高原暴露下血浆红细胞生成素浓度与左心功能及急性高原病的关系  

Relationships between plasma EPO concentration and left ventricular function and AMS after high altitude exposure

作　　者：梁逍 卞士柱[1] 邱友竹 杨杰[1] 张恩浩[1] 余洁[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》2015年第2期101-104,139,共5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：目的观察不同高原暴露人群血浆红细胞生成素(EPO)浓度变化对左心收缩功能的影响及与急性高原病(AMS)的关系。方法将289名健康青年男性分为:Ⅰ组(平原对照组)55人;Ⅱ组(急性高原暴露组,3700 m暴露24 h)74人;Ⅲ组(习服后再急性暴露组,3700 m习服1周后紧急进入4400 m暴露24 h)68人;Ⅳ组(移居高原组,移居3700 m>1年)19人;Ⅴ组(移居后再暴露组,移居3700 m>1年再暴露于4400 m 50 d)73人。行心脏超声检查,以及路易斯湖评分系统(LLSS),并收集血标本行EPO检测。结果急性高原暴露后EPO显著增加,Ⅱ和Ⅲ组均显著高于Ⅰ组,差异有统计学意义(P<0.05),Ⅳ、Ⅴ与Ⅰ组相比差异均无统计学意义(P>0.05)。同时,Ⅱ组EPO浓度与每搏输出量、左心室舒张内径呈正相关(R值分别为0.278、0.236,P<0.05),与AMS评分呈负相关(R=-0.249,P<0.05),而其他组血浆EPO浓度与左心功能指标并无相关性。结论急性高原暴露后EPO可能通过增强左心收缩功能降低AMS发病。Objective To investigate the effect of plasma erythropoietin（ EPO） concentration on left ventricular systolic function and its relationship with acute mountain sickness（ AMS）. Methods A total of 289 healthy young men were recruited in this study and divided into five groups： plain control group（ Ⅰ） with 55 subjects; acute high altitude exposure group（ Ⅱ） with 74 subjects（ 3700 m exposure for 24 h）; the group of acute exposure after acclimatization（ Ⅲ） with 68subjects（ 4400 m exposure for 24 h after 1 week acclimatization at 3700 m）; high altitude migrate group（ Ⅳ） with 19subjects（ migration to 3700 m for more than 1 year）; and the group of exposure after migration（ Ⅴ） with 73 subjects（ 4400 m exposure for 50 d after more than one year migration to 3700 m）. Lake Louise Self-assessment Scoring System（ LLSS） was used to assess AMS. Plasma concentrations of EPO and echocardiography were also determined. Results EPO was significantly increased after acute high altitude exposure. There was no significant difference in EPO between group Ⅱ and Ⅲ（ P〈0. 05）,but significantly higher than in group Ⅰ（ P〈0. 05）. No significant difference was found between group Ⅳ,Ⅴ and Ⅰ（ P〈0. 05）. In group Ⅱ,positive correlation was found between EPO concentration and stroke volume（ SV） as well as left ventricular diastolic diameter（ LVDD）（ R = 0. 278 and 0. 236,respectively,P〈0. 05）,while negative correlation was expressed between EPO concentration and the AMS score（ R =-0. 249,P〈0. 05）. In other groups,there was no relationship between EPO concentration and the index of left ventricular function. Conclusion EPO may work on AMS through left ventricular systolic function enhancement after acute high altitude exposure.

关 键 词：高原暴露 红细胞生成素 心功能 急性高原病 习服 

分 类 号：R594.3[医药卫生—内科学]