超声仪器对急性高原病患者返回平原前后心血管功能变化评价研究  

Echocardiogram evaluation of cardiovascular functions of acute mountain sickness patient before and after returning plain

作　　者：王银[1] 孙艳丹[1] 邹晓娟[1] 

机构地区：[1]解放军451医院,西安710054

出　　处：《医疗卫生装备》2017年第3期77-79,共3页Chinese Medical Equipment Journal

基　　金：兰州军区医药卫生科研计划项目(CLZ15JA17)

摘　　要：目的:探讨超声仪器对急性高原暴露发生急性高原反应患者返回平原后短期内左心结构和功能评价的价值。方法:选择发生急性轻型高原病并按时返回者33例,采用超声心动图检测受试者上高原前、后以及返回平原的每搏输出量(stroke volume,SV)、心输出量(cardiac output,CO)、左心房容积指数(left atrial volume index,LAVI)、左心室舒张末期容积(left ventricular end-diastolic volume,LVEDV)、舒张早期二尖瓣血流速度(E峰)以及舒张晚期二尖瓣血流速度(A峰)等指标。结果:与上高原前比较,上高原1 d后心率(heart rate,HR)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、CO、A峰、LAVI增加(P均<0.05),SV、E峰、E/A、LVEDV减小(P均<0.05);1月后HR、SBP、DBP、CO、A峰、E峰、E/A均有不同程度恢复(与初上高原比较,P均<0.05),但是尚未恢复到上高原前水平(与上高原前比较,P均<0.05),LVEDV、LAVI、SV恢复到上高原前水平(P均>0.05);返回平原1周后,LVEDV、SV、SBP、LAVI、E峰均恢复到高原前水平(P均>0.05),CO、HR、DBP、A峰仍高于高原前水平(P均<0.05),E/A低于上高原前水平(P<0.05)。结论:超声心动图可以对急性高原病患者左心室结构和功能进行准确评价,尤其对于急性轻型高原病患者习服期以及返回平原前后的心血管结构和功能进行动态评价,为临床干预措施提供有价值的参考信息。Objective To investigate the values of echocardiogram for evaluating the changes of left ventricular structure and cardiovascular function of the acute mountain sickness（AMS）patient before and after returning the plain.Methods A total of33 light AMS patients returning to the plain in time underwent echocardiogram examinations on some cardiovascular indexes before and after returning the plain,including stroke volume（SV）,cardiac output（CO）,left atrial volume index（LAVI）,left ventricular end-diastolic volume（LVEDV）,early diastolic mitral flow velocity（E）,late diastolic mitral flow velocity（A）and so on.Results The values of heart rate（HR）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,CO,A and LAVI after going to the plateau were all significantly higher than those before going to the plateau（P〈0.05）,while the values of SV,E,E/A and LVEDV were obviously lower（P〈0.05）.The values of HR,SBP,DBP,CO,A,E and E/A recovered respectively 1 month after going to the plateau when compared with those before going to the plateau（P〈0.05）,while did not restore to the ones before going to the plateau（P〈0.05）,and the values of LVEDV,LAVI and SV reached the level before going to the plateau（P〈0.05）.The values of LVEDV,SV,SBP,LAVI and E 1 week after returning to the plain came to the level before going to the plateau（P〈0.05）,and the values of CO,HR,DBP and A were significantly higher（P〈0.05）while the value of E/A was statistically lower（P〈0.05）.Conclusion Echocardiogram can be used to evaluate the left ventricular structure and cardiovascular function of the AMS patient,especially for those light AMS patients in acclimatization period or before and after returning to the plain.

关 键 词：超声心动图 急性高原暴露 急性高原反应 心血管功能 习服 

分 类 号：R594.3[医药卫生—内科学] R540.45[医药卫生—临床医学]