Effects of MDMA on body temperature in humans.
Effects of MDMA on body temperature in humans.
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DOI：
10.4161/23328940.2014.955433
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发表时间：
2014-10
期刊：
影响因子：
--
通讯作者：
Liechti ME
中科院分区：
文献类型：
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作者：
Liechti ME
热疗是与娱乐性使用3,4-亚甲基二氧基甲基苯丙胺（MDMA，摇头丸）相关的严重并发症。本文就MDMA对体温影响的临床实验室研究进行综述。该机制的基础上的热效应的MDMA在人类和治疗严重的高温提出。数据显示，在健康受试者中，MDMA会引起核心体温的急性剂量依赖性升高。在受控的实验室环境中，体温升高在0.2-0.8°C范围内，不会导致高热（bbb40°C）。然而，在较高剂量下，即使在没有身体活动和室温下，也经常出现中度体温过高（38.0°C）。MDMA主要释放血清素和去甲肾上腺素。机制临床研究表明，mdma诱导的人体体温升高部分依赖于mdma诱导的去甲肾上腺素的释放，涉及代谢产热增强和皮肤血管收缩，导致散热受损。血清素的介导作用尚不清楚。拟交感神经毒性和相关热疗的处理主要包括苯二氮卓类药物镇静和静脉补液。严重的高热应主要通过额外的冷却和机械通气来治疗。
Hyperthermia is a severe complication associated with the recreational use of 3,4-methylenedioxymethamphetamine (MDMA, Ecstasy). In this review, the clinical laboratory studies that tested the effects of MDMA on body temperature are summarized. The mechanisms that underlie the hyperthermic effects of MDMA in humans and treatment of severe hyperthermia are presented. The data show that MDMA produces an acute and dose-dependent rise in core body temperature in healthy subjects. The increase in body temperature is in the range of 0.2-0.8°C and does not result in hyperpyrexia (>40°C) in a controlled laboratory setting. However, moderately hyperthermic body temperatures >38.0°C occur frequently at higher doses, even in the absence of physical activity and at room temperature. MDMA primarily releases serotonin and norepinephrine. Mechanistic clinical studies indicate that the MDMA-induced elevations in body temperature in humans partially depend on the MDMA-induced release of norepinephrine and involve enhanced metabolic heat generation and cutaneous vasoconstriction, resulting in impaired heat dissipation. The mediating role of serotonin is unclear. The management of sympathomimetic toxicity and associated hyperthermia mainly includes sedation with benzodiazepines and intravenous fluid replacement. Severe hyperthermia should primarily be treated with additional cooling and mechanical ventilation.