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。     

Effect of high altitude on sensitivity to the taste of phenylthiocarbamide

Sensitivity to the taste of phenylthiocarbamide (PTC) was studied using the Harris-Kalmus method in healthy human volunteers at sea level and then subsequently at an altitude of 3500 m over a period of 3 weeks, after which they were brought back to sea level. Blood sugar, insulin and blood cortisol levels were estimated weekly. The results indicated that, out of 51 subjects studied, 26 (55%) were PTC tasters at sea level. Eight of those unable to taste PTC at sea level tested as tasters at high altitude, and 2 of them reverted to being non-tasters on return to sea level. In the blood, an increase in cortisol and blood insulin levels was seen without any significant change in sugar levels. All the changes recorded at high altitude tended to return to basal values after re-induction to sea level. The study suggests that high-altitude hypoxia in some way, possibly involving changes in hormonal profile among other factors, causes an alteration in sensitivity to the taste of PTC, resulting in some of the individuals shifting to lower PTC sensitivity. Received: 24 November 1999 / Accepted: 25 January 2000     

Mast cells in the human lung at high altitude

Mast cell densities in the lung were measured in five native highlanders of La Paz (3600 m) and in one lowlander dying from high-altitude pulmonary oedema (HAPO) at 3440 m. Two of the highlanders were mestizos with normal pulmonary arteries and the others were Aymara Indians with muscular remodelling of their pulmonary vasculature. The aim of the investigation was to determine if accumulation of mast cells in the lung at high altitude (HA) is related to alveolar hypoxia alone, to a combination of hypoxia and muscularization of the pulmonary arterial tree, or to oedema of the lung. The lungs of four lowlanders were used as normoxic controls. The results showed that the mast cell density of the two Mestizos was in the normal range of lowlanders (0.6–8.8 cells/mm²). In the Aymara Indians the mast cell counts were raised (25.6–26.0 cells/mm²). In the lowlander dying from HAPO the mast cell count was greatly raised to 70.1 cells/mm² lung tissue. The results show that in native highlanders an accumulation of mast cells in the lung is not related to hypoxia alone but to a combination of hypoxia and muscular remodelling of the pulmonary arteries. However, the most potent cause of increased mast cell density in the lung at high altitude appears to be high-altitude pulmonary oedema.     

The pulmonary circulation of some domestic animals at high altitude

Pulmonary haemodynamics and the histology of the pulmonary vasculature have been studied at high altitude in the yak, in interbreeds between yaks and cattle, and in domestic goats and sheep indigenous to high altitudes together with crosses between them and low-altitude strains. Cattle at high altitude had a higher pulmonary arterial pressure than cattle at low altitude. The yak and two interbreeds with cattle (dzos and stols) had a low pulmonary arterial pressure compared with cattle, while the medial thickness of the small pulmonary arteries was less than would be expected in cattle, suggesting that the yak has a low capacity for hypoxic pulmonary vasoconstriction and that this characteristic is transmitted genetically. Goats and sheep showed haemodynamic evidence of a limited response of the pulmonary circulation to high altitude, but no evidence that the high altitude breeds had lost this response. There were no measurable differences in the thickness of the media of the small pulmonary arteries between high- and low-altitude breeds of goats and sheep. All these species showed prominent intimal protrusions of muscle into the pulmonary veins but no specific effect of high altitude in this respect.     

Cardiopulmonary function in bicycle racing over mountainous terrain at moderate altitude

To examine cardiopulmonary function during exercise in a mountainous region at moderate altitude, we measured cardiac frequency, oxygen consumption , and percentage arterial hemoglobin oxygen saturation (%SaO₂) before and after a bicycle race with a starting point at 638 m and finishing point at 1980 m. The time required to ascend an elevation of 10 m was prolonged with increasing altitude, and heart rate also increased with altitude. The %SaO₂ at the starting point and at the finishing point differed significantly (P<0.01). Faster cyclists exhibited higher %SaO₂ and lower , while slower cyclists exhibited a reduction in %SaO₂ and an increase in immediately after the race. The %SaO₂ recovery time was significantly correlated with the racing time (r=0.54,P<0.001). Therefore, the faster cyclists' oxygen debt upon completion of the race may be small and recovery of cardiopulmonary function may be fast, while the slower cyclists' oxygen debt may be large and recovery of cardiopulmonary function may be slow.     

Influence of vanadium on acclimatization of humans to high altitude

 The study was conducted on human volunteers as controls as well as after administration of vanadyl sulphate on induction to high altitude (HA) at 3500 m. The plasma vanadium contents were significantly reduced in the control group on abrupt induction to HA on days 3 and 10, indicating redistribution to other organs/tissues under the stressful situation. In the vanadium salt-treated group, plasma vanadium contents were similar to those obtained at sea-level. Administration of vanadyl sulphate did not act as a diuretic. Moreover the vanadium supplemented group drank more water and also excrete less urine than the control group. Received: 1 November 1995 / Accepted: 9 October 1996     

Biochemical mechanisms of red blood cell 2,3-diphosphoglycerate increase at high altitude

Red blood cell 2,3 diphosphoglycerate (2,3-DPG) levels increase after ascent to high altitude. Studies were undertaken to identify the biochemical mechanisms responsible for eliciting the 2,3-DPG response in several types of subjects. These included (1) short-term exposure to 3400 m in ten subjects; (2) exposure to 4300 m in an additional ten subjects; (3) studies in 28 high-altitude normal residents of 3100 m; and (4) studies in 28 high-altitude residents with chronic mountain polycythemia. Controls were 41 residents of 240 m. Regression analysis identified the glycolytic variables, termed “key variables,” on which variation in 2,3-DPG levels was dependent (P < .05). Key variables common to the short-term studies were glucose-6-phosphate, phosphoenolpyruvate, and the ratio of the levels of adenosine diphosphate to adenosine triphosphate. The positions of these key variables in the glycolytic pathway and their mean levels suggest erythrocyte hexokinase and pyruvate kinase activation as possible enzymatic mechanisms. Key variables unique to the 3400 m study suggested phosphofructokinase activation also acted to increase 2,3-DPG levels. 2,3-DPG levels in the normal 3100 m residents were not different from low-altitude values, and 2,3-DPG levels in these samples did not appear to be dependent on any of the glycolytic variables examined. Among the high-altitude residents with polycythemia, higher 2,3-DPG levels were dependent on glucose-6-phosphate, fructose diphosphate, dihydroxyacetone phosphate, and the ratio of adenosine diphosphate to adenosine triphosphate levels. The positions of these variables in the glycolytic pathway and their mean levels suggested activation of the hexokinase and phosphofructokinase enzymes.     

Similarity of PO2 and PCO2 values in the air cell of eggs of birds and in the alveolar gas of humans at sea level and at high altitude

At the end of incubation, the partial pressures of oxygen and carbon dioxide in the air cell of sea-level avian eggs are similar to those in the expiratory air of adult birds. At high altitude, changes in the permeability of the shell and probably in the embryo metabolism partially compensates the increase in the gas diffusion constant resulting from the low barometric pressure. The aim of this study was to test whether-despite of the adaptive responses of the high altitude avian embryo-the air cell values would be similar to those of the alveolar air of high altitude human natives. Air cell O₂ (48.3±1.6 torr) and CO₂ (20.9±0.85 torr) pressure values were obtained by studying naturally incubated eggs of the Andean gull (Larus serranus)_at 4650m. Sea-level chicken (Gallus gallus) air cell pressure values of O₂ (102.3±2.7 torr) and of CO₂ (43.3±1.3 torr) were obtained from the literature for comparison. Both these values were similar to those found in the alveolar air of humans at sea level (O₂: 104.4±0.4 torr, CO₂:40.1±0.25 torr) and at high altitude (4540 m) (O₂:50.5±0.53 torr, CO₂: 29.1±0.37 torr). Despite very large evolutionary changes in morphology and physiology of the respiratory organs, the head pressure of O₂ that oxygenates the blood keeps a constant value in the pre-pipping avian embryo and in the alveolar air of adult mammals. This constancy holds valid at high altitude.     

The effect of high altitude on saliva aldosterone and glucocorticoid concentrations

Saliva was collected from six healthy young men at hourly intervals at sea level and after 1-2, 8-9 and 15-16 days at 4450 m on Mount Kenya for measurement of aldosterone (SA) and glucocorticoid (SGC, cortisol + cortisone) concentrations. Blood samples were collected simultaneously with some of the saliva samples and analysis of these showed that plasma and saliva concentrations of aldosterone and glucocorticoids were highly correlated (r = 0.91 and 0.75 respectively; p less than 0.01 for both hormones). Mean SA for the group was reduced to approximately 50% of the sea-level value (p less than 0.05) by the time the first saliva samples were collected at altitude, and remained at this depressed level throughout the 2-week period on Mount Kenya, although there was considerable inter-subject variation. SGC concentration also tended to be lower on Mount Kenya than at sea level. Though SA was lower throughout the day at altitude compared to sea level, the principal difference in the temporal pattern of SA was the reduction or complete absence of the marked rise in SA that normally occurs in the first few hours after rising. SA and SGC responses to exercise, which consisted of stepping on and off and 0.4-m high stool 60 times/min for 25 min, were assessed at sea level and after various periods at 4450 m.(ABSTRACT TRUNCATED AT 250 WORDS)     

Hemoglobin concentration of pastoral nomads permanently resident at 4,850-5,450 meters in Tibet

This paper presents data on the hemoglobin concentration of a sample of 103 pastoral nomads who are lifelong residents of Phala, at 4,850-5,450 m, on the northern plateau of the Tibet Autonomous Region of the Peoples' Republic of China. This native population resides at the highest altitude of which we are aware and is thus exposed to the most extreme chronic hypoxic stress. However, they do not exhibit the most pronounced physiological adaptations, i.e., hemoglobin concentrations exceeding those found in all other high-altitude populations. Adult male and female mean hemoglobin concentrations of 18.2 and 16.7 gm/dl, respectively, were found. These data, in conjunction with earlier studies of ethnic Tibetans living at 3,400 m, demonstrate a pattern of increasing hemoglobin concentration (erythrocytosis) at increasing altitude of residence in the Himalayas and Tibet. At the same time, however, the hemoglobin concentration is lower than that found among Andean highlanders. These new data raise the possibility of quantitative population differences in hematological adaptation to high altitude hypoxia.     

Developmental,genetic, and environmental components of aerobic capacity at high altitude

The aerobic capacity of 268 subjects (158 males and 110 females) was evaluated in La Paz, Bolivia situated at 3,750 m. The sample included 1) 39 high altitude rural natives (all male); 2) 67 high altitude urban natives (32 male, 35 female); 3) 69 Bolivians of foreign ancestry acclimatized to high altitude since birth (37 male, 32 female); 4) 50 Bolivians of foreign ancestry acclimatized to high altitude during growth (25 male, 25 female); and 5) 43 non-Bolivians of either European or North American ancestry acclimatized to high altitude during adulthood (25 male, 18 female). Data analyses indicate that 1) high altitude urban natives, acclimatized to high altitude since birth or during growth, attained higher aerobic capacity than subjects acclimatized to high altitude during adulthood; 2) age at arrival to high altitude is inversely related to maximum oxygen consumption (V?O² max) expressed in terms L/min or ml/min/kg of lean body mass, but not in terms of ml/min/kg of body weight; 3) among subjects acclimatized to high altitude during growth, approximately 25% of the variability in aerobic capacity can be explained by developmental factors; 4) as inferred from evaluations of skin color reflectance and sibling similarities, approximately 20 to 25% of the variability in aerobic capacity at high altitude can be explained by genetic factors; 5) except among the non-Bolivians acclimatized to high altitude during adulthood, the aerobic capacity of individuals with high occupational activity level is equal to the aerobic capacity of high altitude rural natives; and 6) the relationship between occupational activity level and aerobic capacity is much greater among subjects acclimatized to high altitude before the age of 10 years than afterwards. Together these data suggest that the attainment of normal aerobic capacity at high altitude is related to both developmental acclimatization and genetic factors but its expression is highly mediated by environmental factors, such as occupational activity level and body composition. © 1995 Wiley-Liss, Inc.     

模拟海拔3600m低氧环境对人的认知灵活性的影响

目的：探讨模拟高原低氧环境对人认知灵活性的影响。方法：低氧舱模拟海拔3600m低氧环境,采用任务转换范式观察低氧模拟各阶段的认知灵活性,同时监测焦虑状态及基本生理指标的变化。23名无高原生活经验、平均年龄25．1岁的男性受试者参加了实验。结果：与低氧暴露1个月后的基础对照相比,低氧阶段的反应时转换损失显著增加;低氧阶段焦虑水平显著高于适应阶段;在适应阶段,焦虑水平与反应时转换损失显著负相关;而在降舱阶段,焦虑水平与反应时转换损失显著正相关。结论：中度低氧暴露影响人的认知灵活性和焦虑状态;低氧暴露前,焦虑可促进个体的认知灵活性;低氧暴露后,焦虑会阻碍个体的认知灵活性。     

炎症介质在高原暴露下血脑屏障通透性改变中的作用及相互关系

目的:探讨炎症介质在高原暴露下血脑屏障通透性改变中的作用及与脑含水量的关系。方法:应用放射免疫法测定脑组织内TNFα、ET含量,化学法测定脑内NO含量,应用伊文思蓝(EB)透过率测定血脑屏障(BBB)通透性,脑湿干比重法测定脑含水量百分率。结果:高原暴露下,大鼠脑内TNFα、ET、NO含量随着海拔增高而逐渐增高,随着暴露时间延长而逐渐增高,以暴露于5000m的高海拔区第9d增高最明显。与此同时,脑内EB含量和脑内含水量逐渐增高。脑内TNFα、ET、NO含量与脑含水量之间有明显的正相关关系。结论:TNFα、ET、NO在BBB通透性增高中起了重要作用,是高原环境下BBB通透性增高的重要因素。     

Growth of lowland native children of European Ancestry during sojourn at high altitude (3,200 m)

The moderate growth retardation frequently observed among children living at high altitude is usually assumed to result from hypoxic stress. However, such children are frequently from the poorer socioeconomic strata of their societies and may suffer malnutrition, poor hygiene, inadequate medical care, and overcrowding—factors also associated with growth retardation. The objective of this study was to determine if there is a statistically observable alteration in the growth of middle-class children of European ancestry during sojourn at high altitude. Semilongitudinal height/weight measurements were gathered retrospectively from medical records of 18 boys and 17 girls who were born at low altitude, were well-nourished and clinically normal, and who had lived at Achoma, Peru (altitude 3,200 m), continuously for 9–36 months. Measurements were divided, by sex, into four cohorts: I (3–6 months at Achoma), II (6–12 months), III (12–18 months), and IV (18–24 months); initial, presojourn, height and weight were also obtained. All heights and weights were normalized with age-specific reference values. Changes in Z scores (ΔZ) during sojourn were calculated for each subject by subtracting the score of the presojourn value from those of cohorts I–IV. Paired t-tests revealed, among the boys, a significant decline in Z score for weight during sojourn in all four cohorts. Weight scores for the girls also declined in all four cohorts, although only the change in cohort III was significant. Height scores showed a decline with time at sojourn in the boys, but in girls there is an initial drop followed by a steady increase to presojourn levels. These results are consistent with the view that moderate hypoxia exerts a primary growth-limiting effect even on healthy, well-nourished children.     

Effect of intermittent chronic exposure to hypoxia on feeding behaviour of rats

Healthy albino male rats were exposed to a simulated high altitude (HA) equivalent to 25000 ft (7620 m) for 6 h daily, continuously for 21 days to study the feeding behaviour. The 24-h food and water intake and body weight once in 3 days were recorded. Blood samples were drawn once a week from the retro-orbital venous plexus for blood sugar analysis. All the parameters were recorded before, during and after exposure to simulated HA. The results show a decrease in 24-h food and water intake and decreased gain in body weight during hypoxic exposure, which showed a tendency to come back to control during the post-exposure period. The blood sugar reflected a state of mild hyperglycaemia during exposure to HA.     

氧化应激在高原重体力劳动过程中急性高原反应发生中的作用

目的：观察氧化应激在高原重体力劳动过程中急性高原反应（AHAR）发生中的作用。方法：由低海拔（1500m）快速进入高原（3700m）并从事重体力劳动的男性官兵96名,年龄18～35岁。根据AHAR症状评分,分为重度AHAR组（A组,n=24）、轻中度AHAR组（B组,n=47）和无AHAR组（C组,n=25）,在该高度逗留50d后下撤前及返回低海拔（1500m）后12h、15d分别测定血清8．异前列腺素F2a（8-iso-PGF2a）、超氧化物歧化酶（SOD）、丙二醛（MDA）,并与低海拔（1500m）50名健康官兵（D组）比较。结果：A组血清8-iso-PGF2a、MDA[分别为（9．53±0．47）μg／L、（8．91±0．39）μmol／L]水平显著高于B组[分别为（8．34±O．42）μg／L、（7．31±0．32）μmol／L]、C组[分别为（7．02±0．48）μg／L、（6．41±0．23）μmol／L和D组[分别为（5．13±0．56）μg／L、（5．48±0．33）μmol／L]（均P〈0．01）,SOD（52．08±3．44）μ／mL水平显著低于B组（62．27±2．54）μ/mL、C组（71．99±3．35）μ/mL和D组（80．78±3．44）μ/mL,（均P〈0．01）,B组与c组之间和C组与D组之间亦有显著性差异（均P〈0．01）。海拔3700mAHAR总计分与血清8-iso-PGF2α、ⅣⅡ）A呈显著正相关（均P〈0．01）,与血清SOD显著负相关（P〈0．01）;8-iso-PGF2α、MDA与SOD显著负相关（均P〈0．01）。海拔3700m50d,血清8-iso-PGF2α、MDA水平显著高于,SOD水平显著低于海拔1500m12h、15d和D组（均P〈0．01）,海拔1500m12h与15d之间有显著性差异（均P〈0．01）,海拔1500m 15d与D组之间无显著性差异。结论：人体在高原低氧并重体力时氧化应激和氧化．抗氧化失衡与AHAR的发病和程度有密切关系,氧化应激和氧化．抗氧化失衡越严重,AHAR越重。返回低海拔后12h有显著改善,15d恢复到正常水平。     

Body fluid status on induction,reinduction and prolonged stay at high altitude of human volunteers

Studies on adaptation to high altitude (HA) of 3500 m in the Himalayas were conducted in three phases, each including 10 normal and healthy males normally resident at sea-level. Phase I subjects had no previous experience of HA, phase II subjects after 4–6 months at HA were airlifted to sea-level and phase III subjects stayed continuously for 6 months at 3500 m. Body fluid compartments and blood gases were determined in all three groups. Plasma volume was highly elevated in the phase II subjects on reinduction to sea-level from HA. In comparison to phase I subjects, the retention of fluid in extracellular compartment was increased at HA leading to increased susceptibility to high altitude illness. Phase III subjects were hyperhydrated with decreased plasma volume and increased PO₂ in comparison to the other two groups.     

Comparison of muscle force,muscle endurance,and electromyogram activity during an expedition at high altitude

Handgrip force (HF), maximal pinch force (MF), muscle endurance (ME), and the median power frequency (MdPF) of the activity shown in the electromyogram (EMG) were studied at various altitudes in eight normal healthy subjects. MF and ME were measured between the index finger and thumb, and all measurements were obtained at altitudes ranging from 610 to 4860 m during an expedition in the Qinghai Plateau in China. With the change in altitude HF, ME, and MF showed no significant change. Compared to the MdPF at 2260 m on ascent, the MdPF at other altitudes showed a significant decrease (P<0.01). Thus, we conclude that muscle performance (HF, MF, and ME) was not affected by the environment at high altitude. However, MdPF was affected and the mean MdPF at 610 m after the expedition did not recover to initial values of MdPF. We suggest these results may have been affected by fatigue and chronic exposure to the hypobaric hypoxic environment, since the members of the expedition party expressed feelings of sluggishness and fatigue after the expedition.     

谷氨酰胺对急进高原大鼠肠道微生态影响的实验研究

目的探讨谷氨酰胺对急进高原大鼠小肠黏膜形态结构及肠道微生态的影响。方法W istar大鼠50只,随机分为5组:对照组(A组)、3848米未干预组(B组)、3848米谷氨酰胺干预组(C组)、4767米未干预组(D组)和4767米谷氨酰胺干预组(E组),每组10只,急进海拔3848米和4767米造成大鼠急性缺氧模型,检测小肠黏膜上皮细胞形态结构、肠道菌群失衡及细菌易位的变化。结果高海拔缺氧组大鼠小肠黏膜变薄、肠黏膜水肿、绒毛短缩,肠道菌群失衡显著高于对照组(P0.05),且随着海拔升高,菌群失衡更明显。不同海拔高度细菌易位率也有差异。经谷氨酰胺干预后,肠道的菌群失衡及细菌易位率与高海拔缺氧组比较差异有显著性(P0.05)。结论急进高原缺氧环境可导致小肠黏膜损伤、肠道菌群失衡及细菌易位,肠黏膜屏障破坏,且随着海拔升高而上述改变更明显。谷氨酰胺具有保护肠黏膜屏障及调节肠道菌群失衡的作用。