高原劳动能力降低的机理探讨和训练提高劳动能力的人体实…

对生长于低海拔地区的１１名男性健康青年志愿者，训练前、后于低压舱内进行３００ｍ，３５００ｍ，４５００ｍ的自身对比人体实验研究，结果发现高原劳动能力下降是由于乳酸性和非乳酸性氧债增高；表明心肌有早期轻度损害的Ｍｂ和ＣＫ显著增加，以及心电ＱＲＳ波和Ｔ波出现亚临床征候；肌球蛋白和肌动蛋白合成赶不上分解，与高原劳动能力下降呈现负相关，并有显著的统计学意义，采用复合锻炼４周后，在３５００ｍ高度劳动能力接近于     

高原人体血中肌红蛋白,乳酸和氨与劳动能力的关系

以１１名健康男青年在低压舱内模拟在３５００ｍ和４５００ｍ高度劳动并与平原自身对照比较，发现海拔愈高血氧饱和度和劳动效率下降愈明显（Ｐ＜０．０１），呈现前者降１％后者降２％趋势，经复合锻炼后两者有明显提高（Ｐ＜０．０５）。血内Ｍｂ、ＬＡ和ＢＡ的水平与劳动能力的降低和恢复呈负相关变化，提示反映劳动能力的乳酸性氧债和非乳酸性氮债（Ｍｂ）可作为判断高原劳动能力的灵敏指标；ＢＡ可反映肌肉运动时需依赖的肌球蛋     

模拟高原低氧环境下脑-体工作能力研究

实验采用行为功效及劳动能力测定所得分值，为脑－体工作能力定量评分。实验模型为人体在减压舱模拟３５００ｍ和４５００ｍ的低氧环境。结果显示，在３５００ｍ和４５００ｍ，工作能力得分较３００ｍ平原降低了１７．９％和３３．７％，且以体能下降为主，两个高度体能的降幅分别是２３．７％和３１．２％（Ｐ＜０．０５）。脑力活动显著受抑是在４５００ｍ，降幅为２０．４％（Ｐ＜０．０５）。结果说明低氧与工作能力下降有明显量效关系。     

模拟高原低氧环境下脑一体工作能力研究

实验采用行为功效及劳动能力的测定所得分值，为脑－体工作能力定量评分。实验模型为人体在减压舱ｍ和４５００ｍ的低氧环境。结果显示，在３５００ｍ和４５００ｍ，功能能力得分较３００ｍ平原降低了１７．９％和３３．７％，且以体能下降为主，两个高度体能的降分别是２３．７％和３１．２％。脑力活动显著受抑是在４５００ｍ，除幅为２０．４％。结果说明低氧与工作能力下降有明显量效关系。     

模拟高原人体试验中健康人尿液酶及β2—微球蛋白和白蛋…

本文在低压实验舱内研究了１１名男性健康受试者在３００ｍ平原和３５００ｍ、４５００ｍ两高度人体尿激酶（ＮＡＧ、ＧＧＴ、ＡＡＰ、ＡＬＰ）和β２－ＭＧ，Ａｌｂ在锻练前后的变化。结果表明，尿液ＮＡＧ在高原条件下较平原增高１～２倍（Ｐ＜０．０５）较其余三种酶灵敏；β－ＭＧ和Ａｌｂ在高原缺氧后也显著增高；提示高原缺氧可导致肾小球滤过和肾小管重吸收的轻度损害。锻练对ＮＡＧ和β２－ＭＧ有较好的改善作用，而对Ａｌｂ     

高原缺氧环境对青年战士血小板活化的影响

「目的」探讨高原低氧环境对青年战士血小板活化状态的影响。「方法」对从平原（海拔１２００ｍ）进驻海拔３５００ｍ、４０００ｍ４５００ｍ高原７天、６月、１２月的６０名官兵进行了血小板表面α－颗粒膜蛋白（α－ＧＭＰ－１４０）含量,,血浆血栓素Ｂ２（ＴＸＢ２）水平,血小板聚集率（ＰＡＲ）等测定,并与３０名平原健康青年战士作对照。「结果」高原战士α－ＧＭＰ－１４０含量,血浆ＴＸＢ２和ＰＡＲ比平原战士有不同程度     

高原低氧条件下人的劳动能力与冠状循环

人进入高原低氧环境后,劳动能力下降。经研究证明,最大劳动能力较海平面值降低20～30%,有人报告降低5～16%;游泳及长跑等体育运动项目的成绩下降。高原低氧环境对人的劳动能力的影响与进入高原的海拔高度和移居高原时间的长短有关。一般来说,进入高原的海拔高度越高,移居高原的时间越短,劳动能力的降低也越明显;反之亦然。世居高原的居民具有较强的劳动能力。在高原低氧条件下,人的劳动能力降低的原因除与呼吸功能障碍有关外,主要与心脏的功能有关。本文通过高原低氧环境对冠状循环的影响,略述劳动能力下降与冠状循环的关系。     

不同海拔高度对高原筑路民工无氧阈的影响

为了探讨不同海拔高度低氧环境对高原筑路民工劳动能力的影响，本研究分别在海拔２２６０ｍ、３６００ｍ及５０００ｍ地区筑路民工中设立实验组，并以海平作对照，观察不同程度低氧对无氧阈（ＡＴ）的影响。结果表明，海拔２２６０ｍ、３６００ｍ地区无氧阈功率（ＷＡＴ）与海平比较变化不明显（Ｐ＞０．０５）；海拔５０００ｍ地区ＷＡＴ与对照相比下降４５．６％，差异极其显著（Ｐ＜０．０１）。提示海拔５０００ｍ以上人的体力劳动能力明显下降，在劳动卫生方面应予特别注意。     

高原地区一氧化碳中毒特征探讨

对不同海拔高度ＣＯ急性动物试验及高原ＣＯ作业现场流行病学调查结果表明,随海拔升高,小鼠半数致死浓度下降,血氧分压和血氧饱和度降低,作业人员神经行为功能测试多项指标得分减少,自觉症状和体征明显,与对照组比较差异有显著性。说明高原低氧加重了ＣＯ中毒的程度,并由此推荐高原ＣＯ卫生标准为：海拔２０００～３０００ｍ为２０ｍｇ／ｍ３,３５００～４５００ｍ为１５ｍｇ／ｍ３。     

高海拔地区世居与迁居者劳动能力的比较及机理的初步探讨

本文通过在高原现场和低压舱模拟高原中对人体动脉血氧分压（Ｐｏ＿２）、无氧阈（ＡＴ）、还原全血粘度（ηｒ）、每搏输出量（ＳＶ）、有效血容量（ＢＶ）、血浆丙二醛（ＭＤＡ）、血清肌红蛋白（Ｍｂ）、血清乳酸（ＬＡ）等指标的测定，结果表明：（１）高原劳动能力随海拔的升高而降低；（２）体内脂质过氧化水平的升高和血液粘度的增加，可能是迁居者劳动能力降低的机理之一；（３）模拟高原试验汉族两类氧债ＬＡ、Ｍｂ的存在，在一定的程度上表明心脏已呈现亚临床损伤；（４）世居藏族劳动能力明显高于汉族，这与其较高的ＳＶ、ＢＶ、Ｐｏ＿２、Ｈｂ和较低的下、血浆ＭＤＡ有关。     

高原应激与训练的探讨

１１名世居平原健康男性受试者，于适应性训练前后进入模拟不同海拔高度的低压舱内，进行高原应激观察。结果显示，未经训练人群初入高原时，ＮＥ、Ｅ含量明显升高（Ｐ＜０．０５），目标追踪错误率和数字译码得分与海拔高度呈量一效关系。皮质醇随海拔高度变化不明显（Ｐ＞０．０５），经过３０天适应性训练后各指标明显改善，提示适应性训练能降低高原应激损害。     

Exercise-induced cerebral deoxygenation among untrained trekkers at moderate altitudes.

The pathophysiology of altitude-related disorders in untrained trekkers has not been clarified. In the present study, the effects of workload on cardiovascular parameters and regional cerebral oxygenation were studied in untrained trekkers at altitudes of 2700 m and 3700 m above sea level. We studied 6 males and 4 females at each altitude, and their average ages were 31.3+/-7.1 y at 2700 m and 31.2+/-6.8 y at 3700 m, respectively. The resting values of heart rate and mean blood pressure were not significantly different at 2700 m and 3700 m than at sea level. However, increases in these values after exercise were more prominent at high altitudes (heart rate increase = 51.6% at 2700 m and 70.4% at 3700 m; mean blood pressure increase: 19.0% at 2700 m and 17.2% at 3700 m). In addition, post-exercise blood lactate concentration was significantly higher at 3700 m than at sea level or at 2700 m (i.e., 7.6 mM at 3700 m, 3.8 mM at 2700 m, and 4.17 mM at 0 m, respectively). Exercise induced an acute reduction in the arterial oxygen saturation value (SpO2) at 2700 m and 3700 m (i.e., 11.2% reduction at 2700 m and 9.4% at 3700 m), whereas no changes were observed at sea level. The resting values of regional oxygen saturation (rSO2)--measured by a near infra-red spectrophotometer at sea level, 2700 m, and 3700 m-were nearly identical. Exercise at sea level did not reduce this value. In contrast, we observed a decrease in rSO2 after subjects exercised at 2700 m and 3700 m (i.e., 26.9% at 2700 m and 48.1% at 3700 m, respectively). The rSO2 measured 2 min and 3 min after exercise at 3700 m was significantly higher than the preexercise value. From these observations, we concluded that alterations in cardiovascular parameters were apparent only after an exercise load occurred at approximately 3000 m altitude. Acute reduction in cerebral regional oxygen saturation might be a primary cause of headache and acute mountain sickness among unacclimatized trekkers.     

Effect of cold exposure, exercise and high altitude on plasma endothelin-1 and endothelial cell markers in man

The aims were to examine the effect of cold exposure, exercise and high altitude on plasma concentrations of big endothelin-1, endothelin-1, von Willebrand factor and serum e-selectin in twenty five healthy male volunteers. Clinical evaluation and venesection were performed before and after 24 hours of low altitude mountaineering, exposure to temperatures of -18 degrees C and +4 degrees C and whilst ascending from sea level to an altitude of 5000 m in the Karakoram. Plasma big endothelin-1, plasma endothelin-1 and serum soluble e-selectin concentrations were significantly elevated after two hours at -18 degrees C (p < 0.05, p < 0.05 and p < 0.01 respectively). At +4 degrees C, plasma big endothelin-1 and endothelin-1 concentrations rose significantly after 5 hours (p < 0.005 for both) but not after 2.5 hours. Low altitude mountaineering did not alter circulating marker concentrations. At high altitude, big endothelin-1 and endothelin-1 (p < 0.01 for both) rose significantly at 2500 m and initially at 5000 m but returned to sea level values after prolonged exposure to 5000 m. Serum e-selectin rose at all altitudes greater than sea level (p < 0.05). In conclusion, exposure to high altitude, moderate cold or freezing temperatures, but not exercise, selectively activates endothelial cells increasing endothelin-1 production. Cold exposure may contribute to the observed increase in plasma endothelin-1 in mountaineers at high altitude.     

西藏入境外国人高原性疾病现状及健康干预评估

目的 西藏高原恶劣的气候条件和自然环境对旅行者有着较大的危害甚至威胁到高原旅行者的生命.方法 1、在不同海拔中各项指标的检测;2、对82名旅行者进行了与高原病相关知识的问卷调查;3、对105名导游人员高原知识培训前后的问卷调查;4、口岸设立高原咨询和宣传旅行安全知识;结果 1、在不同海拔高度中对两组间的血压、心率和心电图有显著性差异,药物预防和宣传高原病知识有一定的效果;2、在不同海拔高度中两组间一般症状的问卷在海拔45 00米处循环系统的变化有显著性差异;3、对82名旅行者高原知识问卷中75.61％人了解高原气候、65.85％的有旅行计划、65.85％有经常锻炼、78.05％人了解高原病的相关知识、95.12％人对高原病没有恐惧感、59.76％人曾去过海拔3800米以上、78.05％人有旅行社提供过高原旅行健康知识,因此该人群对高原病的危险相对较少;4、导游人员高原病知识问卷对15项相关知识的问卷中有9项知识培训前后有显著性差异,培训对导游人员有一定效果.结论 1、海拔在188和4400米处两组心电图变化有显著性差异,P ＜0.05和0.01;2、海拔在4500米两组的变化具有显著性差异=4.286 P＜0.05;3、导游人员高原病知识问卷15项中10项均有差异.     

Oxygen enrichment of room air to improve well-being and productivity at high altitude.

Increasingly, commercial activities, such as mines, and scientific facilities, such as telescopes, are being placed at very high altitudes, up to 5,000 m. Frequently workers commute to these locations from much lower altitudes, or even from sea level. In addition, large numbers of people permanently live and work at high altitudes. The hypoxia of high altitude impairs sleep quality, mental performance, productivity, and general well-being. Recently it has become feasible to raise the oxygen concentration of room air by injecting oxygen into the air conditioning. This is remarkably effective at reducing the equivalent altitude. For example, increasing the oxygen concentration by 1% (e.g., from 21% to 22%) reduces the equivalent altitude by about 300 m. In other words, a room at an altitude of 4,500 m containing 26% oxygen is effectively at an altitude of 3,000 m. Oxygen enrichment has now been tested in several studies and shown to improve sleep quality and cognitive function. The fire hazard is less than in air at sea level. This innovative technique promises to improve productivity and well-being at high altitude.     

Altitude variation of cosmic-ray neutrons

The altitude variation of the cosmic-ray neutron energy spectrum and the dose equivalent rate was measured at an average geomagnetic latitude of 24 degrees N by using the high-efficiency multi-sphere neutron spectrometer and neutron dose-equivalent counter developed by the authors. The data were obtained from a 2-h flight over Japan on 27 February 1985. The neutron energy spectra measured at sea level and at altitudes of 4,880 m and at 11,280 m were compared with the calculated spectra of O'Brien and with other experimental spectra, and they are in moderately good agreement with them. The dose equivalent rate increases according to a quadratic curve up to about 6,000 m and then increases linearly between 6,000 m and 11,280 m. The dependence of dose equivalent rates at sea level and at an altitude of 12,500 m on geomagnetic latitude also is given by referring to other experimental results.     

Rate pressure product and oxygen saturation in tourists at approximately 3000 m above sea level

Using modern transportation technology, many travelers easily access moderate altitudes of approximately 3000 m above sea level. In the present study the effects of this altitude on cardiovascular parameters were studied among office workers dwelling at sea level. Methods: Heart rate, blood pressure, arterial oxygen saturation (SpO₂), and electrocardiography were monitored before and after Master's double-step exercise at 2700 and 3700 m. The test consisted of stepping onto and off of two 23-cm steps for 3 min at a predefined rate. Results: The resting values recorded for the heart rate and mean blood pressure at 2700 and 3700 m did not statistically significantly differ from those noted at sea level. However, the increases in these values after exercise were significantly greater at high altitude. The rate pressure product more than doubled after exercise at 3700 m. Electrocardiographic abnormalities were observed in some cases. The postexercise blood lactate concentration was significantly higher at 3700 m than at sea level or at 2700 m, suggesting that the oxygen supply-demand relationship was not balanced at this altitude. Furthermore, exercise provoked an acute reduction in SpO₂ at 2700 and 3700 m but showed no effect at sea level. Conclusion: These observations suggest that the oxygenation status of the heart might be at risk in many travelers and workers during and after exercise load at an altitude of approximately 3000 m. Received: 23 March 1998 / Accepted: 4 August 1998     

心率在评价高原体力劳动强度中的应用

目的 心率可反映体力劳动强度,但应用于评价高原体力劳动强度的研究不多。本文探讨将心率指标用于高原体力劳动强度评价的可行性。方法 在不同海拔高度,使用功率车模拟阶梯式递增劳动负荷,运动心肺功能测试仪收集某电力公司共计73名男性工人在不同负荷的心率指标,包括心率绝对值、心率增加值、心率储备百分比（%HRR）。比较不同海拔递增负荷的心率指标变化,及达第一通气无氧阈（VT1）、第二通气无氧阈（VT2）时的心率。结果 心率绝对值、心率增加值、%HRR都随着运动负荷的增加而增加,差异有统计学意义（F分别为 和666.053,P值均＜0.001）,海拔之间差异无统计学意义（F=2.593,P=0.061;F=0.248,P=0.862;F=0.478, P=0.699）。在达到VT1和VT2时,各项心率指标都随海拔升高而下降,在VT2时下降更加明显;从平原到高原,各心率指标随海拔增高而下降幅度缩小。%HRR随海拔增加而下降。达到VT1时,平原的%HRR约40%,至4000~5000m时约33%;达到VT2时,平原的%HRR约75%,在4000~5000m时约60%。结论 心率用于评价高原体力劳动强度时,需考虑海拔、个体差异及年龄的影响,用%HRR并结合VT1、VT2进行体力劳动分级效果最好。     

High altitude dives from 7000 to 14,200 feet in the Himalayas

Indian Navy divers carried out no-decompression dives at altitudes of 7000 to 14,200 ft (2134-4328 m) in the Nilgiris and Himalayas from May to July 1988. Seventy-eight dives on air and 22 dives on oxygen were carried out at various altitudes. The final dives were at Lake Pangong Tso (4328 m) in Ladakh, Himalayas, to a maximum of 140 feet of sea water (fsw) [42.6 meters of sea water (msw)] equivalent ocean depth in minimum water temperature of 2 degrees C. Oxygen diving at 14,200 ft (4328 m) was not successful. Aspects considered were altitude adaptation, diminished air pressure diving, hypothermia, and remote area survival. Depths at altitude were converted to depths at sea level and were applied to the Royal Navy air tables. Altitude-related manifestations, hypoxia, hypothermia, suspected oxygen toxicity, and equipment failure were observed. It is concluded that stress is due to effects of altitude and cold on man and equipment, as well as changes in diving procedures when diving at high altitudes. Equivalent air depths when applied to Royal Navy tables could be considered a safe method for diving at altitudes.