Garcia Christian K, Renteria Liliana I, Leite-Santos Gabriel, Leon Lisa R, Laitano Orlando
Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA.
Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL, USA.
BMJ Med. 2022 Oct 11;1(1):e000239. doi: 10.1136/bmjmed-2022-000239. eCollection 2022.
Exertional heat stroke, the third leading cause of mortality in athletes during physical activity, is the most severe manifestation of exertional heat illnesses. Exertional heat stroke is characterised by central nervous system dysfunction in people with hyperthermia during physical activity and can be influenced by environmental factors such as heatwaves, which extend the incidence of exertional heat stroke beyond athletics only. Epidemiological data indicate mortality rates of about 27%, and survivors display long term negative health consequences ranging from neurological to cardiovascular dysfunction. The pathophysiology of exertional heat stroke involves thermoregulatory and cardiovascular overload, resulting in severe hyperthermia and subsequent multiorgan injury due to a systemic inflammatory response syndrome and coagulopathy. Research about risk factors for exertional heat stroke remains limited, but dehydration, sex differences, ageing, body composition, and previous illness are thought to increase risk. Immediate cooling remains the most effective treatment strategy. In this review, we provide an overview of the current literature emphasising the pathophysiology and risk factors of exertional heat stroke, highlighting gaps in knowledge with the objective to stimulate future research.
运动性中暑是体育活动期间运动员死亡的第三大主要原因，是运动性热疾病最严重的表现形式。运动性中暑的特征是在体育活动期间体温过高的人出现中枢神经系统功能障碍，并且可能受到热浪等环境因素的影响，这使得运动性中暑的发病率不仅限于运动员。流行病学数据显示死亡率约为27%，幸存者会出现从神经功能障碍到心血管功能障碍等长期负面健康后果。运动性中暑的病理生理学涉及体温调节和心血管负荷过重，导致严重体温过高，随后由于全身炎症反应综合征和凝血病而出现多器官损伤。关于运动性中暑危险因素的研究仍然有限，但脱水、性别差异、年龄、身体组成和既往疾病被认为会增加风险。立即降温仍然是最有效的治疗策略。在本综述中，我们概述了当前文献，强调运动性中暑的病理生理学和危险因素，突出知识空白，旨在激发未来的研究。
