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中华心脏与心律电子杂志 ›› 2026, Vol. 14 ›› Issue (02) : 112 -120. doi: 10.3877/cma.j.issn.2095-6568.2026.02.008

综述

热射病相关心血管功能损害的病理生理学研究进展
刘乐乐, 向杰, 张玲†()   
  1. 830013 乌鲁木齐,新疆医科大学第一附属医院临床医学研究院 新疆心电生理与心脏重塑重点实验室
  • 收稿日期:2026-06-01 出版日期:2026-06-25
  • 通信作者: 张玲
  • 基金资助:
    国家自然科学基金地区科学基金(82560065)

Research progress on the pathophysiology of cardiovascular dysfunction related to heat stroke

Lele Liu, Jie Xiang, Ling Zhang†()   

  1. Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830013, China
  • Received:2026-06-01 Published:2026-06-25
  • Corresponding author: Ling Zhang
引用本文:

刘乐乐, 向杰, 张玲. 热射病相关心血管功能损害的病理生理学研究进展[J/OL]. 中华心脏与心律电子杂志, 2026, 14(02): 112-120.

Lele Liu, Jie Xiang, Ling Zhang. Research progress on the pathophysiology of cardiovascular dysfunction related to heat stroke[J/OL]. Chinese Journal of Heart and Heart Rhythm(Electronic Edition), 2026, 14(02): 112-120.

热射病是热相关疾病中最严重的一种,定义为核心体温超过40 ℃伴中枢神经系统功能损害和多器官功能障碍综合征。热射病是高温环境暴露或剧烈运动使自身产热过多导致产热与散热失衡而造成机体多系统损伤的高致命性疾病。随着全球气温的持续升高,热射病的患病率预计将持续上升,因热射病死亡的人数显著增加。心血管系统在体温调节中发挥重要作用。热射病心肌组织损伤的主要病理特征包括全身炎症反应、内皮细胞损伤、铁死亡、心肌代谢紊乱和热休克蛋白调节异常等,本文综述了热射病对心血管系统影响的病理生理学特征,以期为今后热射病造成心脏损害机制的探究提供思路。

Heat stroke represents the most severe manifestation of heat-related illnesses, characterized by a core body temperature exceeding 40 ℃, accompanied by central nervous system dysfunction and multiple organ dysfunction syndrome. This condition is highly fatal, and results from exposure to high-temperature environments or strenuous physical activity, which leads to excessive heat production and an imbalance between heat generation and dissipation, culminating in multi-system damage. As global temperatures continue to rise, the incidence of heat stroke is anticipated to increase, with a concomitant rise in mortality rates. The cardiovascular system plays a pivotal role in thermoregulation, and the primary pathological features of myocardial tissue injury in heat stroke include systemic inflammatory responses, endothelial cell damage, ferroptosis, myocardial metabolic disorders, and dysregulation of heat shock proteins. This article provides a comprehensive review of the pathophysiological effects of heat stroke on the cardiovascular system, with the aim of informing future research on the mechanisms underlying cardiac damage induced by heat stroke.

图1 热射病相关心血管损害可能的机制图Ca2+为钙离子,IP3R为三磷酸肌醇受体,Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ为线粒体呼吸复合体Ⅰ~Ⅴ,RIPK1为受体相互作用蛋白激酶1,RIPK3为受体相互作用蛋白激酶3,MLKL为混合型激酶结构域样蛋白类似物,HMGB1为高迁移率族蛋白B1,P38-MK2为p38丝裂原活化蛋白激酶-蛋白激酶2,P38-mTOR为p38/哺乳动物西罗莫司(雷帕霉素)靶标,GSH为谷胱甘肽,GPX4为谷胱甘肽过氧化物酶4,GSSH为氧化型谷胱甘肽,MDA为丙二醛,ROS为活性氧,PI3K为磷脂酰肌醇3-激酶,Akt为蛋白激酶B
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