健康青年男性急进高原右心功能变化研究  

Change in right heart function among healthy young males following rapid accent to high altitude

作　　者：刘曦[1] 覃军[1] 高旭滨[1] 于世勇[1] 余洁[1] 李相俊[1] 黄岚[1] 

机构地区：[1]第三军医大学新桥医院心血管内科,全军心血管病研究所,重庆400037

出　　处：《军事医学》2013年第5期329-331,共3页Military Medical Sciences

基　　金：国家卫生部卫生行业科研专项基金资助项目(201002012)

摘　　要：目的探讨急进高原初期在不同海拔及进驻时相点,健康青年男性右心结构与功能的变化。方法随机选择62名初次进入高原的健康男性,由同一人分测在海拔400 m平原地区、进入海拔3700 m高原24 h及停留1周进入更高海拔4400 m 5 d右心系统相关参数的变化。结果与平原比较,进入海拔3700 m高原1 d内Tei指数、肺部血管阻力(PVR)、平均肺动脉压(mPAP)明显增高(P<0.05),右房内径(RA)、右室舒张末期内径(RV)显著降低(P<0.001),肺动脉内径(PA)、E/Aratio明显降低(P<0.05);在海拔3700 m处适应1周再次进入更高海拔4400 m地区,与初次进入高原时相比,E/Aratio明显增高,RA、RV明显降低(P<0.05),PA、Tei指数、mPAP、PVR差异无显著性(P>0.05)。结论在初次进入高海拔地区后,健康青年男性右心系统结构与功能有明显改变,经过在海拔3700 m地区短期习服适应后进入更高海拔,右心室做功无明显增加,右室舒张与收缩功能恢复到平原水平。提示随着在高原低氧环境停留时间的延长,右心结构会逐渐发生改变,舒张与收缩功能会随着机体的适应和调节机制得到一定改善。Objective To investigate the changes in right heart structure and function at different altitudes and time courses among healthy young males following rapid accent to high altitude. Methods Young healthy men who entered the plateau for the first time were randomly selected. Their changes in the relative parameters of the fight heart system were measured by the same person at 400 m above sea level ,after entering the plateau at an altitude of 3700 m 24 hours later, and a week for short stay, and five days after reaching the level of 4400 m following a short stay of one week. Results Compared with the case at sea level,Tei index, pulmonary vascular resistance （PVR） and mean pulmonary artery pressure （mPAP） were obviously increased （ P 〈 0.05 ） 1 day after the young males arrived at highlands while RA and RV were significantly decreased （P 〈 0.001 ） , so did PA and E/Aratio （P 〈 0.05 ）. Compared with the level of 3700 m, E/A,ratio was obviously increased （ P 〈 0.05 ） while RA, RV was obviously decreased （ P 〈 0.05 ） ; PA, Tei index, mPAP and PVR did not significantly change （P 〉 0.05 ） at the level of 4400 m. Conclusion The structure and function of the right heart system of these young healthy men improved significantly after their first arrival at the plateau. There was no significant increase in the right ventricular performance. The right ventricular systolic and diastolic function returned to its level on the plains, indicating that the right heart structure will gradually changed with prolonge residence in the high altitude hypoxia environment. The right ventricular systolic and diastolic function will be better preserved by the adaptation and adjustment mechanism of the body.

关 键 词：急性高原病 右心功能 TEI指数 青年男性 

分 类 号：R594.3[医药卫生—内科学]