飞行员与潜艇艇员血小板L-精氨酸/一氧化氮合酶/一氧化氮系统变化的临床意义

目的 探讨不同环境、不同理化因素对潜艇艇员、飞行员和陆勤人员内皮功能的影响,为预防心血管疾病提供依据.方法 晨起抽取48名潜艇艇员(潜艇组)、22名飞行员(飞行组)、17名陆勤人员(陆勤组)的肘正中静脉血(均为健康男性),制备血小板血浆,用放射同位素标记法测定3H-L-精氨酸(3H-L-Arg)在血小板转运中的动力学特征,并测定血浆、血小板中一氧化氮(NO)产物--亚硝酸盐(NO-2)产量及一氧化氮合酶(NOS)的活性.结果 潜艇艇员血小板L-Arg转运功能明显低于飞行组及陆勤组;潜艇艇员L-Arg最大转运速度分别低于陆勤组及飞行组的31.37%(P＜0.01)、12.98%(P＜0.05);且飞行组的L-Arg最大转运速度低于陆勤组21.13%(P＜0.01).潜艇组米氏常数Km值高于陆勤组11.73%(P＜0.01),高于飞行组5.4%(P》0.05);飞行组Km值高于陆勤组6.7%(P＜0.05).潜艇组血小板NOS活性明显下降,分别低于陆勤组51.1%(P＜0.01)、飞行组59.6%(P＜0.01);而飞行组NOS活性高于陆勤组20.9%(P＜0.05).潜艇组血浆NO-2含量明显减低,分别低于陆勤组及飞行组的35.2%(P＜0.01)、14.0%(P＜0.05).而潜艇组血小板NO-2产量减低更明显,仅为地勤组的1/7(P＜0.01)和飞行组的1/4.7(P＜0.01),而飞行组低于地勤组18.75%(P＜0.05).结论 飞行员、潜艇艇员均存在L-Arg/NOS/NO系统功能异常及内皮功能损伤,而潜艇艇员内皮功能受损程度更为严重,这可能与不同环境及理化因素的影响有关.故对军队特殊工作人群应监测内皮功能,早期发现、早期预防心脑血管疾病的发生.

Clinical significance on the changes in L-Arginine/NO synthase/NO pathway in platelets of pilots, submarine sailors, and land servicemen

Objective To discuss the influence of several physico-chemical factors existed in the surrounding environment on the endothelium function of pilots,submarine sailors and ground crew,so as to provide a basis for preventing the cardiovascular disease.Methods 48 submarine sailors(SM group),22 pilots(PI group)and 17 ground crew(control group),all of them were healthy males,were chosen as the subjects.The dynamic features of 3H-L-Arg in the platelets transportation were checked with isotope labeling technique.The yielded nitrite(NO-2),a product of NO metabolism,and the activity of NO synthase(NOS)in platelets were detected.Results In SM group,the ability of L-Arg transportation in platelets was much lower than that of both control group and PI group.The maximum transport velocity(Vmax)of SM group was lower by 31.4% than that of control group(P<0.01)and by 12.98% than that of PI group(P<0.05),respectively.Michaelis constant(Km value)of SM group was higher by 11.4% than that of control group(P<0.01).The activity of NOS in platelets of SM group was lower by 51.1% than that of control group(P<0.01),and by 59.6%(P<0.01)than that of PI group,respectively.The NO production in plasma and platelets was obviously lower in SM group than that of both control and PI groups.Likewise,the ability of L-Arg transportation and the activity of NOS in platelets were significant lower in PI group than that in control group.Conclusion An abnormal function in L-Arg/NO/NOS pathway was found in submarine sailors and pilots,which might be caused by the special environment they work in.Such abnormity might result in the injury on endothelial function,especially in the submarine sailors.Monitoring the endothelial function is necessary in the specific work crew for preventing the cardiovascular diseases from incidence.