心率减速力作为紧急入藏医疗队员筛查标准的可行性研究  

Study on the feasibility of Heart Rate Deceleration Capacity as Screening Criteria of Medical Team Members' Emergent Entering Tibet

作　　者：唐峰[1] 吕宏迪[2] 王锦波[3] 李军[4] 

机构地区：[1]解放军第371中心医院心内科,新乡453000 [2]解放军第371中心医院医务处,新乡453000 [3]解放军第371中心医院普外科,新乡453000 [4]解放军第371中心医院药械科,新乡453000

出　　处：《中华灾害救援医学》2014年第5期263-265,共3页Chinese Journal of Disaster Medicine

摘　　要：目的探讨心率减速力（deceleration capacity,DC）是否可作为入藏前后医疗队员的筛查标准。方法通过动态心电图分析与位相整续信号平均技术（phase rectified signal averaging,PRSA）对医疗队员进行DC的检测,同时动态检测不同DC值的队员收缩压（systolic blood pressure,SBP）、平均动脉压（mean arterial pressure,MAP）、心率（heart rate,HR）、左室射血分数（left ventricular ejection fraction,LVEF）值的变化。结果以不同DC值进行分组,DC值在4.0~4.3 ms和4.3~4.5 ms之间的队员ΔSBP、ΔMAP、ΔHR值均不同程度高于DC值在4.5 ms以上的队员;ΔLVEF%值降低的程度大于DC值在4.5 ms以上的医疗队员,差异均有统计学意义;4.0~4.3 ms和4.3~4.5 ms之间的队员各项指标比较,以及4.5~4.7 ms和4.7~5.0 ms之间的队员各项指标比较差异均无统计学意义。结论高原环境对DC值在4.5 ms以下的队员影响比较明显;可以以DC值4.5 ms为临界值,DC值低于4.5 ms的队员是高原低氧易感人群。Objective To study the screening criteria for detecting heart rate deceleration capacity on medical team members before and after emergent entering Tibet. Methods The heart rate deceleration capacity（ DC） of medical team members was tested by dynamic electrocardiogram analysis and phase rectified signal averaging,and the members with different DC value,was dynamically detected for the change of systolic blood pressure（ SBP）,mean arterial pressure（ MAP）,heart rate（ HR） and left ventricular ejection fraction（ LVEF）. Results All the members were grouped according to the different DC value,ΔSBP,ΔMAP,ΔHR value of the medical team members with DC value of 4. 0 ~ 4. 3 ms and 4. 3 ~ 4. 5 ms,were higher in different extent than that of the members with DC value above 4. 5 and the decreased degree of ΔLVEF% above 4. 5 ms,which were statistically significant; the indexes of medical team members with 4. 0 ~ 4. 3 ms and 4. 3 ~ 4. 5 ms,4. 5 ~ 4. 7 ms and 4. 7 ~ 5. 0 ms were compared,both of which had no statistical significance. Conclusions High plateau environment had an obvious influence on the medical team members of DC value below 4. 5 ms; DC value of 4. 5 ms can be a critical value that used to judge low oxygen susceptible populations.

关 键 词：心率减速力 动态心电图 位相整续信号平均技术 习服 高原反应 

分 类 号：R246.1[医药卫生—针灸推拿学] S717.195[医药卫生—中医临床基础]