超声检测急速入藏汉族青年与世居高原藏族青年吸氧前后脑血流动力学变化  

Comparative study of cerebral hemodynamic changes on ultrasound after oxygen therapy between Han visitors and Tibetan residents

作　　者：徐书真 王佳[2] 张耀仓 袁丽君[2] 谭明木 江水根 洛桑丹伦 

机构地区：[1]武警西藏总队医院特检科,850003 [2]第四军医大学唐都医院超声诊断科

出　　处：《中华医学超声杂志（电子版）》2013年第2期123-128,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨急速入藏世居平原的汉族健康青年和世居高原的藏族健康青年吸氧前后脑血流动力学变化及种族差异。方法选取急速入藏汉族青年和世居高原的藏族青年95名,分为汉族男青年组、汉族女青年组、藏族男青年组和藏族女青年组4组。收集受试者肺活量体重指数和血红蛋白(HGB)浓度等一般资料。采用普通面罩吸氧,氧气纯度不低于97.5%,分别在吸氧前后记录动脉血氧饱和度(SaO2)、外周动脉血压[收缩压(SAP)和舒张压(DAP)]及心率(HR)的变化,并应用经颅彩色多普勒超声技术记录受试者吸氧前后右侧大脑中动脉收缩期峰值血流速度(PSV)、舒张期末期血流速度(EDV)、平均血流速度(Vm)及阻力指数(RI)变化。结果汉族男青年组与藏族男青年组间、汉族女青年组与藏族女青年组间肺活量体重指数和HGB浓度差异均有统计学意义(t值分别为1.706、3.845、2.025、11.918,P均<0.05)。吸氧前汉族男青年组和女青年组SaO2及右侧大脑中动脉RI均分别低于同性别的藏族男青年组和女青年组,且差异均有统计学意义(t值分别为1.680、3.349、2.635、7.524,P均<0.05);汉族男青年组SAP、DAP、HR、PSV、EDV和Vm均高于藏族组,且差异均有统计学意义(t值分别为2.475、4.414、1.915、4.502、6.153、2.481,P均<0.05)。吸氧后8min各组SaO2及RI均有所增高,SAP、DAP、HR及PSV、EDV、Vm均不同程度降低,且差异均有统计学意义。吸氧后8min,汉族男青年组与藏族男青年组比较SAP、DAP、PSV、EDV差异均有统计学意义(t值分别为2.020、2.623、3.288、2.957,P均<0.05);汉族女青年组与藏族女青年组间比较SAP、DAP、HR、EDV、Vm、RI差异均有统计学意义(t值分别为2.474、5.756、5.008、2.316、1.904、2.959,P均<0.05)。结论不同种族急速入藏健康青年吸氧前后脑血流动力学有明显差异,吸氧后差异显著减小,提示吸氧可迅速改善世居平原的急速入藏健康青年血流动�Objective To study the effects of oxygen therapy and ethnic differences on cerebral hemodynamics between short-term Han visitors and healthy Tibetan residents.Methods A total of ninety-five adolescents were divided into four groups:the male Han group,the male Tibetan group,the female Han group and the female Tibetan group.Basic information was collected including age,height,vital capacity body mass index,and hemoglobin(HGB).All subjects underwent oxygen inhalation therapy.Then the arterial blood oxygen saturation(SaO2),peripheral systolic and diastolic arterial blood pressures(SAP and DAP),heart rate(HR),and the waveform parameters of right middle cerebral artery(RMCA)[peak systolic flow velocity(PSV),end diastolic flow velocity(EDV),mean flow velocity(Vm) and resistance index(RI)] were recorded 1 min,2 min,4 min,and 8 min after therapy,respectively.Results The vital capacity body mass index and HGB had significant difference between groups with same gender(t=1.706,3.845,2.025,11.918,all P<0.05).Before oxygen inhalation,SaO2 and RMCA-RI in Han groups were significantly lower than that in Tibetan groups respectively(t=1.680,3.349,2.635,7.524,all P<0.05).The SAP,DAP,HR,RMCA-PSV,RMCA-EDV and RMCA-Vm were significantly higher in Han groups than those in Tibetan groups(t=2.475,4.414,1.915,4.502,6.153,2.481,all P<0.05).After oxygen therapy SaO2 and RI increased while SAP,DAP,HR,RMCA-PSV,RMCA-EDV and RMCA-Vm decreased in various degrees.Eight minutes after oxygen thearpy,the SAP,DAP,RMCA-PSV,and RMCA-EDV had significantly difference between Han male group and Tibetan male group(t=2.020,2.623,3.288,2.957,all P<0.05);the SAP,DAP,HR,RMCA-EDV,Vm and RI had significantly difference between Han female group and Tibetan female group(t=2.474,5.756,5.008,2.316,1.904,2.959,all P<0.05).Conclusions Significant differences exist in cerebral hemodynamics between different ethnics after entering Tibet,while these differences are no longer significant eight minute after oxygen therapy.It indicates that oxygen uptake can improve the hem

关 键 词：超声检查 多普勒 经颅 大脑中动脉 血流动力学 高海拔 缺氧 

分 类 号：R82[医药卫生—临床医学]