Correlation of neurological level and sweating level of injury in persons with spinal cord injury.
Correlation of neurological level and sweating level of injury in persons with spinal cord injury.
复制标题
脊髓损伤患者神经功能水平与损伤出汗水平的相关性。
DOI：
10.1080/10790268.2020.1751489
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
KelloggJr,Dean
中科院分区：
文献类型：
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作者：
Trbovich,Michelle;Ford,Ashley;Wu,Yubo;Koek,Wouter;Wecht,Jill;KelloggJr,Dean
目的：在高温环境下，脊髓损伤（SCI）后的体温调节功能障碍会降低患者的生活质量，并使患者易发生危及生命的热相关疾病（HRI）后遗症。脊髓损伤临床医生目前没有客观的方法来预测哪些人有最大的HRI风险。通过出汗蒸发冷却是人体最有效的散热机制。神经损伤程度（NLOI）与sudymotor功能障碍程度之间的关系尚不明确。本研究探讨了NLOI与损伤出汗水平（SwLOI）之间的关系。这一信息可以帮助脊髓损伤临床医生识别脊髓损伤患者，这些患者的压迫肌功能受损最严重，因此hri的风险最高。单位：人体生理学实验室。参与者：四肢瘫痪者（TP） 10人，截瘫者（PP） 14人，健全者（AB） 10人。干预：被动热应激（核心温度升高1°C），用淀粉碘试验量化出汗反应（SR）。结果测量：观察到出汗的最尾端皮皮水平被记录为SwLOI，并与NLOI进行比较。计算NLOI和SwLOI之间的最小、最大和中位数差异。结果：四肢瘫痪患者无SR表现，截瘫患者SR表现中位数低于NLOI 1级。健全人对照组的所有皮肤表面都出汗。结论：运动性完全四肢瘫痪患者在被动热应激时通过SR缺乏蒸发冷却能力，使他们容易发生HRI。与此同时，截瘫患者的汗液平均比NLOI低1个皮皮水平。
Objective:Thermoregulatory dysfunction after spinal cord injury (SCI) impairs quality of life and predisposes persons to life-threatening sequela of heat-related illness (HRI) in conditions of high ambient temperature. SCI clinicians currently have no objective way to predict which persons are at greatest risk of HRI. Evaporative cooling via sweating is the body’s most efficient mechanism of heat dissipation. The relationship between the neurological level of injury (NLOI) and the degree of sudomotor dysfunction is not well defined. This study examines the relationship between the NLOI and sweating level of injury (SwLOI). This information can assist SCI clinicians in identifying individuals with SCI who have most impaired sudomotor function and thus highest risk of HRI.Design:Observational.Setting:Human physiology laboratory.Participants:10 persons with tetraplegia (TP), 14 with paraplegia (PP) and 10 able-bodied (AB).Intervention:Passive heat stress (1°C rise in core temperature) with sweat responses (SR) quantified with the starch iodine test.Outcome measures:The most caudal dermatomal level in which sweating was visualized was recorded as the SwLOI, which was compared to the NLOI. Minimum, maximum and median differences between NLOI and SwLOI were calculated.Results:Persons with tetraplegia demonstrated no SR. Persons with paraplegia demonstrated SR at a median of 1 level below NLOI. Able-bodied controls demonstrated sweating on all skin surface areas.Conclusions:Persons with motor complete tetraplegia lack evaporative cooling capacity through SR during passive heat stress predisposing them to HRI. Meanwhile, persons with paraplegia sweat on average 1 dermatomal level below their NLOI.