热射病的发病机制及防治策略的研究新进展

29(4)2872920fBiome_ti'calEngineeringResearchJJulTlal*112(125130312250012)(heatstrokeHS)(s)lO50HJHSHSSIRSHSHSt316A16726278(2010)0287AdvanceinPathogenesisandStrategiesofProtectiveandTherapeuticinHeatStrokeRONGPen91MENGJianzhon91CHENYf(1JinanAreaGeneralHospitalofPtAnan25(031China2JnanWomenChildrenHeahhcareHospitalnan250012)AbstractHeatswoke(I-IS)isalifethreateningheatillnessRecentclinicalandexperimentalevidencesuggeststhatacomplexiraerplaybetweenheatcytotoxicitycoagulationandthesystemicinflan-anatoryresponse11c(SIRS)thatcatise8followingIgetothegutandotherorgansistheprimarydeterminantofmorbidityandmortalityofHSPpidcoolingandsupportofmultiorganflli_IctionthemosteffectiveclinicaltreatmentsbutmanypatientsexperiencepertnanentcalimpairmentsordeathdespitetheseeffortsThemortalityrateisto1050ThereforeanalysisofHS11ewhe{toreducethemoaalityrateareveryneceInthispaperthe0athogenesisandpreventionstrategiesa1ereviewedThecomprehensiveanalysisof0athogenesisofHSIlgfactorsofSIRScallssedbyHsinterventionmomentofHStherapeusisarenecessaryforexploringnoveltherapeuticteKeywordsHeatstrokePathogenesisSystemicinflammatoryresponsesyndromeStrategiesofprotectiveandtherapeutic1(heatstrokeHS)(SIRS)(4047oC)1(MOIYS)(classicnonexertionalheatstrokecHs)(exertionalheat*(CJNl0L075)Email_mjz90@yahooccastrokeEHs)CHSEHSm(SIRS)b288291050[4]EHSEHSSIRSEHSEHS237bJ(l)6J17mllkeal600kealh()[2J15205minl17J40416C4245rain8h49505minJo2|39IL1(a[TNFa]7)(6TNFp55p7510)1011J6TNFl2|IL6IL61IL6314J()TNFa1IIJ1R]4IcPm4289a2D3]llLflILNO1434415|()2003[16|DIC52002(SIRS)M0seleyTNIIJlTNFaIL1IL6IL8PAFNOrIN1TNFaIL1u8J(DIC)(MOF)LPS(24h)3J438C672()729913021J24h]]2448h89J]510min101040min39Weinerandghoul642911826300min381LCDIC]CDIClBkBJ()CPKm24hEQ1138C35DIC2J19892009731EHSMODS(TNFaIL1IL6)b1|Pl5qtMODS3213d(HSPTl)HSPTlJMODS[1]GrosHH0pkimi'MHeatstnleimplicationsforcriticalereandanesthesia[J]BrJAnsesth2002(5)700[2]AbdenlnBoudmmaMDHeatStroke[J]ErlgIJMed2002346(25)19781988[3]LeLRHelwigBGHeatstrokeroleofthesystemiciamtofyresponseArticlesin[J]JApplrysioi2010[4][J]199911(5)28[5]Knoehel,IPReedGDisordersofheatregulali011InNarimRGedMaxwell&KleenimisclinicaldisordersoffluidandelectrolytemetabolismMJ5thedNewYorkMcGrawHill1994154990[6][J]200626(1)867]Armm-ongLEFACSM(Chair)ExertionalhemillnessduringtrainiIlgandcontrition[J]OfficialJaJmaloftheAmffficanCollege0fspsMedicine200739(3)556572[8]OainLmgLiraMaekirmonLTTherolesofexerciseiIlIcedimsystemdisturbance8inthepmhologyofheatstwke[J]Med200636()39[9]GnCKushnerIAcutepllaseproteinsandersystemicrestoinflarmlation[J]NEngIJMed199934044854ErratumNEngiJMed19993401376[10]HammamiMMBouchamaAA1SedairySConcentrations0fsolubletumornecrosisfactorandinterleukin6reeept,ninheatstrokeantihetBtr[J]GritCareMed19972513149[11]BoueharaaAHanmlamiMMAIShuilEela1Differentialeffeelsofinvitroandinvivohypen}laOnthepnxinetionofinterleukinlO[J]29229IntensiveCmMed)26164651[12]tLRHeatstrokeandeyloldnes[J]ProgrinBrain2016248l524[13]PedersenBKHoffnmGoetzLE@fciandtheimnimesystemregulationintegrati8ridadaol'l[J]PhysiolRev200080105581[14]MoldoveanuAIShephardIUSlaekPExeleelevatesplasmalevelshutnotgeneexpression0flbetaIL-6andTNFalpIlainbloodlilorlo-nucleareells[J]JAoplPhysiol2000891499504[15]AsalalraHsugaYYodlidaTeta1Pathophysiology0fdisseminatedintravascularcoaJlafion(DIC)progressesmadifferentrateintisstlefactorinducedandldacdldeinducedDIcmodelsinrats[J]BlolFibrinolysis200314221228[16]ItuisseMGPeaseSnllrtlidoNedelecMete11_eukoeyteactivationthelinkbetweeninflammationandcoagulationduringheatstrokeAstudy0fpmientsauringthe2003heatwaveinPs[JJCritCarebled2008362288[17]HuisseMGPeaseSHurudoNedeleeMeta11_Jkocyteactivationthelinkbetweellinflammationandc0gIlidlIgIletrDIeAstuay0fpatientsduringthe2003heatwaveinem-is[J]Ca'itCarel~_led200636222295[18]su,mlerwRSeveresemisneweo,leeptsinpathqenesisal'dmnagemenlJJAmJNedSei2004328193195[19]ryboLExel'eiseandhealstresseerdchallengesandcomequenJJPBrainRes20071622943[20]LFenyTLeQHeta1Shortandlotagtermoutcomes0fheatstrokefollowingtIleBheatwavein1yo[j]FranceArchInternNed2016721772183[21]DemlltteJE0MaraKBueseherJNearfatalheatstileduringthe1995heatwaveinChicaso[J]AnnIIIItl_led12917318l1996[22]PeaseSBouMmaLKermarrecNela1Earlyorglmdysfunctionmcoolingtimeandoutctlrminclassicheatstroke[J]IntensiveCaretded093514541458[23]IleyWItYangHandShahKH1thabdonlyolysis[J]InternEIIHglVled20072210218[24]PatelDRCyzflRandTortesAExertionaldaabdomyolysisandacutekiaeyijury[J]PhysSvo,tea200937,,7179[25][J]200815(9)[26]mH)aldRWGIImRsLSquireDLHeatrelatedillnessesInAuerbachPSeditorWildernessmedicinemmHnllofwilderneandenvigeflci[M]3rdeditionStB(MO)1995167212[27]sldeili1tMDHIstrUkeseninNeurology200525(3)307314[28]~UKnvironmentaleonditiomPammedietextbook[IVI]2ridedStLouis(M0)MOBby200110821085[29]aIiIIMing01enChingChengHouActivatedproteinCtheraprinatatheatstrokemodel[J]CritCarelled2006(7)[30][J]200829(6)58[31][J]20109(6)330332[32]71[J]200119178180(H20101021)IBM(MRI)MRI13DMRIBM?