冷暴露诱导机体病理生理变化及相关疾病的研究进展

doi:10.12092/j.issn.1009-2501.2026.07.015

摘要/Abstract

摘要：

寒冷环境中，机体通过激活下丘脑体温调节中枢启动神经-内分泌-代谢级联反应，以维持核心体温稳态，诱导适应性代偿与病理性损伤。冷暴露触发的主要病理生理进程包括：产热代谢重构、血管功能障碍、免疫稳态失衡、肾素-血管紧张素-醛固酮系统（renin-angiotensin-aldosterone system，RAAS）过度活化及机体多系统损伤与功能障碍。上述改变与冻伤、心脑血管疾病（高血压、房颤、心肌梗死、心力衰竭、脑卒中）及呼吸系统疾病（支气管哮喘、慢性阻塞性肺疾病）等疾病的发生发展密切相关。本文系统综述冷暴露诱导的生理代偿机制及其介导相关疾病的研究进展，为寒冷相关疾病的靶向防治提供理论依据。

关键词: 冷暴露, 能量代谢重编程, 血管功能障碍, 免疫稳态失衡, 肾素-血管紧张素-醛固酮系统, 病理生理机制

Abstract:

Under cold conditions, organism activate the hypothalamic thermoregulatory center, initiating a neuroendocrine-metabolic cascade to maintain core body temperature homeostasis. This process simultaneously induces both adaptive and pathophysiological alterations. Cold exposure triggers key pathophysiological including enhanced thermogenesis, energy metabolism reprogramming, vasomotor dysfunction, immune regulation imbalance, overactivation of renin-angiotensin-aldosterone system (RAAS), and multi-system damage and dysfunction. These alterations are closely associated with the development and progression of frostbite, cardiovascular and cerebrovascular diseases (such as hypertension, atrial fibrillation, myocardial infarction, heart failure, and stroke), and respiratory diseases (including asthma and chronic obstructive pulmonary disease). This article systematically reviews the physiological compensatory mechanisms induced by cold exposure and recent research advances concerning their mediation of common cold-related diseases, thereby providing a theoretical basis for the precision prevention and treatment of cold-associated disorders.

Key words: cold exposure, energy metabolism reprogramming, vascular dysfunction, immune dysregulation, renin-angiotensin-aldosterone system, pathophysiological mechanisms

中图分类号:

R645
R339.6

左顺舫, 徐华丽, 李琳玉, 李天朗, 付雯雯, 薛岩. 冷暴露诱导机体病理生理变化及相关疾病的研究进展[J]. 中国临床药理学与治疗学, 2026, 31(7): 990-1000.

Shunfang ZUO, Huali XU, Linyu LI, Tianlang LI, Wenwen FU, Yan XUE. Cold exposure-induced pathophysiological changes and related diseases: recent advances[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(7): 990-1000.

图/表 1

图 1

Fig.1 Summary of pathophysiological changes linking cold exposure to related diseases Cold exposure triggers two primary thermogenic responses: shivering thermogenesis (ST) and non-shivering thermogenesis (NST). The activation of adipose tissue facilitates these processes, but an inadequate energy supply can precipitate systemic hypothermia. Concurrently, cold stress activates the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone system (RAAS). The interplay of these systems promotes the development of hypertension and cardiac overload. Furthermore, cold-induced vascular dysfunction contributes to tissue hypoxia, ischemia, and an increased susceptibility to infection. Collectively, these pathways drive the progression of cardiovascular and cerebrovascular diseases, including myocardial infarction and stroke. Simultaneously, immune dysregulation— characterized by inflammation, oxidative stress, and immunosuppression— exacerbates tissue damage and promotes the onset of respiratory diseases and multi-organ injury.

参考文献 95

1	Alahmad B, Khraishah H, Royé D, et al. Associations between extreme temperatures and cardiovascular cause-specific mortality: results from 27 countries[J]. Circulation, 2023, 147 (1): 35- 46. doi: 10.1161/CIRCULATIONAHA.122.061832
2	Kysely J, Pokorna L, Kyncl J, et al. Excess cardiovascular mortality associated with cold spells in the Czech Republic[J]. BMC Public Health, 2009, 9, 19. doi: 10.1186/1471-2458-9-19
3	Burkart KG, Brauer M, Aravkin AY, et al. Estimating the cause-specific relative risks of non-optimal temperature on daily mortality: a two-part modelling approach applied to the Global Burden of Disease Study[J]. Lancet, 2021, 398 (10301): 685- 697. doi: 10.1016/S0140-6736(21)01700-1
4	戴晶, 金红旭. 冷损伤的预防与诊治—《2020年中国寒冷损伤预防与诊疗专家共识》解读[J]. 中华急诊医学杂志, 2021, 30 (8): 924- 928.
5	Taga H, Chilliard Y, Meunier B, et al. Cellular and molecular large-scale features of fetal adipose tissue: is bovine perirenal adipose tissue brown ?[J]. J Cell Physiol, 2012, 227 (4): 1688- 1700. doi: 10.1002/jcp.22893
6	Cannon B, Nedergaard J. Brown adipose tissue: function and physiological significance[J]. Physiol Rev, 2004, 84 (1): 277- 359. doi: 10.1152/physrev.00015.2003
7	Dubois-Ferrière R, Chinet AE. Contribution of skeletal muscle to the regulatory non-shivering thermogenesis in small mammals[J]. Pflugers Arch, 1981, 390 (3): 224- 229. doi: 10.1007/BF00658266
8	Kim J, Wang Z, Heymsfield SB, et al. Total-body skeletal muscle mass: estimation by a new dual-energy X-ray absorptiometry method[J]. Am J Clin Nutr, 2002, 76 (2): 378- 383. doi: 10.1093/ajcn/76.2.378
9	Blondin DP, Haman F. Shivering and nonshivering thermogenesis in skeletal muscles[J]. Handb Clin Neurol, 2018, 156, 153- 173. doi: 10.1016/b978-0-444-63912-7.00010-2
10	Blondin DP, Maneshi A, Imbeault MA, et al. Effects of the menstrual cycle on muscle recruitment and oxidative fuel selection during cold exposure [J]. J Appl Physiol (1985), 2011, 111(4): 1014-1020.
11	Li H, Wang C, Li L, et al. Skeletal muscle non-shivering thermogenesis as an attractive strategy to combat obesity[J]. Life Sci, 2021, 269, 119024. doi: 10.1016/j.lfs.2021.119024
12	Bal NC, Sahoo SK, Maurya SK, et al. The role of sarcolipin in muscle non-shivering thermogenesis[J]. Front Physiol, 2018, 9, 1217. doi: 10.3389/fphys.2018.01217
13	李晴晴, 杨芝春. 脂肪组织生物学研究进展[J]. 中南医学科学杂志, 2016, 44 (5): 579- 585.
14	姚旋, 张颖, 单仕芳, 等. 褐色脂肪组织研究的最新进展和科学意义[J]. 中国细胞生物学学报, 2011, 33 (3): 227- 236.
15	Enerbäck S. The origins of brown adipose tissue[J]. N Engl J Med, 2009, 360 (19): 2021- 2023. doi: 10.1056/NEJMcibr0809610
16	Blondin DP, Frisch F, Phoenix S, et al. Inhibition of intracellular triglyceride lipolysis suppresses cold-induced brown adipose tissue metabolism and increases shivering in humans[J]. Cell Metab, 2017, 25 (2): 438- 447. doi: 10.1016/j.cmet.2016.12.005
17	Wu J, Hu Z, Han Z, et al. Human physiological responses of exposure to extremely cold environments[J]. J Therm Biol, 2021, 98, 102933. doi: 10.1016/j.jtherbio.2021.102933
18	Feng F, Ma Y, Zhang Y, et al. Effects of extreme temperature on respiratory diseases in Lanzhou, a temperate climate city of China[J]. Environ Sci Pollut Res Int, 2021, 28 (35): 49278- 49288. doi: 10.1007/s11356-021-14169-x
19	Bandopadhyay P, Selvamurthy W. Respiratory changes due to extreme cold in the Arctic environment[J]. Int J Biometeorol, 1993, 37 (1): 32- 35. doi: 10.1007/BF01212764
20	Schweitzer W, Thali M, Giugni G, et al. Postmortem pulmonary CT in hypothermia[J]. Forensic Sci Med Pathol, 2014, 10 (4): 557- 569. doi: 10.1007/s12024-014-9611-2
21	Giesbrecht GG. The respiratory system in a cold environment[J]. Aviat Space Environ Med, 1995, 66 (9): 890- 902.
22	Brown CM, Sanya EO, Hilz MJ. Effect of cold face stimulation on cerebral blood flow in humans[J]. Brain Res Bull, 2003, 61 (1): 81- 86. doi: 10.1016/S0361-9230(03)00065-0
23	Yang WZ, Xie H, Du X, et al. A parabrachial-hypothalamic parallel circuit governs cold defense in mice[J]. Nat Commun, 2023, 14 (1): 4924. doi: 10.1038/s41467-023-40504-6
24	Thompson-Torgerson CS, Holowatz LA, Kenney WL. Altered mechanisms of thermoregulatory vasoconstriction in aged human skin[J]. Exerc Sport Sci Rev, 2008, 36 (3): 122- 127. doi: 10.1097/JES.0b013e31817bfd47
25	Muza SR, Young AJ, Sawka MN, et al. Respiratory and cardiovascular responses to cold stress following repeated cold water immersion[J]. Undersea Biomed Res, 1988, 15 (3): 165- 178.
26	Stocks JM, Taylor NA, Tipton MJ, et al. Human physiological responses to cold exposure[J]. Aviat Space Environ Med, 2004, 75 (5): 444- 457. doi: 10.1016/j.autneu.2016.02.009
27	Zhang X, Zhang S, Wang C, et al. Effects of moderate strength cold air exposure on blood pressure and biochemical indicators among cardiovascular and cerebrovascular patients[J]. Int J Environ Res Public Health, 2014, 11 (3): 2472- 2487. doi: 10.3390/ijerph110302472
28	徐嘉欣, 那堃, 徐澜婷, 等. 高寒地区冷损伤男性人群血常规指标变化及其临床意义[J]. 临床军医杂志, 2025, 53 (8): 805- 810+766.
29	张艳双, 刘丹, 刘子齐, 等. 寒冷地区作业冻伤人群凝血功能变化分析[J]. 临床军医杂志, 2025, 53 (5): 476- 479.
30	Yang L, Wu J, Hu Z, et al. Effects of workload on human cognitive performance of exposure to extremely cold environment[J]. Physiol Behav, 2021, 230, 113296. doi: 10.1016/j.physbeh.2020.113296
31	Qu TT, Deng JX, Li RL, et al. Stress injuries and autophagy in mouse hippocampus after chronic cold exposure[J]. Neural Regen Res, 2017, 12 (3): 440- 446. doi: 10.4103/1673-5374.202932
32	Cui ZJ, Deng JX, Zhao KB, et al. Effects of chronic cold exposure on murine central nervous system[J]. J Neurosci Res, 2014, 92 (4): 496- 505. doi: 10.1002/jnr.23333
33	Hu W, Zhang X, Tung YC, et al. Hyperphosphorylation determines both the spread and the morphology of tau pathology[J]. Alzheimers Dement, 2016, 12 (10): 1066- 1077. doi: 10.1016/j.jalz.2016.01.014
34	Kwon HS, Koh SH. Neuroinflammation in neurodegenerative disorders: the roles of microglia and astrocytes[J]. Transl Neurodegener, 2020, 9 (1): 42. doi: 10.1186/s40035-020-00221-2
35	Sharma A, Muresanu DF, Lafuente JV, et al. Cold environment exacerbates brain pathology and oxidative stress following traumatic brain injuries: potential therapeutic effects of nanowired antioxidant compound H-290/51[J]. Mol Neurobiol, 2018, 55 (1): 276- 285. doi: 10.1007/s12035-017-0740-y
36	Eliseeva LS, Chramova GM, Gonsales EB, et al. Alpha1- and beta-adrenoblockers effects on immunogenesis in rats under thermoneutral conditions and after cooling of various extent[J]. Bull Exp Biol Med, 2009, 147 (2): 208- 212. doi: 10.1007/s10517-009-0476-4
37	Aarstad HJ, Gaudernack G, Seljelid R. Stress causes reduced natural killer activity in mice[J]. Scand J Immunol, 1983, 18 (5): 461- 464. doi: 10.1111/j.1365-3083.1983.tb00878.x
38	Ben-Nathan D, Lustig S, Kobiler D. Cold stress-induced neuroinvasiveness of attenuated arboviruses is not solely mediated by corticosterone[J]. Arch Virol, 1996, 141 (7): 1221- 1229. doi: 10.1007/BF01718826
39	Ben-Nathan D, Lustig S, Danenberg HD. Stress-induced neuroinvasiveness of a neurovirulent noninvasive Sindbis virus in cold or isolation subjected mice[J]. Life Sci, 1991, 48 (15): 1493- 1500. doi: 10.1016/0024-3205(91)90187-G
40	Crosswhite P, Sun Z. Ribonucleic acid interference knockdown of interleukin 6 attenuates cold-induced hypertension[J]. Hypertension, 2010, 55 (6): 1484- 1491. doi: 10.1161/HYPERTENSIONAHA.109.146902
41	Janský L, Pospísilová D, Honzová S, et al. Immune system of cold-exposed and cold-adapted humans[J]. Eur J Appl Physiol Occup Physiol, 1996, 72 (5/6): 445- 450. doi: 10.1007/bf00242274
42	Silva JE. Thermogenic mechanisms and their hormonal regulation[J]. Physiol Rev, 2006, 86 (2): 435- 464. doi: 10.1152/physrev.00009.2005
43	张艳梅. 蒙古羊对寒冷环境的生理适应性机制研究 [D]. 呼和浩特: 内蒙古大学, 2023.
44	Nikanorova AA, Barashkov NA, Nakhodkin SS, et al. The role of leptin levels in adaptation to cold climates[J]. Int J Environ Res Public Health, 2020, 17 (6): 1- 17.
45	Leppäluoto J, Westerlund T, Huttunen P, et al. Effects of long-term whole-body cold exposures on plasma concentrations of ACTH, beta-endorphin, cortisol, catecholamines and cytokines in healthy females[J]. Scand J Clin Lab Invest, 2008, 68 (2): 145- 153.
46	García-Díaz EC, Gómez-Quiroz LE, Arenas-Ríos E, et al. Oxidative status in testis and epididymal sperm parameters after acute and chronic stress by cold-water immersion in the adult rat[J]. Syst Biol Reprod Med, 2015, 61 (3): 150- 160. doi: 10.3109/19396368.2015.1008071
47	Wang D, Cheng X, Fang H, et al. Effect of cold stress on ovarian & uterine microcirculation in rats and the role of endothelin system[J]. Reprod Biol Endocrinol, 2020, 18 (1): 29. doi: 10.1186/s12958-020-00584-1
48	Bjertnæs LJ, Næsheim TO, Reierth E, et al. Physiological changes in subjects exposed to accidental hypothermia: an update[J]. Front Med (Lausanne), 2022, 9, 824395. doi: 10.3389/fmed.2022.824395
49	Kim KN, Shin MK, Lim YH, et al. Associations of cold exposure with hospital admission and mortality due to acute kidney injury: a nationwide time-series study in Korea[J]. Sci Total Environ, 2023, 863, 160960. doi: 10.1016/j.scitotenv.2022.160960
50	Gonzaga T, Jenabzadeh K, Anderson CP, et al. Use of intra-arterial thrombolytic therapy for acute treatment of frostbite in 62 patients with review of thrombolytic therapy in frostbite[J]. J Burn Care Res, 2016, 37 (4): e323- e334. doi: 10.1097/BCR.0000000000000245
51	Imray C, Grieve A, Dhillon S. Cold damage to the extremities: frostbite and non-freezing cold injuries[J]. Postgrad Med J, 2009, 85 (1007): 481- 488. doi: 10.1136/pgmj.2008.068635
52	舒文韬, 郭长松, 王轶楠. 慢性皮肤创面免疫微环境的特点及调控[J]. 中国免疫学杂志, 2021, 37 (3): 367- 375.
53	岑丽君, 左远娟, 唐乾利. NRF2信号通路对慢性难愈合创面修复影响的研究进展[J]. 右江民族医学院学报, 2022, 44 (5): 749- 753.
54	Kaltenmeier C, Wang R, Popp B, et al. Role of immuno-inflammatory signals in liver ischemia-reperfusion injury[J]. Cells, 2022, 11 (14): 2222. doi: 10.3390/cells11142222
55	Chen D, Chen C, Xiao X, et al. TNF-α induces neutrophil apoptosis delay and promotes intestinal ischemia-reperfusion-induced lung injury through activating JNK/FoxO3a pathway[J]. Oxid Med Cell Longev, 2021, 2021, 8302831. doi: 10.1155/2021/8302831
56	Ghafouri-Fard S, Shoorei H, Poornajaf Y, et al. NLRP3: Role in ischemia/ reperfusion injuries[J]. Front Immunol, 2022, 13, 926895.
57	Liu C, Yavar Z, Sun Q. Cardiovascular response to thermoregulatory challenges[J]. Am J Physiol Heart Circ Physiol, 2015, 309 (11): H1793- H1812. doi: 10.1152/ajpheart.00199.2015
58	Mills KT, Stefanescu A, He J. The global epidemiology of hypertension[J]. Nat Rev Nephrol, 2020, 16 (4): 223- 237. doi: 10.1038/s41581-019-0244-2
59	Wang Q, Li C, Guo Y, et al. Environmental ambient temperature and blood pressure in adults: A systematic review and meta-analysis[J]. Sci Total Environ, 2017, 575, 276- 286. doi: 10.1016/j.scitotenv.2016.10.019
60	Hu J, He G, Luo J, et al. Temperature-adjusted hypertension prevalence and control rate: a series of cross-sectional studies in Guangdong Province, China[J]. J Hypertens, 2021, 39 (5): 911- 918. doi: 10.1097/HJH.0000000000002738
61	Goel H, Shah K, Kumar A, et al. Temperature, cardiovascular mortality, and the role of hypertension and renin-angiotensin-aldosterone axis in seasonal adversity: a narrative review[J]. J Hum Hypertens, 2022, 36 (12): 1035- 1047. doi: 10.1038/s41371-022-00707-8
62	Sun Z, Fregly MJ, Cade JR. Effect of renal denervation on elevation of blood pressure in cold-exposed rats[J]. Can J Physiol Pharmacol, 1995, 73 (1): 72- 78. doi: 10.1139/y95-010
63	Wang B, Liu J, Lei R, et al. Cold exposure, gut microbiota, and hypertension: A mechanistic study[J]. Sci Total Environ, 2022, 833, 155199. doi: 10.1016/j.scitotenv.2022.155199
64	Guan WX, Lan Z, Wang QC, et al. Effects of prolonged cold stress on vascular function in guinea pigs with atherosclerosis[J]. J Cardiovasc Pharmacol, 2025, 85 (1): 63- 74. doi: 10.1097/fjc.0000000000001645
65	Nguyen JL, Link MS, Luttmann-Gibson H, et al. Drier air, lower temperatures, and triggering of paroxysmal atrial fibrillation[J]. Epidemiology, 2015, 26 (3): 374- 380. doi: 10.1097/EDE.0000000000000284
66	Yu L, Meng G, Huang B, et al. A potential relationship between gut microbes and atrial fibrillation: trimethylamine N-oxide, a gut microbe-derived metabolite, facilitates the progression of atrial fibrillation[J]. Int J Cardiol, 2018, 255, 92- 98. doi: 10.1016/j.ijcard.2017.11.071
67	Wu K, Yuan Y, Yu H, et al. The gut microbial metabolite trimethylamine N-oxide aggravates GVHD by inducing M1 macrophage polarization in mice[J]. Blood, 2020, 136 (4): 501- 515. doi: 10.1182/blood.2019003990
68	Luo Y, Zhang Y, Han X, et al. Akkermansia muciniphila prevents cold-related atrial fibrillation in rats by modulation of TMAO induced cardiac pyroptosis[J]. EBioMedicine, 2022, 82, 104087.
69	Borup A, Donkin I, Boon MR, et al. Association of apolipoprotein M and sphingosine-1-phosphate with brown adipose tissue after cold exposure in humans[J]. Sci Rep, 2022, 12 (1): 18753.
70	Farb A, Tang AL, Burke AP, et al. Sudden coronary death. Frequency of active coronary lesions, inactive coronary lesions, and myocardial infarction[J]. Circulation, 1995, 92 (7): 1701- 1709.
71	Kienbacher CL, Kaltenberger R, Schreiber W, et al. Extreme weather conditions as a gender-specific risk factor for acute myocardial infarction[J]. Am J Emerg Med, 2021, 43, 50- 53.
72	Katayama Y, Tanaka A, Taruya A, et al. Increased plaque rupture forms peak incidence of acute myocardial infarction in winter[J]. Int J Cardiol, 2020, 320, 18- 22.
73	Cheng J, Bambrick H, Tong S, et al. Winter temperature and myocardial infarction in Brisbane, Australia: Spatial and temporal analyses[J]. Sci Total Environ, 2020, 715, 136860.
74	Aronson D. Environmental factors, winter respiratory infections and the seasonal variation in heart failure admissions[J]. Sci Rep, 2021, 11 (1): 11292.
75	Takeda R, Hissen SL, Akins JD, et al. Sympathetic neural control at rest and during the cold pressor test in patients with heart failure with preserved ejection fraction[J]. Hypertension, 2024, 81 (4): 917- 926.
76	Wu W, Ziemann M, Huynh K, et al. Activation of hippo signaling pathway mediates mitochondria dysfunction and dilated cardiomyopathy in mice[J]. Theranostics, 2021, 11 (18): 8993- 9008.
77	Liu Y, Xing J, Li Y, et al. Chronic hypoxia-induced Cirbp hypermethylation attenuates hypothermic cardioprotection via down-regulation of ubiquinone biosynthesis[J]. Sci Transl Med, 2019, 11 (489): eaat8406.
78	Wolf K, Schneider A, Breitner S, et al. Air temperature and the occurrence of myocardial infarction in Augsburg, Germany[J]. Circulation, 2009, 120 (9): 735- 742.
79	Luo Y, Li H, Huang F, et al. The cold effect of ambient temperature on ischemic and hemorrhagic stroke hospital admissions: A large database study in Beijing, China between years 2013 and 2014-Utilizing a distributed lag non-linear analysis[J]. Environ Pollut, 2018, 232, 90- 96.
80	Qi X, Wang Z, Xia X, et al. The effects of heatwaves and cold spells on patients admitted with acute ischemic stroke[J]. Ann Transl Med, 2021, 9 (4): 309.
81	Chen Z, Liu P, Xia X, et al. The underlying mechanisms of cold exposure-induced ischemic stroke[J]. Sci Total Environ, 2022, 834, 155514.
82	王长征. 改善支气管哮喘控制现状, 需要重视患者的长期管理[J]. 中华肺部疾病杂志(电子版), 2013, 6 (4): 296- 298.
83	崔海洋, 马壮, 孙文武. 冷空气诱发支气管哮喘的研究进展[J]. 中华肺部疾病杂志(电子版), 2016, 9 (5): 558- 561.
84	Hyrkäs H, Jaakkola MS, Ikäheimo TM, et al. Asthma and allergic rhinitis increase respiratory symptoms in cold weather among young adults[J]. Respir Med, 2014, 108 (1): 63- 70.
85	Xu Z, Crooks JL, Davies JM, et al. The association between ambient temperature and childhood asthma: a systematic review[J]. Int J Biometeorol, 2018, 62 (3): 471- 481.
86	Zhou J, Xu J, Geng F, et al. Childhood co-exposure of cold stress and PM(2.5) aggravates the susceptibility and severity of asthma in adulthood of mice[J]. Environ Toxicol, 2021, 36 (2): 177- 184.
87	Suadicani P, Hein HO, Meyer HW, et al. Exposure to cold and draught, alcohol consumption, and the NS-phenotype are associated with chronic bronchitis: an epidemiological investigation of 3387 men aged 53-75 years: the Copenhagen Male Study[J]. Occup Environ Med, 2001, 58 (3): 160- 164.
88	Scheerens C, Nurhussien L, Aglan A, et al. The impact of personal and outdoor temperature exposure during cold and warm seasons on lung function and respiratory symptoms in COPD[J]. ERJ Open Res, 2022, 8 (1): 1- 13.
89	Lim YH, Park MS, Kim Y, et al. Effects of cold and hot temperature on dehydration: a mechanism of cardiovascular burden[J]. Int J Biometeorol, 2015, 59 (8): 1035- 1043.
90	Kim E, Kim H, Kim YC, et al. Association between extreme temperature and kidney disease in South Korea, 2003-2013: Stratified by sex and age groups[J]. Sci Total Environ, 2018, 642, 800- 808.
91	Mikkelsen TS, Toft P. Prognostic value, kinetics and effect of CVVHDF on serum of the myoglobin and creatine kinase in critically ill patients with rhabdomyolysis[J]. Acta Anaesthesiol Scand, 2005, 49 (6): 859- 864.
92	Chang J, Pan Y, Liu W, et al. Acute temperature adaptation mechanisms in the native reptile species Eremias argus[J]. Sci Total Environ, 2022, 818, 151773.
93	Liu Y, Xue N, Zhang B, et al. Cold stress induced liver injury of mice through activated NLRP3/Caspase-1/GSDMD pyroptosis signaling pathway[J]. Biomolecules, 2022, 12 (7): 927.
94	Guo J, Nie J, Chen Z, et al. Cold exposure-induced endoplasmic reticulum stress regulates autophagy through the SIRT2/FoxO1 signaling pathway[J]. J Cell Physiol, 2022, 237 (10): 3960- 3970.
95	Teng T, Zheng Y, Zhang M, et al. Chronic cold stress promotes inflammation and ER stress via inhibiting GLP-1R signaling, and exacerbates the risk of ferroptosis in the liver and pancreas[J]. Environ Pollut, 2024, 360, 124647.

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