急性高山病患者肺弥散功能的变化  

Changes of pulmonary diffusing capacity in subjects with acute mountain sickness

作　　者：陈秋红[1] 格日力[1] 阮宗海[1] 王占刚[1] 

机构地区：[1]青海省高原医学科学研究所,西宁810012

出　　处：《中华结核和呼吸杂志》2000年第2期101-103,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的　探讨肺弥散功能的改变在急性高山病发病中的作用。方法　按照LakeLouiseConsensus症状评分法将急进海拔 470 0m高原的 32名受试者分为急性高山病组 (AcutMountainSiskness,AMS) 12例和非急性高山病组 (non AMS) 2 0名。在急进高原前、后分别对两组的一氧化碳肺弥散量 (DLco)、血气分析进行测定。结果　在急进高原前两组的DLco、肺泡氧分压差 (P(A a) O2 )无显著差异 ,从 2 2 6 0m快速到达 470 0m后两组DLco都有增加 ,但non AMS组增加的幅度大于AMS组 ,ΔDLco分别为 (10 7± 1 3)ml·min-1·mmHg 1和 (1 3± 1 7)ml·min-1·mmHg-1(P <0 0 ) ;P(A a) O2 减小 ,但non AMS组减小的幅度显著大于AMS组 (P <0 0 5 ) ,DLco和急性高山病的症状评分值呈显著负相关 (r=- 0 885 ,P <0 0 1)。结论　肺弥散量的不足可能是急性高山病发病的重要因素 ,早期肺间质的水肿是影响肺弥散功能的重要原因。Objective The study was conducted to invenstigate whether the changes in the pulmonary diffusing capacity found in individuals with acute mountain sickness (AMS)reflect the early stage of high altiude pulmonary edema (HAPE) Methods According to international definition of AMS (Lake Louise Consensus) thirty two subjects were divided into AMS and non AMS group The pulmonary diffusion capacity for carbon monoxide (DLco) by the single breath method, arterialized capillary blood gas were measured in all subjects at an altitude of 2 260 m and after ascent to 4 700 m Results All subjects exhibited an increase in DL CO from 2 260 m to 4 700 m, the degree of increase in DLco in the AMS group was significantly lower than that of the non AMS group, ΔDLco (1 3±1 7) ml·min -1 ·mm Hg -1 vs (10 7±1 3) ml·min -1 ·mm Hg -1 ( P >0 01) The AMS group showed a greater alveolar arterial oxygen pressure difference at 4 700 m compared with the non AMS group DL CO showed a significantly negative correlation with AMS score ( r =-0 885 P <0 01). Conclusions These results suggest that the decreased pulmonary diffusing capacity has an important role in the incidence of acute mountain sickness, it reflects the presence of pulmonary gas exchange abnormality, which is probably due to subclinical interstitial edema of the lung

关 键 词：急性 高山病 肺弥散功能 

分 类 号：R594.3[医药卫生—内科学]