热习服对热射病康复后军人的热耐力及凝血功能的影响  

The effect of heat acclimation on heat tolerance and coagulation function of soldiers after rehabilitation from heatstroke

作　　者：何龙平 钟林翠 余永春 窦建林 林青伟 罗竹青 宋景春[1] He Longping;Zhong Lincui;Yu Yongchun;Dou Jianlin;Lin Qingwei;Luo Zhuqing;Song Jingchun(Department of Intensive Care Medicine,No.908 Hospital of the Joint Logistic Support Force of the PLA/Nanchang Key Laboratory of Thrombosis and Hemostasis,Nanchang 330002,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院重症医学科/南昌市血栓与止血学重点实验室,南昌330002

出　　处：《血栓与止血学》2023年第3期111-116,共6页Chinese Journal of Thrombosis and Hemostasis

基　　金：中国医药教育协会2022重大科学攻关课题(2022KTZ013);江西省卫健委科技计划(202311381)。

摘　　要：目的探讨热习服对热射病康复后军人的热耐力重建的效果及凝血功能的影响。方法选取2022年6月至2022年9月我科收治的10名热射病军人患者,康复后在人工热室内进行为期5 d的热习服训练,并与10名健康军人对照,比较两组热习服训练第1 d和第5 d的运动时间、运动距离、耳鼓膜温度上升速度、脉率上升速度、生理应激指数(PSI)、常规凝血项目、血栓弹力图(TEG)指标、血栓调节蛋白(TM)、凝血酶⁃抗凝血酶复合物(TAT)、纤溶酶⁃α2纤溶酶抑制物复合物(PIC)和组织纤溶酶原激活物/纤溶酶原激活物抑制剂⁃1复合物(t⁃PAIC)水平。结果两组军人热习服训练第5 d的运动时间、运动距离均较训练第1 d显著延长,耳鼓膜温度上升速度、脉率上升速度、PSI均较训练第1 d显著下降,差异均有统计学意义(P<0.05)。热射病军人训练第5 d的PSI高于健康军人训练第5 d的PSI,差异有统计学意义(P<0.05),但与健康军人训练第1 d的PSI相比无统计学差异(P>0.05)。热射病军人热习服训练前后的血小板计数、PT、APTT、TT、FIG、FDP、D⁃D、抗凝血酶、TM、TAT、PIC、t⁃PAIC和TEG的R时间、K时间、α角、MA、CI指标,均无统计学差异(P>0.05)。结论热室内主动热习服训练对军人热射病后热耐力重建效果显著,且在该运动条件下不会导致凝血异常。Objective To explore the clinical evaluation of the effect of heat acclimation on the heat tolerance reconstruction and coagulation function of soldiers with heatstroke.Methods Ten soldiers with heatstroke who were admitted to our department from June 2022 to September 2022 were selected to undergo heat acclimation training in the hot room for five days after recovery,and 10 healthy soldiers were compared.All the items of the two groups on the first and fifth days of heat acclimation training were compared,including exercise time,exercise distance,core temperature rising speed,heart rate rising speed,physiological stress index(PSI),routine coagulation items,thromboelastogram(TEG)index,thrombomodulin(TM),thrombin⁃antithrombin complex(TAT),fibrinolytic enzyme⁃α2 plasmin inhibitor complex⁃α2 anti⁃plasmin inhibitor complex(PIC)and tissue plasminogen activator/plasminogen activator inhibitor⁃1 complex(t⁃PAIC)levels.Results The exercise time and distance of the soldiers in the two groups on the fifth day of heat acclimation training were significantly longer than that on the first day of training,and the core temperature rising speed,heart rate rising speed and PSI were significantly lower than that on the first day of training,with significant differences(P<0.05).The PSI of the soldiers with heatstroke on the fifth day of training was higher than that of the healthy soldiers on the fifth day of training,the difference was statistically significant(P<0.05),but there was no statistical difference with the PSI of the healthy soldiers on the first day of training(P>0.05).All coagulation items including platelet count,PT,APTT,TT,FIG,FDP,D⁃dimer,antithrombin,TM,TAT,PIC,t⁃PAIC,TEG⁃R time,K time,αand MA.Conclusion Heat acclimation training in the hot room has a significant effect on the heat tolerance reconstruction of soldiers after heatstroke,and does not affect the coagulation function index under this exercise condition.

关 键 词：热习服 热耐力 热射病 重建 血栓弹力图 凝血功能 

分 类 号：R594.1[医药卫生—内科学]