高海拔地区施工人员血压动态变化影响因素及其机制探讨  

A prospective study of blood pressure dynamic change and related factors in construction workers in high-altitude regions

作　　者：陈建华[1] 郑必海[2] 严亦平[1] 李生惠[1] 郑健保[2] 唐爱科[1] 董瓅瑾[3] 

机构地区：[1]武警水电第二总队医院特诊科,南昌330000 [2]西藏军区总医院高干科,拉萨850000 [3]武警后勤学院,天津300162

出　　处：《武警医学》2012年第7期583-585,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨高海拔地区施工人员血压变化与海拔高度、劳动强度、生活方式等影响因素的关系,并探讨其发生机制。方法通过设计专门的调查表,并由指定的研究人员,通过培训后对由平原进入高海拔地区施工人员的"亚习服期"血压进行测定,测定的时间点分别为平原、进入高原3、7、15、30、60 d。结果施工人员由平原进入高原后,在"亚习服期"(即出现血压明显改变,其中进入高原第3天及第7天与平原比较差异有统计学意义,后逐渐下降,至第30天时血压开始接近平原水平,而至第60天时血压再次高于平原和第30天。与平原比较第3天、第7天有统计学差异(P<0.05或P<0.01);在1000例中,高原高血压发病人数202例,患病率为20.2%,且高空作业人群高原高血压的发病率显著高于地面作业人群(P<0.01),患病率随海拔高度、劳动强度增加而增高。结论高海拔地区施工人员在"亚习服期"即出现高原高血压,与海拔高度、劳动强度、不良情绪、心理压力、不良生活方式等因素有相关性。Objective To investigate the the relationship between blood pressure changes and the altitude,labor intensity and life style factors among high-altitude construction workers,and to study its mechanism.Methods Using a specially-designed questionnaire,designated researchers,after training,measured the blood pressure of construction workers who recently arrived in high altitude regions from plains during the ＂sub-acclimatization period＂.The time points of blood pressure measurement were 3,7,15,30 and 60 days after arrival.Results Construction workers who arrived in the plateau from the plains during the ＂sub-acclimatization period＂ showed significantly high blood pressure on days 3 and 7.Then the blood pressure gradually declined to the level on the plains on day 30,but on day 60 was again higher than that on the plains or on day 30.Compared with that on the plains,the blood pressure was P〈0.01 on day 3,and P〈0.05 on day 7.Among the 1000 workers surveyed,there were 202 cases of plateau hypertension,with an incidence of 20.2%.The incidence of hypertension in workers operating high above the ground was significantly higher than that in workers operating on the ground（P〈0.01）.The prevalence of plateau hypertension increased with sea level,labor intensity,bad humor,mental pressure,and unhealthy life style.Conclusions Hypertension in high-altitude construction workers during the ＂sub-acclimatization period＂ is related to the altitude,labor intensity,negative emotions,mental pressure and unhealthy life style.

关 键 词：高海拔地区 高原习服 高原高血压 动态变化 相关因素 

分 类 号：R544.1[医药卫生—心血管疾病]