中暑伴随的凝血功能紊乱  

Coagulation Disorders Associated With Heat Illness

作　　者：高铁婴[1] 杨文超[1] 宋青[1] GAO Tieying;YANG Wenchao;SONG Qing(Department of Critical Care Medicine,Chinese People’s Liberation Army General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院重症医学科,北京100853

出　　处：《中国卫生标准管理》2018年第20期52-54,共3页China Health Standard Management

摘　　要：中暑是指人体在高温环境下出现的以中枢神经系统和心血管功能障碍为主要表现的热损伤疾病,热射病是其中最严重的阶段。中暑患者普遍存在凝血功能障碍,凝血功能障碍最终可能引起弥散性血管内凝血,导致多器官功能衰竭甚至死亡。可能的原因是高热激活内源性及外源性凝血系统,引起循环中凝血因子水平下降及血小板计数的改变,同时抗凝血系统受抑制,纤溶系统功能紊乱,凝血-抗凝血平衡被破坏。中暑合并凝血功能异常的发病机制目前尚不清楚,炎症因子、内皮损伤、肝功能损害及热休克蛋白等因素都参与其中。针对凝血功能紊乱的发生和发展进行干预,可能是中暑的有效治疗措施。Heat illness is a kind of thermal injury which is mainly manifested by the central nervous system and cardiovascular dysfunction.Heat stroke is the most serious condition.Heat illness always accompanied by coagulation dysfunction,may eventually cause DIC(disseminated intravascular circulation),multiple organ failture and even death.Coagulation dysfunction may be caused by hyperthermia and characterized by decreased blood coagulation factor levels and changes in platelet counts,inhibition of anticoagulant systems,and dysfunction of fibrinolytic system.The balance of coagulation-anticoagulant was destroyed.The pathogenesis of heat stroke combined with coagulation dysfunction is not clear at present.Inflammatory factors,endothelial injury,liver function damage and heat shock protein are all involved.Treatment for the coagulation disorders may be effective for heat illness.

关 键 词：中暑 热射病 弥散性血管内凝血 多器官功能障碍 蛋白C 热休克蛋白 

分 类 号：R651[医药卫生—外科学]