本文選題：急性高山病 + 左心室�。� 參考：《中國(guó)病理生理雜志》2017年12期

【摘要】：目的:評(píng)價(jià)駐平原官兵急進(jìn)高原前后心功能的變化情況并探討其與急性高山病(AMS)的關(guān)系。方法:采用超聲心動(dòng)圖評(píng)價(jià)42名健康青年男性官兵進(jìn)入高原前及快速進(jìn)入高原后(3 658 m,3 d)的心臟功能,同時(shí)觀察心率、血壓和血氧飽和度等生理指標(biāo)的變化,以及進(jìn)入高原后AMS的發(fā)病情況。結(jié)果:與進(jìn)入高原前相比,青年男性官兵急進(jìn)高原后,左房收縮末期內(nèi)徑和左室舒張末期內(nèi)徑顯著減小,右房收縮末期內(nèi)徑顯著減小,右室流出道和肺動(dòng)脈內(nèi)徑顯著增寬,射血分?jǐn)?shù)顯著增大,心輸出量顯著增多,肺動(dòng)脈收縮壓及平均肺動(dòng)脈壓顯著增高,二尖瓣E峰流速顯著降低(P0.05)。進(jìn)入高原后,42人中有15人發(fā)生AMS(AMS組),27人未發(fā)病(non-AMS組)。比較2組官兵在平原的心功能發(fā)現(xiàn),AMS組的主動(dòng)脈竇部?jī)?nèi)徑和左室舒張末期內(nèi)徑顯著小于non-AMS組,肺動(dòng)脈收縮壓顯著高于non-AMS組。比較2組官兵進(jìn)入高原后的心功能發(fā)現(xiàn),AMS組左房收縮末期內(nèi)徑顯著小于nonAMS組(P0.05)。AMS評(píng)分與進(jìn)入高原前的心輸出量呈顯著負(fù)相關(guān)性(r=-0.3814,P0.05)。結(jié)論:青年男性官兵從平原快速進(jìn)入高原后,右心功能受損合并左心功能代償;在平原運(yùn)用超聲心動(dòng)圖進(jìn)行肺動(dòng)脈收縮壓及心輸出量的檢查有助于AMS易感人群的篩選。
[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.
【作者單位】： 第三軍醫(yī)大學(xué)高原軍事醫(yī)學(xué)系高原特需藥品與衛(wèi)生裝備研究室高原環(huán)境醫(yī)學(xué)教育部重點(diǎn)實(shí)驗(yàn)室全軍高原醫(yī)學(xué)重點(diǎn)實(shí)驗(yàn)室;
【基金】：軍隊(duì)十二五重大課題(No.AWS14C007) 第三軍醫(yī)大學(xué)高原醫(yī)學(xué)特殊學(xué)科點(diǎn)項(xiàng)目(No.J1310001)
【分類號(hào)】：R82

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