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目的研究高原高寒地区短期驻训对罹患高血压Ⅰ级青年官兵血压的影响并分析其可能机制。方法测定13名高血压Ⅰ级青年官兵基础血压和高原驻训期间血压和心率(驻训10,30,60 d),并采集相应时间点血样检测血管紧张素Ⅰ、血管紧张素Ⅱ、醛固酮和皮质醇水平。结果进驻高原10 d后官兵收缩压和舒张压均较基线水平显著升高(P<0.05),此后驻训30 d和驻训60 d患者收缩、舒张压数值均高于基线水平(P<0.05)。比较驻训高原前后全天平均心率未见组间明显差异。分析机制发现,高原驻训10 d起血管紧张素Ⅰ和血管紧张素Ⅱ水平均较驻训前显著升高(P<0.05),且此后持续高于驻训前水平(P<0.05),而血清醛固酮和皮质醇水平在驻训60 d时较驻训前显著升高(P<0.05)。结论高原高寒环境作为应激刺激会导致高血压1级青年官兵血压出现持续升高,其机制可能与肾素-血管紧张素-醛固酮系统激活及应激激素水平升高相关。
Objective To study the effect of short-term resident training on the blood pressure of first-grade young officers and men with hypertension in the plateau and alpine region and to analyze the possible mechanism. Methods The blood pressure and heart rate of 13 grade Ⅰ young men and women of the first grade were measured and the blood pressure and heart rate were measured at training days (10, 30, 60 days after training). Blood samples were collected to detect the levels of angiotensin Ⅰ, angiotensin Ⅱ, aldosterone and Cortisol levels. Results The systolic pressure and diastolic pressure of officers and soldiers were significantly higher than those of the baseline at 10 days after entering the plateau (P <0.05), and the values of systolic and diastolic blood pressure were higher than baseline at 30 days after training and at 60 days after training ). There was no significant difference between the two groups in the mean daily heart rate before and after training in the plateau. The analysis found that the levels of angiotensin I and angiotensin II in the 10th day of training were significantly higher than those before training (P <0.05), and remained higher than those before training (P <0.05) Serum aldosterone and cortisol levels were significantly higher at 60 d after resuscitation than before resuscitation (P <0.05). CONCLUSIONS: Alpine conditions in the plateau lead to the continual increase of blood pressure in the first grade hypertensive patients, which may be related to the activation of the renin-angiotensin-aldosterone system and the elevation of stress hormone levels.