长期氧疗对海拔5000m以上地区慢性高原病的影响  

Effect of long-term oxygen therapy on prevention of chronic mountain sickness

作　　者：崔建华 高亮 邢文荣[2] 王福领 薛欣[2] 王琰 吴佩峰 李年华 张俊才 

机构地区：[1]解放军18医院全军高山病防治研究中心,新疆叶城844900 [2]兰州军区联勤部卫生部

出　　处：《西北国防医学杂志》2015年第2期101-104,共4页Medical Journal of National Defending Forces in Northwest China

基　　金：国家科技支撑计划资助项目(2009BAI85B06);高原医学教育部重点实验室资助项目(2011JSGY05);兰州军区医药卫生科研基金资助项目(CWS10JA04)

摘　　要：目的:探讨长期氧疗(LTOT)对移居海拔5000m以上青年慢性高原病(CMS)预防作用。方法:对2010年进驻海拔5 070m、5 200m和5 380m的96例男性青年,在进入高原后每人每天持续鼻管吸氧(2L/min)1h(LTOT组),驻守1年根据国际CMS诊断标准进行CMS流行病学调查,采用超声诊断仪检测右室舒张末前后径(RVED)、右室前壁厚度(RVAW)、右室流出道(RVOT)、肺动脉主干内径(MPA)和左室后壁收缩末内径(LVSD),同时采血检测丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、r-谷氨酰转肽酶(r-GT)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)及一氧化氮合酶(NOS)和氧饱和度(SaO2)的浓度,并与2008年驻守相同海拔高度1年的同一群体91例青年(未采用任何干预措施,对照组)作对照。结果:1CMS流行病学调查显示,LTOT组较对照组SaO2增高,有显著性差异,CMS、高原红细胞增多症(HAPC)患病率降低,有显著性差异(P<0.05)。2超声心动图结果显示,LTOT组较对照组RVAW、RVED、RVOT降低,有显著性差异(P<0.05或<0.01),LVSD、MPA无统计学差异(P>0.05)。3生化指标结果显示,LTOT组较对照组SOD、NO、NOS增加,有显著性差异(P<0.05或<0.01),MDA、ALT、AST、LDH降低,有显著性差异(P<0.05或0.01),γ-GT、CK无统计学差异(P>0.05)。结论:在高海拔地区LTOT能减轻脂质过氧化反应,对预防慢性高原病的发生有重要作用。Objective：To explore the effect of long-term oxygen therapy（LOTO）on the chronic mountain sickness（CMS）of young men who were stationed at an altitude of above 5000 meters.Methods：Ninety-six male young men stationed at 5070 m,5200 mand 5380 min 2010 were given oxygen therapy at2L/min daily by nasal cannula（LTOT group）.After one year,epidemiological survey were carried out according to the international CMS diagnostic criteria,including the ultrasonic examination of RVED,RVAW,RVOT,MPA and LVSD,and the blood tests of ALT,AST,r-GT,CK,LD,SOD,MDA,NO,NOS and SaO2.The results were compared with those from 91 males who were stationed at the same altitude without any interventions in 2008.Results：The epidemiological survey showed that SaO2 in the LTOT group was significantly higher than that of the control group（P〈0.05）,while the prevalence rate of CMS and HAPC were significantly decreased（P〈0.05）.Ultrasonic examinations indicated that RVAW,RVED and RVOT were significantly decreased（P〈0.05or〈0.01）,but LVSD and MPA were not significantly changed（P 〉0.05）.The biochemical index examinations showed SOD,NO,and NOS were increased compared to those of the control（P〈0.05or〈0.01）,while MDA,ALT,AST,and LDH were decreased（P〈0.05or〈0.01）,andγ-GTand CK were no significantly different.Conclusion：LTOT can reduce lipid peroxidation,protect important organ from injuries caused by hypoxia,and there play an important role in the prevention of chronic high altitude diseases.

关 键 词：高原 长期氧疗 慢性高原病 超声心动图 自由基代谢 血清酶 

分 类 号：R821.52[医药卫生—临床医学]