Body temperature regulation and circulatory response of persons with spinal cord injury during exercise in a hot environment.

摘要本研究旨在探讨高温环境下脊髓损伤性截瘫患者手臂屈曲运动时的体温调节特征。损伤位于T3 - L5之间的成年男性SCI和成年男性健全受试者（AB）参加了本研究。受试者在高温（33℃）或中等温度（25℃）环境中暴露1小时。在暴露的最后5或30分钟，受试者在40瓦的运动强度下进行5分钟的手臂弯曲运动或在20瓦的运动强度下进行30分钟。在实验过程中，连续监测体表6个部位的皮肤温度、鼓膜温度、大腿皮肤血流量（SBFT）和心率。高病变截瘫患者（T3-T10）在休息和运动时的鼓膜温度和心率均高于低病变截瘫患者（T11-L5）。高病变截瘫患者的SBFT在33℃的实验过程中保持不变，而低病变截瘫患者的SBFT在运动过程中连续增加，与ab相似。高病变截瘫患者的下肢交感血管舒动功能受损，皮肤血流量在高温下保持不变。高病变截瘫患者的核心温度升高被认为是由于瘫痪区域缺乏血管舒缩活动和汗液反应。根据本研究结果，我们可以认为，高核心温度而不增加SBFT可能是高病变截瘫患者在高温环境下运动时的身体热平衡。

The purpose of this investigation was to clarify the characteristics of body temperature regulation in paraplegics due to spinal cord injury (SCI) during arm cranking exercise in a hot environment. Adult male SCI with lesions located between T3 and L5 and adult male able-bodied subjects (AB) participated in this study. The subjects were exposed to a hot (33℃) or a moderate temperature (25℃) environment for one hour. During the last 5 or 30 min of the exposure, the subject performed arm cranking exercises for 5 min at an exercise intensity of 40 W or for 30 min at 20 W.The skin temperature at six sites of the body, the tympanic membrane temperature, the skin blood flow of the thigh (SBFT), and heart rate were continuously monitored during the experiment. Paraplegics with high lesion (T3-T10) showed the higher tympanic membrane temperature and heart rate than those with low lesions (T11-L5) at rest and during exercise. SBFT of paraplegics with high lesion remained unchanged during the experiment at 33℃, while paraplegics with low lesions showed consecutive increases in SBFT during exercise similar to AB.In paraplegics with high lesions, who have impaired sympathetic vasomotor function in the lower limbs, skin blood flow is unchanged by exposure to a high temperature. The increased core temperature in paraplegics with high lesions was considered to be due to lack of a vasomotor activity and a sweat response in the paralyzed area. On the basis of the findings in this study, it can be suggested that high core temperature without any increment of SBFT may be characterized as body heat balance of paraplegics with high lesions during exercise in a hot environment.