Chaney R H, Olmstead C E
School of Medicine, University of California, Los Angeles.
Brain Inj. 1994 Jul;8(5):475-81. doi: 10.3109/02699059409150999.
Brain injury causing dysthermia has appeared to be not uncommon in institutionalized people with mental retardation. We sought to determine the characteristics and risks of patients of one institution. Of 1100 residents surveyed over 10 years 92 were reported to have unexplained high or low body temperatures, and 48 were monitored. Core temperatures were taken by non-invasive thermometers recording continuously for 24 h. Results were related to clinical conditions and aetiologies of mental retardation. Twenty-one per cent of the residents monitored showed hyperthermia, often related to prenatal metabolic or chromosomal abnormalities. Forty-two per cent had hypothermia, related to other causes of brain injury. Seventy-five per cent had abnormal patterns, including flat or exaggerated rhythms, reversed day-night cycle, unusual fluctuations, or sleep phase delay. Sixty-two per cent of 21 deaths to date have occurred in hypothermic patients. Occasional discrepancies between history of dysthermia and monitored results are best explained by fluctuations of temperature control over several days, probably due to changes in timing of hypothalamic rhythmicity. This could be better delineated by longer periods of monitoring.
脑损伤导致体温异常在机构化照料的智障人群中似乎并不罕见。我们试图确定某一机构中此类患者的特征和风险。在10年期间接受调查的1100名居民中，有92人报告出现不明原因的体温过高或过低，其中48人接受了监测。通过无创温度计连续记录24小时的核心体温。结果与临床状况及智障病因相关。接受监测的居民中有21%出现体温过高，通常与产前代谢或染色体异常有关。42%体温过低，与其他脑损伤原因有关。75%有异常模式，包括体温曲线平坦或夸张、昼夜节律颠倒、异常波动或睡眠相位延迟。在迄今的21例死亡病例中，62%发生在体温过低的患者中。体温异常病史与监测结果之间偶尔出现的差异，很可能是由于下丘脑节律性定时变化导致的数天内体温调节波动所致，通过更长时间的监测可以更好地描绘这种情况。
