汉族久居高原人群返回平原后心肺结构和功能变化的研究  

Investigation of cardiac structure,heart function and pulmonary arterial pressure of the Hans back to the plain after living long on Tibetan Plateau

作　　者：赵锋仓 景藴华 

机构地区：[1]西藏民族学院附属医院,陕西咸阳712082

出　　处：《延安大学学报（医学科学版）》2014年第1期9-12,共4页Journal of Yan'an University:Medical Science Edition

基　　金：西藏自治区科技厅自然科学基金项目(基金编号:2011-24)

摘　　要：目的研究久居高原汉族人群返回平原后其心脏结构、心功能、肺动脉压的变化。方法随机选取从内地平原移居至西藏高原多年(移居高原年数:26.36±9.23年)的汉族人群,经病史及相关检查排除其他原因引起疾病共58例、在他们返回平原平均45 d左右时,分别检测其心脏结构、心脏功能、肺动脉压和瓣膜口血流速度等指标,随机选取66例内地健康者作为对照并进行统计学分析,探讨久居高原汉族人群返回平原后其心肺适应问题。结果研究显示,左室射血分数(EF)、心脏指数(CI)、每搏输出量(SV)、心输出量(CO)值、左心室(LV)内径、二尖瓣舒张早期血流最大流速(MVE峰)、三尖瓣返流(TR)等指标,返回平原组(返回平原平均时间43.42±4.05天)与对照组比较无明显差别(P>0.05)。返回平原组右心房(RA)、右心室(RV)和左心房(LA)内径;肺动脉内径(PA)、右肺动脉内径(RPA)、肺动脉收缩压(PASP)、二尖瓣舒张晚期血流最大流速(MVA峰)、三尖瓣舒张期血流E峰(TVE峰)、三尖瓣舒张期血流A峰(TVA峰)值,与对照组比较存在明显差异(P<0.001)。结论本研究表明,同内地对照组比较,汉族人群移居高原多年后返回平原平均45 d左右时间其右心脏结构无明显变化、肺动脉收缩压及相关指标、MVA峰、TVE峰、TVA峰未恢复至对照组水平,心功能指标与对照无明显差异。MVE峰和TR值指标发生了较明显的高原脱适应性变化,其值基本恢复至对照组水平。Objective To study the changes of cardiac structure, heart function and pulmonary arterial pressure of the Hans back to the plain after living long on Tibetan Plateau. Methods Randomly choose 58 cases out of the Han peo- ple who have moved to the Tibetan Plateau and lived for many years （28.88 ± 9.76 years） ,and been examined to make sure they have no disease caused by other factors, against 66 healthy inland persons randomly chosen. Exam- ine cardiac structure, their heart function, pulmonary arterial pressure and valve flow velocity after they have returned to the plains about 45 days. Then make statistical analysis of high altitude eardiopulmonary de - adaptation reaction according to the differences. Results In left ventricular ejection fraction （ EF）, cardiac index （ CI）, stroke volume （SV） and cardiac output （CO）, Left ventricular internal diameter （LV）, Mitral flow velocity of E peak （MV E peak）, Tricuspid regurgitation（TR）, there are no significant differences between the group back in plains and the control group （ P 〉 0.05 ）. There is significant difference in the right atrium （ RA ）, right ventricular （ RV ） and left atrium（LA） ,pulmonary artery systolic pressure（PASP）, pulmonary artery （PA） and the right pulmonary artery（ RPA ） value between the experimental group and the control （ P 〈 0. 001 ）. Conclusions Right cardiac structure in the Hans back to the plain about 45 days after living long on Tibetan Plateau have not undergone significant changes, and PASP, PA and RPA, MV A peak, TV E peak and TV A peak are not restored to the level of the control group. Obvious changes of the MV E peak and TR values occurred, and the values are recovered to the level of the control group.

关 键 词：高原汉族移居者 返回平原 心脏结构 肺动脉压 心脏功能 三尖瓣返流 

分 类 号：R541.9[医药卫生—心血管疾病]