这一假说,对未做手术的对照(NO)兔、肾切除(NX)兔和假肾切除(SHAM)兔施加轻度寒冷(5摄氏度)和炎热(30摄氏度)应激。术后48小时,NX兔的核心体温显著低于NO兔或SHAM兔(P<0.01)。与NO兔相比,暴露于5摄氏度环境中时,NX兔的体温显著下降(从39.1摄氏度降至38.3摄氏度;P<0.05)。SHAM兔的体温有下降趋势,因此,SHAM兔和NX兔的体温变化无显著差异。暴露于30摄氏度环境中时,NO兔或SHAM兔的核心体温几乎没有变化,但NX兔的核心体温却显著升高(分别比较,P<0.02和P<0.01),且死亡率显著增加(P<0.02)。基于这些数据,我们得出结论,与正常动物相比,无肾动物对温度变化更敏感,且更难以耐受暴露于温暖环境。