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人类出汗、血管收缩和寒战阈值的速率及性别依赖性。

Rate and gender dependence of the sweating, vasoconstriction, and shivering thresholds in humans.

作者信息

Lopez M, Sessler D I, Walter K, Emerick T, Ozaki M

机构信息

Department of Anesthesia, University of California, San Francisco 94143-0648.

出版信息

Anesthesiology. 1994 Apr;80(4):780-8. doi: 10.1097/00000542-199404000-00009.

Abstract

BACKGROUND

The range of core temperatures not triggering thermoregulatory responses ("interthreshold range") remains to be determined in humans. Although the rates at which perioperative core temperatures vary typically range from 0.5 to 2 degrees C/h, the thermoregulatory contribution of different core cooling rates also remains unknown. In addition, sweating in women is triggered at a slightly greater core temperature than in men. However, it is unknown whether the vasoconstriction and shivering thresholds are comparably greater in women, or if women tolerate a larger range of core temperatures without triggering thermoregulatory responses. Accordingly, the authors sought to (1) define the interthreshold range; (2) test the hypothesis that, at a constant skin temperature, the vasoconstriction and shivering thresholds are greater during rapid core cooling than during slowly induced hypothermia; and (3) compare the sweating, vasoconstriction, and shivering thresholds in men and women.

METHODS

Eight men and eight women participated. The men participated on 2 separate days; no anesthesia or sedatives were administered. On each day, they were cutaneously warmed until sweating was induced and then were cooled by a central venous infusion of cold fluid. The cooling rates were 0.7 +/- 0.1 degrees C/h on 1 day and 1.7 +/- 0.4 degrees C/h on the other, randomly ordered. Skin temperature was maintained near 36.7 degrees C throughout each trial. The women were studied only once, in the follicular phase of their menstrual cycles, at the greater cooling rate.

RESULTS

The interthreshold range was approximately 0.2 degrees C in both men and women, but all thermoregulatory response thresholds were approximately 0.3 degrees C higher in women. All thresholds were virtually identical during slow and fast core cooling.

CONCLUSIONS

Our findings confirm the existence of an interthreshold range and document that its magnitude is small. They also demonstrate that the interthreshold range does not differ in men and women, but that women thermoregulate at a significantly higher temperature than do men. Typical clinical rates of core cooling do not alter thermoregulatory responses.

摘要

背景

人体中不触发体温调节反应的核心温度范围(“阈间范围”)仍有待确定。尽管围手术期核心温度变化速率通常在每小时0.5至2摄氏度之间,但不同核心降温速率对体温调节的影响仍不清楚。此外,女性出汗时的核心温度略高于男性。然而,尚不清楚女性的血管收缩和寒战阈值是否也相应更高,或者女性是否能耐受更大范围的核心温度而不触发体温调节反应。因此,作者试图:(1)定义阈间范围;(2)验证如下假设,即在皮肤温度恒定的情况下,快速核心降温期间的血管收缩和寒战阈值高于缓慢诱导低温期间;(3)比较男性和女性的出汗、血管收缩和寒战阈值。

方法

8名男性和8名女性参与研究。男性在两个不同日期参与;未给予麻醉或镇静剂。在每一天,他们被皮肤加热直至出汗,然后通过中心静脉输注冷液体进行降温。其中一天的降温速率为每小时0.7±0.1摄氏度,另一天为每小时1.7±0.4摄氏度,顺序随机。在每个试验过程中,皮肤温度维持在36.7摄氏度左右。女性仅在月经周期的卵泡期以较高的降温速率进行一次研究。

结果

男性和女性的阈间范围均约为0.2摄氏度,但女性的所有体温调节反应阈值约高0.3摄氏度。在缓慢和快速核心降温期间,所有阈值实际上是相同的。

结论

我们的研究结果证实了阈间范围的存在,并表明其幅度较小。研究结果还表明,男性和女性的阈间范围没有差异,但女性体温调节的温度明显高于男性。典型的临床核心降温速率不会改变体温调节反应。

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