Cheng C, Matsukawa T, Sessler D I, Ozaki M, Kurz A, Merrifield B, Lin H, Olofsson P
Department of Anesthesia, University of California, San Francisco 94143-0648, USA.
Anesthesiology. 1995 May;82(5):1160-8. doi: 10.1097/00000542-199505000-00011.
The contribution of mean skin temperature to the thresholds for sweating and active precapillary vasodilation has been evaluated in numerous human studies. In contrast, the contribution of skin temperature to the control of cold responses such as arteriovenous shunt vasoconstriction and shivering is less well established. Accordingly, the authors tested the hypothesis that mean skin and core temperatures are linearly related at the vasoconstriction and shivering thresholds in men. Because the relation between skin and core temperatures might vary by gender, the cutaneous contribution to thermoregulatory control also was determined in women.
In the first portion of the study, six men participated on 5 randomly ordered days, during which mean skin temperatures were maintained near 31, 34, 35, 36, and 37 degrees C. Core hypothermia was induced by central venous infusion of cold lactated Ringer's solution sufficient to induce peripheral vasoconstriction and shivering. The core-temperature thresholds were then plotted against skin temperature and a linear regression fit to the values. The relative skin and core contributions to the control of each response were calculated from the slopes of the regression equations. In the second portion of the study, six women participated on three randomly ordered days, during which mean skin temperatures were maintained near 31, 35, and 37 degrees C. At each designated skin temperature, core hypothermia sufficient to induce peripheral vasoconstriction and/or shivering was again induced by central venous infusion of cold lactated Ringer's solution. The cutaneous contributions to control of each response were then calculated from the skin- and core-temperature pairs at the vasoconstriction and shivering thresholds.
There was a linear relation between mean skin and core temperatures at the response thresholds in the men: r = 0.90 +/- 0.06 for vasoconstriction and r = 0.94 +/- 0.07 for shivering. Skin temperature contributed 20 +/- 6% to vasoconstriction and 19 +/- 8% to shivering. Skin temperature in the women contributed to 18 +/- 4% to vasoconstriction and 18 +/- 7% to shivering, values not differing significantly from those in men. There was no apparent correlation between the cutaneous contributions to vasoconstriction and shivering in individual volunteers.
These data indicate that skin and core temperatures contribute linearly to the control of vasoconstriction and shivering in men and that the cutaneous contributions average approximately 20% in both men and women. The same coefficients thus can be used to compensate for experimental skin temperature manipulations in men and women. However, the cutaneous contributions to each response vary among volunteers; furthermore, the contributions to the two responses vary within volunteers.
在众多人体研究中,已对平均皮肤温度对出汗阈值和活跃的毛细血管前血管舒张阈值的影响进行了评估。相比之下,皮肤温度对诸如动静脉分流血管收缩和寒战等冷反应控制的影响尚不明确。因此,作者检验了以下假设:在男性中,平均皮肤温度和核心温度在血管收缩和寒战阈值时呈线性相关。由于皮肤温度与核心温度之间的关系可能因性别而异,因此还确定了女性中皮肤对体温调节控制的影响。
在研究的第一部分,6名男性在5个随机安排的日子里参与实验,在此期间,平均皮肤温度维持在31、34、35、36和37摄氏度左右。通过中心静脉输注冷的乳酸林格液诱导核心体温过低,足以诱发外周血管收缩和寒战。然后将核心温度阈值与皮肤温度绘制成图,并对这些值进行线性回归拟合。根据回归方程的斜率计算皮肤和核心对每种反应控制的相对贡献。在研究的第二部分,6名女性在3个随机安排的日子里参与实验,在此期间,平均皮肤温度维持在31、35和37摄氏度左右。在每个指定的皮肤温度下,再次通过中心静脉输注冷的乳酸林格液诱导足以诱发外周血管收缩和/或寒战的核心体温过低。然后根据血管收缩和寒战阈值时的皮肤温度和核心温度对计算皮肤对每种反应控制的贡献。
在男性中,反应阈值时平均皮肤温度与核心温度之间存在线性关系:血管收缩时r = 0.90±0.06,寒战 时r = 0.94±0.07。皮肤温度对血管收缩的贡献为20±6%,对寒战的贡献为19±8%。女性的皮肤温度对血管收缩的贡献为18±4%,对寒战的贡献为18±7%,这些值与男性的值无显著差异。在个体志愿者中,皮肤对血管收缩和寒战的贡献之间没有明显的相关性。
这些数据表明,皮肤温度和核心温度对男性血管收缩和寒战的控制呈线性贡献,并且在男性和女性中皮肤的贡献平均约为20%。因此,相同的系数可用于补偿男性和女性实验性皮肤温度操作的影响。然而,皮肤对每种反应的贡献在志愿者之间存在差异;此外,对两种反应的贡献在志愿者内部也存在差异。