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寒冷对心血管疾病的影响:现状与机制
王温,孙嘉岑,谭兴,王杨凯,王伟忠*
0
(海军军医大学(第二军医大学)海军特色医学中心海洋生物医药与极地医学研究室, 上海 200433
*通信作者)
摘要:
心血管疾病给我国医疗卫生系统带来巨大负担,而寒冷是心血管疾病的重要危险因素。寒冷能导致机体自主神经系统、内分泌系统等发生复杂改变,从而影响心脏和血管的功能与结构,最终导致心血管疾病风险增加。交感神经兴奋介导的神经-体液通路是冷暴露下机体参与的重要生理过程,免疫失衡、氧化损伤和代谢异常等特异性机制也参与了心血管疾病的发生与发展。采取合适的防治措施有利于降低寒冷导致的心血管疾病风险,保暖防寒、适当的冷适应、合理的膳食疗法及中医药治疗有利于降低心血管疾病的发生率。冷损伤发生后,合理的院内外救治是挽救患者的关键。明确寒冷诱发心血管疾病的流行病学现状与病理生理机制并提出防治策略,对于缓解我国的医疗卫生压力、保护寒区人群健康及推进极地开发战略具有重大意义。
关键词:  寒冷  心血管疾病  流行病学  病理生理学
DOI:10.16781/j.CN31-2187/R.20230140
投稿时间:2023-03-27修订日期:2023-05-30
基金项目:海军重点学科专业建设项目(21JX017),军队后勤科研项目(22AH0801).
Effects of cold exposure on cardiovascular diseases: status and mechanism
WANG Wen,SUN Jia-cen,TAN Xing,WANG Yang-kai,WANG Wei-zhong*
(Laboratory of Marine Biomedicine and Polar Medicine, Naval Medical Center, Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Cardiovascular diseases bring a huge burden to health care, and cold is an important risk factor for cardiovascular diseases. Cold can lead to complex changes in autonomic nervous system, endocrine system and so on, thus affecting the function and structure of the heart and blood vessels, ultimately leading to an increased risk of cardiovascular diseases. Sympathetic excitation-mediated neurohumoral pathways are important physiological processes involved in cold exposure, while other specific mechanisms including immune imbalance, oxidative damage, and metabolic abnormalities are also involved in the development and progression of cardiovascular diseases. Appropriate preventive and control measures can reduce the risk of cold-induced cardiovascular diseases. Keeping warm, appropriate cold adaptation, rational dietary therapy, and Chinese herbal medicine treatment can reduce the incidence of cardiovascular diseases. After cold injury, reasonable treatment inside and outside the hospital is the key to save lives. In conclusion, clarifying the epidemiological status and pathophysiological mechanisms between cold and cardiovascular diseases and proposing prevention and treatment strategies are of great significance to alleviate the health care pressure in China, protect people’s health in cold regions, and promote polar development strategies.
Key words:  cold  cardiovascular diseases  epidemiology  pathophysiology