应用超声分析高原居住时间对急进高海拔人群视神经鞘直径的影响  

Effect of residence time in high altitude on the optic nerve sheath diameter in rapid ascent to high altitude people:an ultrasonic analysis

作　　者：张芸芸 杨登 李新顺[3] 马小婷 张建波 ZHANG Yunyun;YANG Deng;LI Xinshun;MA Xiaoting;ZHANG Jianbo(Department of Ultrasound Diagnosis,the 925th Hospital of PLA,Guiyang 550009,China)

机构地区：[1]中国人民解放军第九二五医院超声诊断科,贵阳市550009 [2]中国人民解放军第九二五医院预防控制科,贵阳市550009 [3]中国人民解放军第九二五医院院办,贵阳市550009 [4]中国人民解放军第九二五医院检验病理科,贵阳市550009 [5]中国人民解放军南部战区总医院神经外科

出　　处：《临床超声医学杂志》2024年第11期900-905,共6页Journal of Clinical Ultrasound in Medicine

基　　金：基础加强计划重点基础研究项目(2019-JCJQ-ZD-141-02-06)。

摘　　要：目的 应用超声测量急进高海拔人群视神经鞘直径(ONSD),并与高原原住居民ONSD进行对比分析,探讨急进高海拔人群ONSD随高原居住时间的变化规律及其影响因素。方法 选取从海拔1100 m急进至海拔3500 m处高原且居住时间不少于6个月的健康志愿者53例(试验组)及高原原住居民健康志愿者137例(对照组),应用超声测量试验组初到高原时及高原居住3、6个月时左、右眼ONSD,以及对照组左、右眼ONSD。比较两组男、女性ONSD,以及试验组不同高原居住时间男、女性ONSD的差异。采用简单线性回归分析两组ONSD与性别、体质量指数(BMI)、吸烟、体质量、年龄、身高、收缩压、舒张压及脉搏的关系;多元线性回归分析筛选两组ONSD的独立影响因素。结果 对照组和试验组初到高原时男性左、右眼ONSD均大于女性,差异均有统计学意义(均P<0.05);且试验组男性和女性左、右眼ONSD均小于对照组,差异均有统计学意义(均P<0.01)。随着高原居住时间的延长,试验组男性和女性左、右眼ONSD均增大,但女性高原居住3、6个月时左、右眼ONSD与初到高原时比较差异均无统计学意义;男性高原居住6个月时左、右眼ONSD与初到高原时比较差异均有统计学意义(均P<0.05)。对照组和试验组初到高原时男性双眼平均ONSD均大于女性,差异均有统计学意义(均P<0.05)。简单线性回归分析显示,对照组ONSD与性别、BMI、吸烟及体质量均相关(均P<0.01);试验组ONSD与性别、吸烟均相关(均P<0.01);多元线性回归分析显示,性别为试验组和对照组ONSD的共同独立影响因素(均P<0.05),而BMI为对照组ONSD的独立影响因素(P=0.017)。结论 超声可用于评估急进高海拔人群ONSD;急进高海拔人群ONSD较高原原住居民低,其大小随高原居住时间的延长缓慢增加,且高原居住时间对男性ONSD的影响较女性大。Objective To measure the optic nervr sheath diameter(ONSD)in rapid ascent to high altitude people by ultrasound,and compare with that of native high-altitude residents,to explore the changes and influencing factors of ONSD in rapid ascent to high altitude people with residence time.Methods Fifty-three healthy volunteers who rapid ascend from an altitude of 1100 m to an altitude of 3500 meters and stayed for at least 6 months were selected as the experimental group,and 137 native healthy high-altitude residents as the control group.Ultrasound measurements of ONSD in both eyes were taken in the experimental group upon initial arrival,after 3,6 months of residence at high altitude.Measurements were also taken in both eyes in the control group.ONSD of males and females in both groups were compared,as well as across different high-altitude residence time in the experimental group.Simple linear regression was used to analyze the relationship between ONSD and gender,body mass index(BMI),smoking,weight,age,height,systolic blood pressure,diastolic blood pressure and pulse in two groups.Multiple linear regression was used to identify the independent influencing factors for ONSD in two groups.Results Upon initial arrival,ONSD of males in the control and experimental groups were larger than those of females(all P<0.05),and the ONSD in both eyes of males and females in the experimental group were significantly smaller than those of the control group(all P<0.01).With prolonged high-altitude residence,the ONSD in both eyes increased in males and females in the experimental group.However,for females,there were no significant difference in ONSD at 3,6 months compared with initial arrival.For males,there were significant differences in ONSD in both eyes at 6 months compared with initial arrival(all P<0.05).Both the control group and newly arrived males in the experimental group had a higher average ONSD than females(both P<0.05).Simple linear regression analysis showed that ONSD in the control group was correlated with gender,BMI,

关 键 词：超声检查 视神经鞘 视神经鞘直径 急进高海拔人群 

分 类 号：R445.1[医药卫生—影像医学与核医学]