健康男性青年急进高原初期心脏功能变化特点研究  

Change of cardiac function in healthy young males following rapid travel to highlands

作　　者：潘丽[1] 李素芝[2] 

机构地区：[1]第三军医大学高原军事医学系高原疾病学教研室,高原医学教育部重点实验室,全军高原生理与高原病研究重点实验室,重庆400038 [2]西藏军区总医院,拉萨850007

出　　处：《第三军医大学学报》2012年第11期1104-1106,共3页Journal of Third Military Medical University

摘　　要：目的了解健康青年人由平均海拔400 m平原初次进入平均海拔3 680 m高原后同海拔、不同时相(进入高原后1 d、1周、1个月)的心脏功能的变化情况。方法使用美国索诺声公司MMX型便携式心脏彩超仪,由同一人分别测47例健康男性青年进高原前1周在平原地区及进入高原地区后同海拔不同时相的室间隔的厚度与运动幅度、左室后壁的厚度与运动幅度、左室舒张末内径、左室舒张末容积、左室收缩末容积、肺动脉压(pulmonary artery pressure,PAP),计算射血分数(left ventricular ejection fraction,LVEF)、短轴缩短率(left ventricular minor axis decurtation,LVMAD,△D%)、每搏量(stroke volume,SV)、心输出量(cardiac output,CO)。使用北京福田公司7101型心电图机,由同一人分别做47例健康男性青年进高原前1周在平原地区及进入高原地区后同海拔不同时相的心电图(electrocardiogram,ECG),计算心率(heart rate,HR)。结果与平原相比较:进入高原1 d的HR、PAP、CO明显增高(P<0.05),SV则明显降低(P<0.05);进入高原1周的HR、PAP明显增高(P<0.05),LVEF、△D%、SV明显降低(P<0.05);进入高原1个月时CO、PAP明显增高(P<0.05),LVEF、△D%、SV明显降低(P<0.05);与进入高原1 d相比较:进入高原1周时HR、LVEF、△D%、SV、CO均明显降低(P<0.05);进入高原1个月的PAP明显增高(P<0.05),HR、CO明显降低(P<0.05);与进入高原1周相比较:进入高原1个月的LVEF、△D%、SV、CO明显增高(P<0.05),HR明显降低(P<0.05)。结论健康男性青年进高原后心脏功能会出现明显的变化,其变化在急进高原早期(1周内)较为明显,此期应注意对急性高原病及心血管意外的预防。1个月后,机体进入习服期,此时心脏功能仍明显异常者可能为罹患慢性高原病的高危人群。Objective To investigate the change of cardiac function in healthy young males in 1 day,1 week and 1 month after they first arrived at highlands of 3 680 meters above seal level from an altitude of 400 meters over sea level.Methods The interventricular septum thickness and amplitude,posterior left ventricular thickness and amplitude,left ventricular end-diastolic diameter,left ventricular end-diastolic volume and end-systolic volume,pulmonary artery pressure（PAP） were measured by Doppler echocardiography,and left ventricular ejection fraction（LVEF）,left ventricular minor axis decurtation（LVMAD,△D%）,stroke volume（SV）,cardiac output（CO） and heart rate（HR） were calculated in 47 healthy young males in 1 week before and after they arrived at highlands of different meters over seal level.Results The HR,PAP and CO were significantly higher while the SV was significantly lower in the young males in 1 day after they arrived at highlands（P〈0.05）.The HR and PAP were significantly higher while the LVEF,△D% and SV were significantly lower in the young males in 1 week after they arrived at highlands（P〈0.05）.The CO and PAP were significantly higher while the LVEF,△D% and SV were significantly lower in the young males in 1 month after they arrived at highlands（P〈0.05）.The HR,LVEF,△D%,SV and CO were significantly lower in 1 week after they arrived at highlands while the PAP was significantly higher in 1 month after they arrived at highlands than in 1 week they arrived at highlands.The LVEF,△D%,SV and CO were significantly higher while the HR was significantly lower in 1 month after they arrived at highlands than in 1 week after they arrived at highlands（P〈0.05）.Conclusion Significant changes of cardiac function will occur in healthy young males after their rapid arrival at highlands,especially in 1 week after their arrival at highlands,during which attention should paid to the prevention of acute mountain sickness（AMS） and cardiovascular accidents（CVA）.As young mal

关 键 词：高海拔 超声心动描记术 心电描记术 心率 心排血量 每搏输出量 心室功能 肺楔压 男性 

分 类 号：R331.31[医药卫生—人体生理学] R339.31[医药卫生—基础医学]