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目的综合评价高海拔地区高原习服后的缺氧性右心重构情况。方法随机选择从内地低海拔地区空运进藏的100名志愿者列为对照组,从低海拔地区移居海拔3000m以上且对高原完全习服的100名驻藏部队官兵列为高原组。后者根据移居高原的海拔高度再分为移居高度Ⅰ组(海拔高度3000~4000m,n=67)和移居高度Ⅱ组(海拔高度4000~5500m,n=33);根据受试者移居高原时间的不同又分为移居时间Ⅰ组(进藏1~2年,n=72)和移居时间Ⅱ组(进藏2年以上,n=28)。应用便携式多功能复合超声心动图技术测量静息状态下的右心结构与功能,综合分析与评价高海拔地区高原习服后的缺氧性右心重构情况。结果与对照组比较,移居高海拔地区后右心重构主要表现为右室、右房增大,右室壁增厚,三尖瓣反流程度增加,肺动脉主干及分支增宽(P<0.01)等。随着海拔高度增加,右心重构更加明显,移居海拔4000m以上受试者的右心重构程度明显高于4000m以下者(P<0.01),4500m以上者尤甚。随着移居时间延长,右心重构亦更加明显,移居时间2年以上的受试者右心重构程度明显高于2年以下者(P<0.01),5年以上者尤甚。结论海拔高度和时间是影响缺氧性右心重构的主要因素,高原习服仅仅是机体对高原低氧环境的一种调节性适应。应用便携式多功能超声技术能早期、及时地评价缺氧性右心重构情况,对保障移居高原部队官兵的身体健康具有重要意义。
Objective To evaluate the hypoxic right ventricular remodeling after altitude acclimation in high altitude area. Methods A total of 100 volunteers who were airlifted into the Tibetan plains from low altitude areas of the Mainland were randomly selected as the control group. 100 troops stationed in the Tibetan Plateau that migrated altitude above 3000m above sea level and were completely accustomed to the plateau were selected as the control group. The latter was subdivided into group Ⅰ (altitude 3000 ~ 4000m, n = 67) and migration Ⅱ (altitude 4000 ~ 5500m, n = 33) according to the altitude of the migrating plateau. According to the time when the subjects migrated to plateau The difference was divided into group Ⅰ (1 to 2 years into Tibet, n = 72) and group Ⅱ (2 years or more, n = 28). The structure and function of the right heart under resting state were measured by portable multifunctional compound echocardiography. The hypoxic right ventricular remodeling after high altitude acclimation was analyzed and evaluated comprehensively. Results Compared with the control group, the right ventricular remodeling mainly manifested as right ventricle and right atrium enlargement, thickening of the right ventricular wall, increased degree of tricuspid regurgitation and widening of the trunk and branches of the pulmonary artery (P <0.01) )Wait. With the increase of altitude, the remodeling of right heart became more obvious. The degree of right heart remodeling in those who migrated to an altitude of 4000m was significantly higher than that of 4000m (P <0.01). With the prolongation of migration time, right-ventricular remodeling was also more obvious. Right-ventricular remodeling was significantly higher in subjects who migrated for more than 2 years (P <0.01), especially for those who were more than 5 years. Conclusion Altitude and altitude are the main factors influencing right ventricular remodeling in hypoxia. Habitat acclimatization is only a kind of accommodative adaptation to the hypoxic environment in the plateau. The application of portable multi-function ultrasound can evaluate the hypoxic right ventricular remodeling in an early and timely manner, which is of great significance for the protection of the officers and soldiers of the plateau troops.