CAJ | 학술논문

目的：研究急速进入高原地区的健康中、青年人群心、肺功能的改变。方法选择武汉市医疗机构2011-2013年急速进入高原地区行医疗资源支持的健康志愿者27名,进入高原地区前和进入高原地区24~48 h均经胸心脏超声记录所有受试者心脏超声数值并计算肺动脉平均压( PAMP)和全肺阻力( TPR),行动脉血气分析记录血氧饱和度( SaO2)、二氧化碳分压( PCO2)、血红蛋白( Hb)、pH值以及B型钠尿肽( BNP)。观察急性高原反应( acute mountain sickness, AMS)的发生情况。结果所有受试者进入高原地区24~48 h未出现AMS。16例受试者出现相对性碱中毒。进入高原地区后24~48 h 左心室舒张末最大径( LVd )、左心室射血分数( LVEF )、右心室射血分数(RVEF)和血红蛋白(Hb)与进入高原地区前比较无明显变化(P>0．05),而右心室舒张末最大径(RVd)、PAMP、TPR、pH和BNP较进入高原地区前升高,SaO2、PCO2较进入高原地区前降低(P<0．01)。结论急速进入高原地区的中、青年健康志愿者短期内会出现TPR、肺动脉压力上升等改变,并存在早期右心功能不全。
목적：연구급속진입고원지구적건강중、청년인군심、폐공능적개변。방법선택무한시의료궤구2011-2013년급속진입고원지구행의료자원지지적건강지원자27명,진입고원지구전화진입고원지구24~48 h균경흉심장초성기록소유수시자심장초성수치병계산폐동맥평균압( PAMP)화전폐조력( TPR),행동맥혈기분석기록혈양포화도( SaO2)、이양화탄분압( PCO2)、혈홍단백( Hb)、pH치이급B형납뇨태( BNP)。관찰급성고원반응( acute mountain sickness, AMS)적발생정황。결과소유수시자진입고원지구24~48 h미출현AMS。16례수시자출현상대성감중독。진입고원지구후24~48 h 좌심실서장말최대경( LVd )、좌심실사혈분수( LVEF )、우심실사혈분수(RVEF)화혈홍단백(Hb)여진입고원지구전비교무명현변화(P>0．05),이우심실서장말최대경(RVd)、PAMP、TPR、pH화BNP교진입고원지구전승고,SaO2、PCO2교진입고원지구전강저(P<0．01)。결론급속진입고원지구적중、청년건강지원자단기내회출현TPR、폐동맥압력상승등개변,병존재조기우심공능불전。
Objective To study cardiac and pulmonary adaptive changes of healthy middle-aged&young adults after rushing into highland area. Methods A total of 27 volunteers from medical institutions in Wuhan City from 2011 to 2013 had transported medical resources into the highland area. The values of transthoracic echocardiography were recor-ded, before and after rushing into the Highland within 24 -48 h, the values of pulmonary arterial mean pressure ( PAMP) and total pulmonary resistance ( TPR) were calculated, and values of oxygen saturation ( SaO2 ) , partial pres-sure of carbon dioxide ( PCO2 ) , hemoglobin ( Hb) , potential of hydrogen ( PH) and B-type natriuretic peptide ( BNP) were analyzed by arterial blood gas analysis. The incidence of acute mountain sickness ( AMS) was also observed. Re-sults No volunteers suffered AMS after rushing into highland areas within 24-48 h, but 16 patients experienced relative alkalosis. Within 24-48 hours upon rushing into highland areas, the differences in values of left ventricular end-diastolic pressure ( LVd) , left ventricular ejection fraction ( LVEF) , right ventricular ejection fraction ( RVEF) and hemoglobin (Hb) showed no statistically significances (P>0. 05); the values of right ventricular end-diastolic pressure (RVd), PAMP, TPR and BNP were significantly increased, while the values of SaO2 and PCO2 were significantly decreased com-pared with those before rushing ( P<0. 01 ) . Conclusion The healthy middle-aged & young adults after rushing into highland areas may experience TPR and ascending pulmonary vascular resistance with early right heart insufficiency.