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[高环境温度对健康受试者及血栓形成风险患者血液凝固各项参数的影响]

[Influence of high environmental temperature on various parameters of blood coagulation in healthy subjects and in thrombosis risk patients].

作者信息

Di Blasi S, Pintacuda S, Ferotti N, Tranchina G, Lo Coco L, Di Fazio L, Di Blasi U, Morici G, Tralongo A, Fradà G

机构信息

Università degli Studi di Palermo, Clinica Medica Generale e Terapia Medica II.

出版信息

Minerva Med. 1987 Nov 30;78(22):1655-63.

PMID:3696444
Abstract

The effects of environmental hyperthermia (exposure to a hot, dry microclimate) on the human body were investigated with particular reference to certain clotting parameters in healthy subjects and patients at risk of thrombosis. The study covered 70 volunteers, 10 of them clinically healthy (6 males and 4 females) aged 37.7 +/- 9.7 and 60 patients at risk of thrombosis aged 18-60 and divided according to pathology as follows: 26 with ischaemic cardiopathy, 22 with metabolic disorders (12 diabetics, 8 with dyslipidaemia, 2 with hyperuricaemia) and 12 with obliterating arteriopathies of the lower extremities (Fontaine stage 2 and 3). The following standardised protocol was adopted: 2 hours exposure in a controlled climate chamber (40 degrees C, 40-50% humidity, standard air speed 4 m/min, barometric pressure 760 mmHg) for a total of 8 exposures (2 per week for 1 month). This approach was adopted in order to assess not only the effect of each single exposure but also the role of any adaptation to heat. Three blood samples were taken from each subject for each session: the first in basal conditions in a comfortable environment, the second at the end of the 2 hour exposure; the third 30 minutes after the end of the session. Simultaneously samples of arterial blood were taken for pH assays and a spleen echography was performed in basal conditions and at the end of the session for each subject. Each blood sample was tested for several parameters essentially attributable to blood concentration for a broader view of the biological effects of exposure to heart (Ht, blood protein, Nat, K+). The clotting factors under specific study were also assessed (platelet count and volume, beta-thromboglobulin, PF4, von Willebrand Factor VIII, thromboxane B2, fibronectin). Body weight, blood pressure and oral temperature were also measured in all subjects before and after each session. In all subjects both healthy and at risk of thrombosis oral temperature increased (1 +/- 0.4 degrees); on average blood pressure was already higher in basal conditions in the patient group; body weight fell by 900 +/- 120 G in both groups. Ht and blood protein increased significantly in both groups while electrolyte changes were insignificant and blood pH showed a tendency towards acidosis. Clotting parameters revealed a tendency towards thrombophilia in all subjects: platelet count and volume were already higher in the patient group in basal conditions and increased after exposure to hyperthermia. Beta-thromboglobulin, FP4, Factor VIII, thromboxane B2 and fibronectin all increased.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

研究了环境高温(暴露于炎热、干燥的微气候中)对人体的影响,特别参考了健康受试者和有血栓形成风险患者的某些凝血参数。该研究涵盖了70名志愿者,其中10名临床健康(6名男性和4名女性),年龄为37.7±9.7岁,以及60名有血栓形成风险的患者,年龄在18至60岁之间,并根据病理情况分为以下几类:26例患有缺血性心脏病,22例患有代谢紊乱(12例糖尿病患者,8例血脂异常患者,2例高尿酸血症患者),12例患有下肢闭塞性动脉病(Fontaine 2期和3期)。采用了以下标准化方案:在可控气候舱中暴露2小时(40摄氏度,湿度40 - 50%,标准风速4米/分钟,气压760毫米汞柱),共进行8次暴露(每周2次,持续1个月)。采用这种方法不仅是为了评估每次单次暴露的效果,也是为了评估任何热适应的作用。每次实验从每个受试者采集三份血样:第一份在舒适环境的基础条件下采集,第二份在2小时暴露结束时采集;第三份在实验结束后30分钟采集。同时采集动脉血样进行pH测定,并在基础条件下和实验结束时对每个受试者进行脾脏超声检查。对每份血样检测了几个主要归因于血液浓缩的参数,以便更全面地了解暴露于高温(Ht、血液蛋白、Nat、K +)的生物学效应。还评估了特定研究中的凝血因子(血小板计数和体积、β - 血小板球蛋白、PF4、血管性血友病因子VIII、血栓素B2、纤连蛋白)。在每次实验前后还测量了所有受试者的体重、血压和口腔温度。在所有健康和有血栓形成风险的受试者中,口腔温度均升高(1±0.4摄氏度);平均而言,患者组在基础条件下血压就已经较高;两组体重均下降了900±120克。两组的Ht和血液蛋白均显著增加,而电解质变化不显著,血液pH呈酸中毒趋势。凝血参数显示所有受试者都有血栓形成倾向:患者组在基础条件下血小板计数和体积就已经较高,暴露于高温后进一步增加。β - 血小板球蛋白、FP4、因子VIII、血栓素B2和纤连蛋白均增加。(摘要截断于400字)

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