摘要
目的评价高原低氧环境对心血管系统的影响。方法人群试验采用分组调查从平原到高原地区工作的男性青年志愿者1244人。其中A组486人，地区海拔2260-2800m；B组675人。海拔3800—4300m；C组83人，海拔〉4500m。对比分析各组症状反应及入住时间和海拔高度的关系。动物实验：将平原兔24只随机分为4组，每组6只。A组为平原对照组，B、C、D组为平原兔在48h内直接迁饲到海拔4320m地区后1d、7d和30d组。选高原（海拔2260m）兔12只随机分为E、F两组，每组6只，E组为高原对照组，F组为24h内迁饲到海拔4320m后1d。各组宰杀后取心脏及动静脉行HE染色进行病理学观察。结果人群试验结果：B组和C组人群平均血氧饱和度值分别为88．14％和74．50％，明显低于A组。A、B、C组胸闷、气短、心悸和口唇紫绀症状阳性率组间比较差异有统计学意义（P〈0．01），A、B组入住≥1年者较初进者各症状明显减少。C组差异无统计学意义（P〉0．05）。动物实验结果：与A组相比，B组心肌间隙增宽，内充红细胞，部分心肌浑浊肿胀，横纹消失或凝固性变，核大小不一致，间质内血管扩张充血；C、D组病变与B组相比较轻。E、F组心肌排列正常，部分心肌横纹模糊或消失，心肌毛细血管扩张充血，核大小一致。在D、E、F组可见动脉血管内皮细胞增生，静脉管壁增厚。结论心血管系统的低氧应激性症状反应与海拔高度成正比，尤其海拔3800m以上地区的症状反应阳性率陡然升高，但随入住时间的延长而下降。高原低氧环境可使心肌细胞形态学发生改变，与海拔及居住时间有关。
Objective To explore the effect on the cardiovascular system when exposed actively in high altitude hypoxia environment. Methods In human trial, 1,244 young male volunteers who work in the high altitude environment transferred from plain were randomly divided into three groups, group A of 486 people on 2,260-2,800 meters above sea levels, group B of 675 people on 3,800-4,300 meters and group C of 83 people on and above 4,500 meters. The altitude sickness associated with time and different heights in groups were observed and analyzed. In animal testing, 24 rabbits were evenly divided into four groups, group A which was kept in plain and served as control group, while the groups B, C, D were transferred to 4,320 meters above sea level in 48 hours for one day, seven days, and 30 days. In addition, 12 altitude rabbits taken from 2,260-meter altitude were transferred to 4,320 meter in 24 hours and divided into 2 groups, group E which served as control group, and group F. HE staining of the heart, artery and vein was observed from histopathological perspective after the rabbits were slaughtered. Results In human trial, mean SaO2 in group B and group C reflected 88.14% and 74.50% respectively, obviously lower than that of group A. There was a statistical difference among group A, B and C on the incidence rates of chest distress, shortness of breath, palpitation and cyanotic lips （P〈0.01）. The altitude sickness reflected less severe in people who lived on altitude for one year or longer than the people who barely arrived in both groups A and B. There was no statistic difference in group C （P 〉 0.05）. In animal testing,compared with group A, it demonstrated the wider gap of myocardial cells, filling with red blood cells, partial cloudy and swelling myocardial cells, stripes disappeared and changed, inconsistent nuclear size, dilated stromal vascular, in group B. Lesions in group C and D were slighter than group B. The myocardial cells in group E and F arranged normally. In group D, E, and F, artery endothelial cell proliferated, and vein wall became thicker. Conclusion The manifestation of hypoxic stress response reflected in direct ratio with altitude, and the incidence rates of these manifestations increase sharply in the areas above 3,800 na sea level. Yet, the incidence rate of acute symptoms gradually decreased with extension of stay. In high altitude hypoxia environment, the myocardial cells change in morphology, and are related to sea level and time of stay.
出处
《中国急救复苏与灾害医学杂志》
2012年第3期217-220,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
高原
低氧
兔
心脏
组织病理学
Altitude
Hypoxia
Rabbit, Heart, Histopathology
