Cox17基因拷贝数在高原习服中的变化规律

本文通过研究Cox17基因拷贝数在世居藏族、移居汉族、平原汉族中的变化,旨在探讨其拷贝数变化与高原习服的关系。作者随机选取已经获得高原适应的世居藏族（n=20）、完全高原习服的移居汉族（n=20）及未到过高原的平原汉族（n=18）健康青年男性作为受试者,世居藏族受试者3代均为藏族,在西藏高原地区（3 658m）出生成长。     

藏区高原环境对武警执勤官兵肾脏功能的影响

目的 了解藏区高原环境对武警执勤官兵肾脏功能的影响,全面提升卫勤保障水平.方法 选取90例驻于海拔高度约4300 m地区及100例驻于海拔高度约3200 m地区的来自平原地带(海拔高度约50 m)的武警某部执勤1年的男性官兵作为研究对象,分别于进藏前,进藏后6、12个月,以及撤离高原6个月时进行血尿素、肌酐、尿酸,以及尿微量白蛋白(u-rine micro-albumin,MALB)测定.应用SPSS 18.0统计软件进行数据处理.结果 两组官兵的血尿素、肌酐、尿酸,以及MALB在进藏6、12个月时均高于进藏前(P＜0.05),且12个月时[高、低海拔组MALB分别为(12.50±2.33) mg/L和(11.43±2.70) mg/L]明显高于6个月时[高、低海拔组MALB分别为(10.66±1.95) mg/L和(9.91±2.75) mg/L]水平(P＜0.05);在进藏6、12个月时高海拔组各项指标与低海拔组相比,差异有统计学意义(P＜0.05),高海拔组明显高于低海拔组(P＜0.05);撤离6个月与进藏前比较,各个指标差异无统计学意义.结论 随着海拔高度的升高,武警高原地区执勤部队官兵的血尿素、肌酐、尿酸及MALB水平增高.高原环境对武警执勤部队官兵的肾脏功能可产生较大影响;当脱离该环境后,其功能可逐渐改善.     

高压氧治疗高原地区缺氧性颅内高压综合征31例临床分析

青海大部分牧区地处海拔3000m以上,其中部分牧区人类定居点在海拔4000m以上,道路在海拔4000m以上的节段也较多(如唐古拉山公路的最高点在5500m),随着海拔高度的增加而空气中含氧量和氧分压下降,因此从低海拔地区急进高海拔地区,特别是急进4000m以上的高海拔地区,发生高     

多普勒超声心动图评价不同海拔高原驻守官兵心功能

目的：比较驻守海拔2800 m官兵与海拔4820 m官兵的左心功能及右心参数变化差异,探讨海拔高度对高原驻守官兵心脏的影响。方法利用飞利浦便携CX50型超声诊断仪,对驻守海拔2800 m官兵33名（ A组）和海拔4820 m官兵25名（B组）行超声心动图检查,重点检查左室短轴舒张末内径（LVDd）、左房收缩末左右径（LASd）、右房收缩末左右径（RASd）、右室舒张末左右径（RVDd）、肺动脉内径（PAd）、二尖瓣口E峰与A峰血流速度（MVE、MVA）、二尖瓣环舒张早期速度（ E′）、二尖瓣环舒张晚期速度（ A′）、肺动脉加速时间（ PVAT）、肺动脉平均压力（ PAMP）。结果 B组的MVE、MVA、E′、E′/A′均低于A组,LVDd小于A组,PAd及A′大于A组,PVAT明显小于A组,PAMP明显高于A组（P﹤0.05）,两组RASd、RVDd无显著差异（ P﹥0.05）。结论与低海拔高原驻守官兵比较,驻守超高海拔高原官兵左室舒张功能减低,PAd增宽,PVAT缩短,PAMP增加,表明超高海拔高原环境对驻守官兵的心脏有一定影响,应该制定相应的健康保障策略,以切实防止或减轻超高海拔高原对官兵健康的影响。     

不同海拔高原地区健康成人右心Tei指数研究

目的:探讨不同海拔高原地区健康成人右心Tei指数。方法:应用多普勒超声心动图对高原地区(海拔3 800m)健康世居、移居成人右房室内径、主肺动脉内径及右心Tei指数测定,并与西宁地区(海拔2 260m)相对照。结果:高原地区世居成人右房室内径、主肺动脉内径及右心Tei指数与西宁地区(海拔2 260m)健康成人比较,无统计学差异,但高原移居健康成人右房室内径、主肺动脉内径及右心Tei指数均高于西宁地区世居健康成人,西宁地区世居健康人群与移居健康人群右心各项参数无统计学差异。结论:高原地区移居健康成人右心Tei指数高于世居健康成人。     

彩色多普勒超声心动图评价高原驻守官兵右心参数变化

目的:探讨高原驻守官兵右心系统相关参数变化特点。方法:应用多普勒超声心动图对驻守海拔2 800m A组官兵以及驻守海拔4000m以上B组官兵进行研究。结果:1B组官兵肺动脉内径(PA)大于A组官兵(P<0.05),右心房(RA)、右心室内径(RV)无显著差异;2B组官兵的肺动脉持续时间(PVDT)及加速时间(PVAT)明显少于A组官兵;3B组官兵肺动脉平均压力(PAMP)明显高于A组官兵。结论:驻守高海拔官兵PA增宽,PVDT、PVAT缩短,肺动脉平均压力(PAMP)显著增加,RV内径无明显变化。     

吸入伊洛前列素对初入高海拔地区青年自由基代谢的影响

目的观察雾化吸入伊洛前列素溶液对初入高海拔地区青年自由基代谢的影响,为促进高原习服提供新的措施,以预防和治疗急性高原病。方法将32名受试者随机分为伊洛前列素组(n=16)和对照组(n=16),自海拔1 400 m历时5d进入5 200 m。从进入海拔5 200 m当天开始,伊洛前列素组每天4次雾化吸入伊洛前列素溶液,连续5 d。对照组用同样的方法吸入少量生理盐水。于吸入伊洛前列素溶液生理盐水第5天检测血中超氧化物歧化酶(SOD)、丙二醛(MDA)、乳酸(BLA)、一氧化氮(NO)及一氧化氮合酶(NOS)的含量。结果伊洛前列素组较对照组,SOD、MDA、BLA、NO及NOS差异有统计学意义(P<0.01)。结论在高海拔地区雾化吸入伊洛前列素溶液能增强移居者抗氧化酶活性和乳酸清除能力,可以促进高原习服、预防和治疗急性高原病。     

中高度海拔地区世居与移居汉族慢性胃炎患者胃黏膜内MDA、SOD、XOD、NO含量比较

目的：探讨高原地区世居与移居汉族人群慢性胃炎胃组织内四种体液因子代谢水平差异及其意义.方法：检测高海拔地区（2 000m～2 500m）（西宁市及周边县区）世居与移居汉族人群慢性胃炎胃组织内氧自由基、脂质过氧化物丙二醛（MDA）、超氧化物歧化酶（SOD）、一氧化氮（NO）、黄嘌呤氧化酶（XOD）水平.结果：相同海拔高度地区世居与移居汉族人群胃黏膜内MDA、SOD、NO与XOD含量或活力无明显差异.结论：平原地区人群移居高原后同样发生了严重的氧自由基与氧自由基清除剂失衡,而且高原习服后的上述因子的水平与同海拔高度地区的世居汉族相同.     

不同海拔高度及任务对官兵心理健康状况的调查

目的：探讨不同海拔高度对驻守官兵的心理健康状况的影响以及担负不同任务的高原官兵心理健康状况的差异。方法采用症状自评量表（SCL-90）对不同海拔高度且担负不同任务的336名高原官兵进行心理测量。结果海拔越高,高原官兵的SCL-90得分越高;高原驻守部队官兵SCL-90得分高于高原后勤勤务保障部队官兵。结论高海拔地区官兵的心理健康状况比低海拔地区官兵心理健康状况低,高原驻守官兵的心理健康状况比高原后勤保障官兵心理健康状况低;加强高海拔驻守官兵的心理保健,定期开展健康教育、心理疏导,对提高部队的战斗力具有重要意义。     

吸入伊洛前列素治疗缺氧性肺动脉高压的超声心动图对比研究

目的:研究雾化吸入伊洛前列素治疗缺氧性肺动脉高压的疗效.方法:对55名移居5380m(30人)、4300m(6人)、3700m(19人)海拔高度一年的缺氧性肺动脉高压患者,于雾化吸入伊洛前列素前后进行超声心动图检查,观察肺动脉压的变化.结果:吸入伊洛前列素后较吸入前,海拔5380m受试者三尖瓣返流人数明显降低(P＜0.05),3700m、4300m、5380m右室前后径、右室前壁、右室流出道、主肺动脉内径降低,有非常显著性(P＜0.01).结论:雾化吸入伊洛前列素治疗缺氧性肺动脉高压患者,可迅速降低肺动脉压力,明显提高肺的氧合效率.从而使动脉血氧饱和度明显升高,人体供氧得以充分改善.     

Chemoreceptor sensitivity in adaptation to high altitude

Studies were carried out in a group of 20 young male subjects to investigate the changes in chemoreceptor sensitivity during acclimatization to altitude. Their hypoxic sensitivity and carbon dioxide sensitivity were studied at Delhi, during acclimatization at 3500 m, and on return to sea level. Similar studies were also done in a group of 10 acclimatized lowlanders who stayed at 3500-4000 m for 12-14 months, and also on 10 high-altitude natives. The results showed no significant alteration in the hypoxic sensitivity of the lowlanders; but CO2 sensitivity was markedly elevated at altitude, both in sojourners and acclimatized lowlanders. The high-altitude natives showed less sensitivity to hypoxia, whereas the CO2 sensitivity was normal.     

超声心动图观察急性高原反应和习服后心功能变化

目的 :探讨发生急性高原反应时和习服后心功能变化。方法 :对比研究高原 (日喀则 ,海拔 390 0m) 5 6例发生急性高原反应者和平原 (西安 ,海拔 4 0 0m) 5 6例年龄和性别匹配的健康对照者心功能指标 ,并观察高原低氧习服后 ,心功能指标的变化过程。结果 :发生急性高原反应时心率、左室射血分数、短轴缩短率、心输出量均增大 ,室间隔运动幅度减低 ,左室舒张末期容积减小 ,右室轻度扩大。经过 6 0d习服后上述改变均有不同程度恢复。结论 :发生急性高原反应者 ,在初上高原时心功能变化较大 ,习服后适应高原环境     

Prior altitude experience of climbers attempting to summit Aconcagua

Aconcagua (6962 m) is one of the seven summits and the highest mountain outside of Asia. Climbers of varying experience are drawn to its nontechnical route. Our objective was to detail the prior altitude experience of climbers attempting to summit Aconcagua. We asked all climbers on the normal route of Aconcagua to complete questionnaires with demographics and prior high altitude experience while acclimatizing at Plaza de Mulas base camp during 9 nonconsecutive days in January 2009. 127 volunteers from 22 countries were enrolled. Mean age was 39.8 years and 88.2% were male. Median altitude at place of residence was 200 m (IQR: 30, 700). Median previous maximum altitude reached was 5895 m (IQR: 5365, 6150). 7.1% of climbers had never been above 4000 m. Median previous maximum sleeping altitude was 4800 m (IQR: 4300, 5486). 12.6% of climbers had never slept above 4000 m. Climbers who performed acclimatization treks spent a mean of 3.6 (2.5, 4.7) days at>3000 m in the previous 2 months. However, 50.4% of climbers performed no acclimatization treks. Although the majority of mountaineers who attempt Aconcagua have prior high altitude experience, a substantial minority has never been above 4000 m.     

Role of airway receptors in altitude-induced dyspnea

PURPOSE: The purpose of this study was to examine the role of airway receptors in respiratory-related sensations after ascent to altitude. METHODS: Ratings of respiratory-related sensations, perceived exertion and acute mountain sickness, heart rate, and peripheral oxygen saturation were recorded at rest and exercise in male and female subjects who had inhaled either aerosolized saline or saline with tetracaine after acute ascent to an altitude of 3500 m and after prolonged acclimatization of 18 d at altitudes between 4000 and 5000 m. RESULTS: Tetracaine had no effect on respiratory-related sensations at altitude either at rest or during exercise, and male and female subjects experienced similar respiratory-related sensations. Sensations of rapid breathing were experienced at rest after acute exposure to 3500 m as compared with sea level, but not after acclimatization to 5000 m. Sensations of rapid breathing, air hunger, and heavy breathing were experienced during exercise after acute and prolonged altitude exposure as compared with sea level, with a sensation of chest tightness experienced at 3500 m and a sensation of gasping experienced at 5000 m. CONCLUSION: These results suggest that airway afferents play no role in the respiratory-related sensations experienced by male and female subjects either during acute ascent to altitude or after prolonged acclimatization at altitude.     

Military applications of hypoxic training for high-altitude operations

Rapid deployment of unacclimatized soldiers to high mountainous environments causes debilitating effects on operational capabilities (physical work performance), and force health (altitude sickness). Most of these altitude-induced debilitations can be prevented or ameliorated by a wide range of physiological responses collectively referred to as altitude acclimatization. Acclimatization to a target altitude can be induced by slow progressive ascents or continuous sojourns at intermediate altitudes. However, this "altitude residency" requirement reduces their utilization in rapid response military missions that exploit the air mobility capability of modern military forces to quickly deploy to an area of operations on short notice. A more recent approach to induce altitude acclimatization is the use of daily intermittent hypoxic exposures (IHE) in lieu of continuous residence at high altitudes. IHE treatments consist of three elements: 1) IHE simulated altitude (inspired oxygen partial pressure: PIO2), 2) IHE session duration, and 3) total number of IHE sessions over the treatment period. This paper reviews and summarizes the results of 25 published IHE studies. This review finds that an IHE altitude>or=4000 m, and daily exposure duration of at least 1.5 h repeated over a week or more are required to have a high probability of developing altitude acclimatization. The efficacy of shorter duration (<1.5 h) hypoxic exposures at >or=4000 m simulated altitudes, and longer exposures (>4 h) at moderate altitudes (2500-3500 m) is not well documented. The predominate IHE-induced altitude acclimatization response appears to be increased arterial oxygen content through ventilatory acclimatization. Thus, IHE is a promising approach to provide the benefits of altitude acclimatization to low-altitude-based soldiers before their deployment to high mountainous regions.     

缺氧习服大鼠骨骼肌葡萄糖代谢特点研究

目的 :探讨缺氧习服后组织物质代谢特点。方法 :将大鼠置模拟海拔 5 0 0 0m低压舱内 ,30d后取动脉血 ,测定血气、血糖等 ;取双后肢骨骼肌用3 H 脱氧葡萄糖测定葡萄糖摄取率 ,用葡萄糖氧化酶法测定葡萄糖、糖原含量 ;用酶法测定ATP、磷酸肌酸、乳酸水平 ,并以平原动物作为对照组进行对比分析。结果 :与对照组相比 ,缺氧组血糖、骨骼肌葡萄糖摄取率、葡萄糖含量显著增加 ,而糖原显著降低 ,骨骼肌ATP、磷酸肌酸、乳酸在缺氧组与对照组之间没有显著性差异。结论 :经过缺氧习服之后 ,组织能量代谢能达到平衡状态 ,葡萄糖利用能力加强     

Heart rate variability in rats acclimatized to high altitude

The aims of this study were to relate heart morphology and functions changes to heart rate variability (HRV) components after acclimatization to high altitude and to define whether preadaptation to hypoxia could modulate HRV responses to acute hypoxic stress. Doppler-echocardiographic studies of the left ventricle were performed in female Wistar rats before, during, and after a 10-week exposure to moderate hypobaric hypoxia (CH rats, approximately 4000 m simulated) or normoxia (N rats, approximately 55 m). Right ventricular morphology and function and pulmonary artery pressure were evaluated using heart catheterization. Spectral analysis of HRV was studied after exposure in conscious unrestrained rats in normoxia and during acute hypoxic stress. Necropsy right ventricular hypertrophy and intraventricular and pulmonary artery hypertension were found in CH rats compared with N rats. Echocardiographic left ventricular morphology and functions were similar between the groups after exposures. Compared to the control group, CH rats had similar heart rates and HRV components when measured in normoxia. During acute hypoxic stress, HRV decreased in all rats, but less in CH rats. These results support the hypothesis that long-term mild hypoxia may moderate sympathetic activation induced by acute hypoxia and that right ventricular hypertrophy cannot be the direct cause of such a shift in sympathovagal nerve interaction during acute hypoxic stress.     

高住低练对大鼠心肌线粒体活性氧的影响

目的:探讨常压不同低氧(14.5%、12.6%氧含量)环境下(相当于模拟海拔3000m和4000m)高住低练对大鼠心肌线粒体活性氧(ROS)的影响,为运动与低氧适应的应用研究提供参考。方法:120只SD大鼠,随机分为12组,分别为低住安静组、低住低练组、急性高住安静组、急性高住运动组、急性高住低练组、高住安静组和高住低练组,5个高住组又分为常压14.5%氧含量和12.6%含氧量2个亚组。采用二氯荧光素双醋酸盐(DCFH-DA)荧光探针观察线粒体ROS的变化。结果:急性低氧应激后,大鼠心肌线粒体ROS呈上升趋势。与低住安静组相比,模拟海拔3000m和4000m急性高住安静组和急性高住运动组线粒体ROS均显著升高(P<0.05,P<0.01);与低住低练组相比,急性高住运动组均显著升高(P<0.01),模拟海拔4000m高住低练组显著升高(P<0.05);与急性高住运动组相比,模拟海拔3000m急性高住低练组和高住低练组均显著下降(P<0.05),可见模拟海拔3000m高住低练能使ROS生成减少。结果提示:心肌线粒体ROS可能参与低氧适应的形成和发展,高住低练有利于缺氧耐受性的形成。     

中日联合阿尼玛卿山医学科学考察——人在极高高原的生理研究

为了探讨人在极高高原的低氧生理适应,考察队在急速进抵阿尼玛卿山(海拔6282m)进行了一项综合性的生理学研究。在4个不同海拔(2261m,3719m,4 904m及5 200m)动态地检测了静息及运动负荷下的心肺功能、心电图改变、运动动脉血氧饱和度、球结膜微循环、神经反应时、睡眠特征、凝血因子、能量消耗与体重丧失,急性高山病的发生率及生理学评价指标,同时进行了低氧动物实验研究。本研究获取了大量有意义的高原生理资料,特别在若干生理反应和急性高山病的发生率上在汉族队员与藏族世居者间存在明显差别,提示他们生理适应方式的差别和高原藏族的适应优势。