青藏列车乘务人员间断性低氧作业对健康的影响  

Influence of Intermittent Hypoxia Operation on Health of Trainmen on Qinghai-Tibet Train

作　　者：施红生[1] 邱永祥[1] 赵亚林[1] 谷丽华[1] 

机构地区：[1]中国铁道科学研究院节能环保劳卫研究所,北京市100081

出　　处：《职业与健康》2010年第14期1561-1567,共7页Occupation and Health

基　　金：国家科技支撑计划资助项目(2006BAC07B01)

摘　　要：目的研究青藏列车乘务人员间断低氧工作对健康影响的控制指标,防止高原病的发生。方法对北京—拉萨试验和运营列车进行空气氧含量和乘务人员高原反应指标检查。以北京—拉萨车队343人为对象和西宁—拉萨车队141人为参照进行健康影响队列研究,追踪试验观察主要生理指标的远期变化。结果列车乘务人员格拉段高原反应症状比平原阶段升高约8倍,比海拔3000m阶段升高约4倍,中度以上高原反应发生率为8%～11%。急性高原反应症状评分与呼吸频率、脉搏、血氧饱和度有相关性。不同海拔高度呼吸频率、脉搏、血氧饱和度异常发生率差异有统计学意义(P<0.01)。3次追踪体检统计,主要是大血管内径和右心室增大,异常率达41.3%和43.6%;肺功能持续降低,异常率达11.9%;血液系统反应最强烈的指标为血红蛋白,异常率达21.1%;肝功能转氨酶、总胆红素、蛋白代谢指标升高;肾功能3项指标和脂质代谢指标升高。结论呼吸频率、脉搏、血氧饱和度能敏感地反映机体缺氧状态,可作为短期生理适应指标和车上快速检测高原反应生理指标。远期健康监护控制指标主要为血红蛋白、红细胞、肺动脉高压、超声心动图、心电图、转氨酶、胆红素、体重、肺功能及握力。[Objective]To study the control indexes of intermittent hypoxia operation on health of trainmen on Qinghai-Tibet train,prevent altitude sickness.[Methods]The passenger trains on trial and on operation from Beijing to Lhasa were selected for the experiment of the oxygen content in air and high altitude reaction among trainmen.343 trainmen of Beijing-Lhasa train crew were collected as object and 141 trainmen of Xining-Lhasa train crew were collected as control,the cohort study of influence on health was performed,and the long-term change of main physiological indexes were observed longitudinally.[Results]The high altitude reaction symptom of trainmen in the Geermu-Lhasa section increased about 8 times as compared with plain section and about 4 times as compared with 3000 m altitudes section,the incidence of high altitude reaction above moderate was 8%-11%.The symptom score of acute high altitude reaction was related to respiratory rate,pulse and blood oxygen saturation.There were significant differences in the abnormal rate of respiratory rate,pulse and blood oxygen saturation among different altitude sections （P0.01）.Three tracing physical examinations showed that great vessels diameter and right ventricle enlarged,which the abnormal rate reached 41.3% and 43.6% respectively,the pulmonary function declined consistently with abnormal rate of 21.1%,the transaminase,total bilirubin,indexes of protein metabolism increased,three indexes of renal function and lipid metabolism raised.[Conclusion]The respiratory rate,pulse and blood oxygen saturation can reflect hypoxia state of body sensitively,which can be use as a short-term physiological adaptive indexes and physiological indexes of high altitude reaction for rapid detection on trains.The long-term health surveillance indexes are hemoglobin,red blood cell,pulmonary hypertension,echocardiography,electrocardiogram,transaminase,bilirubin,body weight,pulmonary function and grip strength.

关 键 词：青藏列车 间断性低氧 高原病 控制指标 

分 类 号：R134[医药卫生—劳动卫生]