儿童青少年游泳运动员初入2366米高原肺动脉收缩压及心脏功能变化的超声心动图研究  

Pulmonary Artery Pressure and Cardiac Function in Children and Adolescents Swimmers at Altitude of 2366m

作　　者：宋小波[1] 王斌[1] 高扬[2] 房昶 闫会萍[2] 白云飞[3] 陆一帆[2] 

机构地区：[1]华中师范大学,武汉430079 [2]北京体育大学 [3]国家体育总局运动医学研究所

出　　处：《中国运动医学杂志》2015年第11期1058-1063,共6页Chinese Journal of Sports Medicine

摘　　要：目的:采用彩色多普勒超声心动图估测初入高原儿童青少年游泳运动员肺动脉收缩压并测量心脏功能参数,探讨高原低氧暴露对儿童青少年游泳运动员肺动脉压及心脏功能的影响。方法:以儿童青少年游泳运动员共33人为研究对象,平均年龄12.25±0.36岁。分别于高原前以及进入高原(海拔2366米)12小时采用彩色多普勒超声心动图估测肺动脉收缩压并测量心脏功能参数。彩超检查日晨起,肘正中静脉取血,测试血清内皮素(ET-1)和一氧化氮(NO)。于进入高原12小时进行急性高山病(AMS)评分并完成高原肺水肿(HAPE)早期症状问诊。结果:(1)33名运动员均未出现HAPE的相应症状;(2)初入高原儿童青少年游泳运动员肺动脉收缩压(PASP)显著高于高原前水平(20.32±3.71 vs 18.14±3.69 mm Hg,P<0.05)且与年龄呈负相关(r=-0.26,P<0.01),其最高值为29 mm Hg;(3)初入高原儿童青少年游泳运动员SV下降,心率升高而CO升高。左心室Tei指数以及右心室Tei指数均未发生显著变化(0.34±0.09 vs 0.32±0.06,P>0.05;0.28±0.04 vs0.24±0.09,P>0.05);(4)初入高原儿童青少年游泳运动员血清ET-1显著高于高原前水平(123.45±23.45 vs109.57±15.32 ng/l,P<0.05),且与PASP正相关(r=0.3,P=0.035)。血清NO显著低于高原前水平(120.78±32.55 vs 136.42±36.97μmol/l,P<0.05),且与PASP负相关(r=-0.306,P=0.042)。结论:(1)海拔2366米高原可以引起儿童青少年游泳运动员PASP升高,PASP升高与ET-1的释放增加以及NO合成减少有关,而PASP升高并未对心脏功能构成影响;(2)海拔2366米高原儿童青少年游泳运动员AMS以及HAPE的发生率较低。Purpose To investigate the change in the cardiac function of children and adolescent swimmers after hypoxic exposure. Methods Thirty three children and adolescent swimmers（average age： 12.25 ±0.36years）participated in our research. The echocardiography was performed for the subjects at plain and 12 hours after staying at altitude of 2366 m. Pulmonary artery pressure was estimated by measuring systolic right ventricular to right atrial pressure gradient. The presence of acute mountain sickness（AMS）was assessed with the Lake Louise Scoring System and the early symptoms of high altitude pulmonary edema（HAPE）was assessed clinically. Tei index [（ICT＋IRT） / ET）] and endothelin-1（ET-1）were also tested. Results（1）None of the participants developed symptoms or clinical signs of HAPE.（2）Pulmonary artery pressure was higher at high than at low altitude（20.32±3.71 vs 18.14±3.69 mm Hg,P〈0.05）,and was inversely related to the age of t he subjects（r=-0.26,P〈0.01）. The highest value of pulmonary artery pressure was 29 mm Hg at high altitude.（3）12 hours after hypoxic exposure,the resting heart rate increased,stroke volume decreased and cardiac output increased significantly,and there was no significant differences in Tei index of the left ventricle and right ventricle（0.34 ±0.09 vs 0.32 ±0.06,P 0.05;0.28 ±0.04 vs 0.24 ±0.09,P 0.05）before and after the hypoxic exposure.（4）The ET-1 was higher at high than at low altitude（123.45±23.45 vs 109.57±15.32 ng/l,P〈0.05）and was positively related to the PASP of the subjects（r=0.3,P=0.035）. Serum NO was lower at high than at low altitude（120.78±32.55 vs 136.42±36.97μmol/l,P〈0.05）and was inversely related to PASP of the subjects（r=-0.306,P=0.042）. Conclusions（1）The hypoxic exposure at 2366 m altitude could cause the elevation of PASP in children and adolescent swimmers. The cardiac function of the subjects remained unchanged even when the altitude-induced pulmonary hypertension appeared. The increase

关 键 词：儿童青少年游泳运动员 高原低氧 心脏功能 肺动脉收缩压 

分 类 号：R87[医药卫生—运动医学]