高温高湿环境下军事训练致新兵横纹肌溶解及相关脏器损伤的研究  

Rhabdomyolysis and related organ damage in new recruits during military training under high temperature and humidity environment

作　　者：沈建 张昕 刘赫男 周伯宁 李影 焦阳 刘冰[3] 郑小来 付振虹 SHEN Jian;ZHANG Xin;LIU Henan;ZHOU Boning;LI Ying;JIAO Yang;LIU Bing;ZHENG Xiaolai;FU Zhenhong(Department of Cardiology,the Sixth Medical Center,Chinese PLA General Hospital and Chinese PLA Medical School,Beijing,100853;Department of Cardiology,No.305 Hospital of PLA,Beijing,100034;Department of Cardiology,No.970 Hospital of PLA,Weihai,Shandong Province,264299;Department of Cardiology,Jiayuguan Hospital of Traditional Chinese Medicine,Jiayuguan,Gansu Province,735199;Outpatient Department of Tongzhou Retired Cadres Rest Center,Beijing,101149,China)

机构地区：[1]解放军医学院解放军总医院第六医学中心心血管病医学部,北京100853 [2]中国人民解放军第三〇五医院心血管内科,北京100034 [3]中国人民解放军第九七〇医院心血管内科,山东威海264299 [4]甘肃省嘉峪关市中医院心血管内科,甘肃嘉峪关735199 [5]通州离职干部休养所门诊部,北京101149

出　　处：《陆军军医大学学报》2024年第10期1063-1067,共5页Journal of Army Medical University

基　　金：解放军总医院青年成长项目(QNC19004)。

摘　　要：目的通过比较不同训练环境对新兵实验室检测指标及心电图的影响,探讨新兵在高温高湿环境下出现横纹肌溶解和相关脏器损伤的可能性。方法选择两地新兵500名,均为男性,年龄(21.36±2.59)岁,按新兵所在环境分为常规环境组(北京某部,n=250)和高温高湿环境组(海南某部,n=250)。进行相同科目训练后4周,采集新兵的一般情况、训练前后血液及尿液学指标、心电图检查相关指标,并进行统计学分析。结果高温高湿环境组炎症反应、心肌损伤、肌肉损伤、肝损伤、肾损伤的发生率分别为45.76%、3.39%、12.71%、25.42%、12.71%,较常规环境组显著增加(P<0.05)。高温高湿环境组新兵窦性心动过缓、房性早搏、非特异ST-T变化、左室高电压、短PR间期的发生率分别为6.78%、5.93%、8.47%、6.78%、2.54%,显著高于常规环境组(P<0.05)。结论高温高湿环境下新兵军事训练后更易出现炎性反应、心肌损伤、肌肉损伤、肝损伤、肾损伤以及心电异常。Objective To explore the possibility of rhabdomyolysis and related organ damage in new recruits training in high temperature and high humidity environment by comparing the effects of different training environments on the laboratory indicators and electrocardiogram.Methods A total of 250 new recruits from a unit in Beijing and another 250 ones from a unit in Hainan were recruited and assigned into conventional environment group and high temperature and high humidity environment group,respectively.All of them were male,with an average age of 21.36±2.59 years.Before and in 4 weeks after training in the same subjects,their general information,blood and urine indicators,and electrocardiogram were collected.All data were statistically analyzed.Results The incidences of inflammatory reaction,myocardial injury,muscle injury,liver injury,and kidney injury were 45.76%,3.39%,12.71%,25.42%,and 12.71%,respectively,in the high temperature and high humidity environment group,which were all significantly higher than those in the conventional environment group(P<0.05).The former group had an incidence rate of 6.78%,5.93%,8.47%,6.78%,and 2.54%,respectively,in sinus bradycardia,atrial premature beats,unspecific ST-T changes,left ventricular hypertension and short PR interval,and all of the rates were higher than those of the conventional environment group(P<0.05).Conclusion The incidences of inflammatory reaction,myocardial injury,muscle injury,liver injury,kidney injury,and ECG abnormalities are more common in new recruits after military training in high temperature and high humidity environment.

关 键 词：军事训练 高温 高湿 横纹肌溶解 脏器损伤 心电图异常 

分 类 号：R337.52[医药卫生—人体生理学] R685.5[医药卫生—基础医学] R821.2