Keatinge W R, Donaldson G C
Department of Physiology, Queen Mary and Westfield College, London, England.
Arctic Med Res. 1995;54 Suppl 2:16-8.
Ischaemic heart disease is the biggest single cause of excess mortality in winter, accounting for approximately half of all the excess deaths. Most of these deaths take place hours or a day or two after exposure to cold suggesting that some result from thrombosis starting during or shortly after cold exposure, although some can result from immediate reflex effects of cold, and some can occur in association with respiratory deaths which are delayed many days after cold weather. Changes in blood composition observed in the cold that may explain the rapid thrombotic deaths include increased red cell count, plasma cholesterol, and plasma fibrinogen, which are all thrombogenic. The protective protein C does not increase significantly. British data suggests that cold housing particularly affects respiratory mortality in winter, and outdoor cold exposures mortality from arterial thrombosis. A Europe-wide survey is now being run as part of the EC- funded project "Eurowinter" to assess such factors.
缺血性心脏病是冬季超额死亡率的最大单一原因，约占所有超额死亡人数的一半。这些死亡大多发生在暴露于寒冷环境后的数小时或一两天内，这表明一些死亡是由于在寒冷暴露期间或之后不久开始的血栓形成所致，尽管有些可能是寒冷的即时反射效应导致的，还有一些可能与寒冷天气数天后延迟发生的呼吸道死亡有关。在寒冷环境中观察到的血液成分变化可能解释了快速血栓形成导致的死亡，这些变化包括红细胞计数增加、血浆胆固醇和血浆纤维蛋白原增加，这些都具有血栓形成倾向。保护性蛋白C没有显著增加。英国的数据表明，寒冷的住房条件尤其会影响冬季的呼吸道死亡率以及户外寒冷暴露导致的动脉血栓形成死亡率。作为欧盟资助项目“欧洲冬季”的一部分，目前正在进行一项全欧洲范围的调查，以评估此类因素。
