急性高原暴露后左心功能变化及与急性高原病的关系

目的：研究青年男性由平原急进高原后心脏血流动力学变化及其与急性高原病的关系。方法：分别检测218名健康青年男性在平原及急进高原24h内的血压、心卒和血氧饱和度，使用彩色多普勒超声仪检测左心功能；根据路易斯湖评分标准将受试者分为急性高原病纽（AMS组）和无急性高原病组（无AMS组）。结果：急性高原暴露后心率、舒张压、平均动脉压、左室射血分数、每搏输出量、每博指数、心输出量、心脏指数显著增加（P〈0．05），血氧饱和度、左室收缩末容积则显著降低（P〈0．05）；急进高原后AMS组心率、收缩压、平均动脉压显著高于无AMS组（P〈0．05），每博指数、左室舒张末容积显著低于无AMS组（P〈0．05）。结论：健康男性青年急性高原暴露后左心室收缩功能增强，左室舒张末容积、心率、每博指数可能作为预测急性高原病的参考指标。

The change of left ventricular function upon acute high altitude exposure and its relationship with acute mountain sickness

Objective： To investigate the changes of the cardiac hemodyrmmics after acute high altitude exposure in healthy young males and the relationship with acute mountain sickness（AMS）. Methods： Left ventricular function and oxyhemoglobin saturation （SaO2）, heart rate （HR）, blood pressure （BP） were measured in 218 healthy young males before and after high altitude exposure within 24 h respectively. According to the lake louise score criteria, the subjects were divided into two groups： acute mountain sickness group （AMS group） and non acute mountain sickness group （non-AMS group）. Results： HR, diastolic blood pressure （DBP）, mean arterial pressure （MAP）, left ventricular ejection fraction （LVEF）, stroke volume （SV）, stroke index （SI） cardiac output（CO）, cardiac index（CI） were significantly increased upon acute high altitude exposure（ P 〈 0.05）. Whereas SaO2 and end-systolic volume （ESV） were significantly decreased （ P 〈 0.05）. In addition, HR, systolic blood pressure （SBP） and MAP in AMS group were significantly higher than those in non-AMS group（ P 〈 0.05）. But stroke index （SI） and end-diastolic volume （EDV） in AMS group were significantly lower than those in non-AMS group （ P 〈 0.05）. Conclusion： Cardiac function in healthy young males upon acute high altitude exposure was enhanced. EDV, HR and SI might become the indexes of predicting the acute mountain sickness in the future.