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目的了解健康青年人由平均海拔400 m平原初次进入平均海拔3 680 m高原后同海拔、不同时相(进入高原后1 d、1周、1个月)的心脏功能的变化情况。方法使用美国索诺声公司MMX型便携式心脏彩超仪,由同一人分别测47例健康男性青年进高原前1周在平原地区及进入高原地区后同海拔不同时相的室间隔的厚度与运动幅度、左室后壁的厚度与运动幅度、左室舒张末内径、左室舒张末容积、左室收缩末容积、肺动脉压(pulmonary artery pressure,PAP),计算射血分数(left ventricular ejection fraction,LVEF)、短轴缩短率(left ventricular minor axis decurtation,LVMAD,△D%)、每搏量(stroke volume,SV)、心输出量(cardiac output,CO)。使用北京福田公司7101型心电图机,由同一人分别做47例健康男性青年进高原前1周在平原地区及进入高原地区后同海拔不同时相的心电图(electrocardiogram,ECG),计算心率(heart rate,HR)。结果与平原相比较:进入高原1 d的HR、PAP、CO明显增高(P<0.05),SV则明显降低(P<0.05);进入高原1周的HR、PAP明显增高(P<0.05),LVEF、△D%、SV明显降低(P<0.05);进入高原1个月时CO、PAP明显增高(P<0.05),LVEF、△D%、SV明显降低(P<0.05);与进入高原1 d相比较:进入高原1周时HR、LVEF、△D%、SV、CO均明显降低(P<0.05);进入高原1个月的PAP明显增高(P<0.05),HR、CO明显降低(P<0.05);与进入高原1周相比较:进入高原1个月的LVEF、△D%、SV、CO明显增高(P<0.05),HR明显降低(P<0.05)。结论健康男性青年进高原后心脏功能会出现明显的变化,其变化在急进高原早期(1周内)较为明显,此期应注意对急性高原病及心血管意外的预防。1个月后,机体进入习服期,此时心脏功能仍明显异常者可能为罹患慢性高原病的高危人群。
Objective To understand the change of cardiac function of healthy young people from the average altitude of 400 m plain for the first time into an altitude of 3 680 m high altitude and at different time phases (1 d, 1 week, 1 month after entering the plateau). Methods Using Sonoac MMX portable cardiac color Doppler, the same person were measured 47 healthy young men into the plateau 1 week before and after entering the plateau region at different altitudes of the interventricular septum thickness and amplitude Left ventricular end-diastolic diameter, left ventricular end-diastolic volume, left ventricular end-diastolic volume, pulmonary artery pressure (PAP), left ventricular ejection fraction (LVEF ), Left ventricular minor axis decurtation (LVMAD, ΔD%), stroke volume (SV) and cardiac output (CO). Using Beijing Futian 7101 electrocardiogram machine, the electrocardiogram (ECG) of 47 healthy male adolescents one week before entering the plateau and into the plateau area at the same altitude were taken from the same person to calculate the heart rate , HR). Results Compared with the plain, HR, PAP, CO increased significantly (P <0.05) and SV decreased significantly (P <0.05) LVEF, △ D% and SV were significantly decreased (P <0.05); CO, PAP significantly increased (P <0.05), LVEF, △ D% and SV decreased significantly at 1 month after entering the plateau (P <0.05). The PAP of one month after entering the plateau increased significantly (P <0.05), but HR and CO decreased significantly (P <0.05). Compared with 1 week after entering the plateau, the LVEF, △ D%, SV, CO increased significantly (P <0.05) and HR decreased significantly (P <0.05) Conclusions The healthy male youth will have obvious changes in cardiac function after entering the highland. The changes are obvious in the early stage of acute plateau (within 1 week), and should pay attention to the prevention of acute altitude sickness and cardiovascular accidents in this period. One month later, the body into the accustomed period, when abnormal cardiac function may still be at high risk of suffering from chronic mountain sickness.