高原养路工高原红细胞增多症与性激素、免疫、血细胞的相关性

目的：调查高原慢性习服群体公路护路职工的高原红细胞增多症达到血液学诊断标准的患病率,揭示其性激素、免疫、血细胞的特征性改变及其生理与病理的关联。方法：随机抽取海拔（2 800~2 900）m、（3 600~3 740）m、（4 250~4 300）m护路职工189名,用免疫速率散射比浊法测定血清IgG、IgM、IgA含量,Epics XL流式细胞仪测定CD3、CD4、CD8,d iff2全自动血细胞分析仪测定21项血细胞,ACS180化学发光仪测定性激素FSH、LH、E2、P、PRL、T。结果：方差统计三个海拔梯度人群Hb≥210g/L者检出率分别为4.50%、17.20%和44.12%;同时与未患病组对照,偏相关、线性回归分析显示密切关联着特征性的LH降低、E2升高、PLT减少、Hct增高;还伴有一定相关的FSH、CD3、CD4、IgM、WBC、RBC升高和CD4/CD8比值减小。结论：在高原低氧环境中从事劳动强度较大的护路人群有较高Hb≥210g/L的检出率;Hb过度增生与这几方面存在着生理与病理的互相关联。

Study of Relationship between High Altitude Polycythemia and Features of Sex Hormones, Immune, Blood Cells in Road Maintenance Workers at High Altitude

Objective：To investigation prevalence of high altitude polycythemia met diagnostic criteria of hematology（Hb ≥210g/L） to reveal the relation between it and features of sex hormones,immune function,blood cells in road maintenance workers during high altitude chronic acclimatization.Methods：189 road maintenance workers were recruited from 2 800m~2 900m altitude,assigned in group Ⅰ（n=51）、3 600m~3 740m altitude,assigned in group Ⅱ（n=39）,and 4 250m~4 300m altitude,assigned in group Ⅲ（n=99） respectively.We measured the level of IgG、 IgM,IgA,CD3、CD4 and CD8,level,and FSH,LH,E2,P,PRL or T level using Immunization rate nephelometry,the full-automatic blood cell analyses,Stream style cell instrument（Epics XL）,and Bayer AG ACS180SE fully automated chemiluminescence instrument,respectively,in the three groups.Results：Detection rate of subjects with Hb ≥210g/L in group I,Ⅱ and Ⅲ was 4.50%、17.20% and 44.12%,respectively,and in which lower LH,PLT level,higher level E2 and Hct were found as compared with subjects withHb210g/L;Furthermore,these changes were accompanied by raised FSH,CD3,CD4,IgM,WBC and RBC,as well as decreased CD4 / CD8 ratio.All study data were analyzed statistically with the parTIAl correlation and linear regression analysis.Conclusions： In the high-altitude hypoxia environment,higher labor intensity and altitude would have a higher prevalence of high altitude polycythemia in road maintenance workers,and over-proliferation of Hb associates with these test parameters in physiology and pathology.