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目的:研究汉族人群移居高原后其心脏结构、心功能、肺动脉压变化。方法:随机选取从内地平原移居至西藏高原多年(移居高原时间:28.88年±9.76年)的汉族人群,经病史及相关检查排除其他原因引起疾病共67例为移居高原组,并随机选取内地平原健康者61例为平原对照组。分别检测其心脏结构、心脏功能、肺动脉压和瓣膜口血流速度等指标,并进行统计分析探讨高原心血管适应问题。结果:移居高原组右心房、右心室和左心房内径;肺动脉收缩压、肺动脉内径、右肺动脉内径,均显著大于平原对照组(P<0.001),而且移居高原组内肺动脉收缩压与右心房、右心室内径存在正相关关系(r=0.370,P=0.011;r=0.403,P=0.005)。移居高原组左室射血分数显著高于平原对照组(P=0.018)、而心脏指数明显低于平原对照组(P=0.036)、每搏输出量和心输出量值两组无明显差异。移居高原组二尖瓣舒张期血流E峰、二尖瓣舒张期血流A峰、三尖瓣舒张期血流E峰、三尖瓣舒张期血流A峰均明显高于平原对照组(P=0.000)。结论:本研究表明,汉族人群移居高原多年后其心脏结构、心功能、肺动脉压、瓣口血流速度等指标均发生了显著的高原适应性变化;而且研究表明移居高原者心脏增大与肺动脉收缩压升高之间存在关联。
Objective: To study the changes of heart structure, cardiac function and pulmonary arterial pressure after Han population migrated to plateaus. Methods: A random sample of 67 Han Chinese who migrated from the hinterland plain to the Tibetan plateau for many years (28.88 ± 9.76 years of age) were excluded from the plains. 61 healthy subjects were plain control group. The cardiac structure, cardiac function, pulmonary arterial pressure and valvular flow velocity were measured respectively, and statistical analysis was conducted to investigate the cardiovascular adaptation in plateau. Results: The diameter of the right atrium, right ventricle and left atrium in the plateau group were significantly higher than those in the control group (P <0.001). The systolic pulmonary artery pressure, the diameter of the pulmonary artery and the diameter of the right pulmonary artery in the plateau group were significantly higher than those in the plain control group Right ventricular diameter has a positive correlation (r = 0.370, P = 0.011; r = 0.403, P = 0.005). Left ventricular ejection fraction was significantly higher in the plateau group than in the plain control group (P = 0.018), but the cardiac index was significantly lower than that in the plain control group (P = 0.036). There was no significant difference in stroke volume and cardiac output between the two groups. The mitral diastolic flow peak E, mitral diastolic flow peak A, tricuspid diastolic flow E peak and tricuspid diastolic flow peak A were all significantly higher in the plateau group than those in the plain control group P = 0.000). CONCLUSIONS: This study indicates that significant changes in plateau fitness have been observed in many indicators of cardiac structure, cardiac function, pulmonary arterial pressure, and apical flow velocity in Han Chinese population after being migrated to the plateau for many years. Moreover, studies have shown that elevated heart and pulmonary artery There is a correlation between elevated systolic blood pressure.