急进高原后男性官兵心功能的变化及其与AMS的关系

发布时间：2018-07-11 13:57

本文选题：急性高山病 + 左心室　；参考：《中国病理生理杂志》2017年12期

【摘要】：目的:评价驻平原官兵急进高原前后心功能的变化情况并探讨其与急性高山病(AMS)的关系。方法:采用超声心动图评价42名健康青年男性官兵进入高原前及快速进入高原后(3 658 m,3 d)的心脏功能,同时观察心率、血压和血氧饱和度等生理指标的变化,以及进入高原后AMS的发病情况。结果:与进入高原前相比,青年男性官兵急进高原后,左房收缩末期内径和左室舒张末期内径显著减小,右房收缩末期内径显著减小,右室流出道和肺动脉内径显著增宽,射血分数显著增大,心输出量显著增多,肺动脉收缩压及平均肺动脉压显著增高,二尖瓣E峰流速显著降低(P0.05)。进入高原后,42人中有15人发生AMS(AMS组),27人未发病(non-AMS组)。比较2组官兵在平原的心功能发现,AMS组的主动脉窦部内径和左室舒张末期内径显著小于non-AMS组,肺动脉收缩压显著高于non-AMS组。比较2组官兵进入高原后的心功能发现,AMS组左房收缩末期内径显著小于nonAMS组(P0.05)。AMS评分与进入高原前的心输出量呈显著负相关性(r=-0.3814,P0.05)。结论:青年男性官兵从平原快速进入高原后,右心功能受损合并左心功能代偿;在平原运用超声心动图进行肺动脉收缩压及心输出量的检查有助于AMS易感人群的筛选。
[Abstract]:Objective: to evaluate the changes of cardiac function and its relationship with acute alpine disease (AMS). Methods: echocardiography was used to evaluate the cardiac function of 42 healthy young male officers and soldiers before and after entering the plateau quickly (3 658 mm / 3 d). The changes of heart rate, blood pressure and oxygen saturation were observed at the same time. And the incidence of AMS after entering high altitude. Results: compared with those before entering the plateau, the left atrial end-systolic diameter and left ventricular end-diastolic diameter, the right atrial end-systolic diameter and the right ventricular outflow tract and pulmonary artery diameter of young male officers and soldiers decreased significantly, and the right ventricular outflow tract and pulmonary artery diameter widened significantly. Ejection fraction increased, cardiac output significantly increased, pulmonary artery systolic pressure and mean pulmonary artery pressure increased significantly, mitral valve E peak velocity decreased significantly (P0.05). After entering high altitude, 15 out of 42 patients developed AMS (AMS group) and 27 did not (non-AMS group). Comparing the cardiac function of the two groups in plain, it was found that the aortic sinus and left ventricular end-diastolic diameter in AMS group were significantly lower than those in non-AMS group, and the pulmonary artery systolic pressure was significantly higher than that in non-AMS group. Compared with the cardiac function of the two groups after entering the high altitude, the left atrial end-systolic diameter in the AMS group was significantly lower than that in the nonAMS group (P0.05). The AMS score had a significant negative correlation with the cardiac output before entering the high altitude (r = 0.3814, P 0.05). Conclusion: after young male officers and soldiers enter high altitude quickly from plain, the right heart function is damaged and the left heart function compensates, and the examination of pulmonary artery systolic pressure and cardiac output by echocardiography in plain is helpful to the screening of susceptible population of AMS.
【作者单位】：第三军医大学高原军事医学系高原特需药品与卫生装备研究室高原环境医学教育部重点实验室全军高原医学重点实验室;
【基金】：军队十二五重大课题(No.AWS14C007) 第三军医大学高原医学特殊学科点项目(No.J1310001)
【分类号】：R82

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