高原作业的电网职工肺功能及动脉血气变化调查研究

目的通过对进人不同海拔地区作业的电网联网职工肺功能及动脉血气变化的研究。分析高原环境对肺功能和动脉血气的影响，探讨高原环境下工作人员肺功能和动脉血气的变化规律及机体调节机制。方法随机选择在海拔2960~4200m地区（新都桥一甘孜县一石渠沿线）工作的电网联网职工468例，进行肺通气功能测试和血气分析检测，并对数据进行统计分析。结果①进入高原2～3个月后，用力肺活量（FVC）、Is用力呼气容积（FEV，）显著降低；1秒率（FEV。o／FVC）、最大呼气高峰流量（PEF）、最大通气量（MVV）、25％肺活量位最大呼气流速（FEF25％）、50％肺活量位最大呼气流速（FEF50％）、75％肺活量位最大呼气流速（FEF75％）明显升高；②进入高原前后肺功能差值受海拔高度影响变化明显，海拔越高，PEF、FEF＂／5％升高幅度越多，MVV升高幅度越小；③吸烟人群进入高原前后肺功能差值受吸烟量影响显著。进入高原后FEVl、FVC降低，吸烟量越大，降低程度越大。FEV。dFVC、FEF25％、Mvv升高，吸烟量越大，升高程度越小；④年龄因素对进入高原前后肺功能差值影响明显。年龄越大，FEV。加vC、MVV的升高幅度越小，FVC降低幅度越大；⑤进入高原前后血气指标pH、PaCO2、AB、BE均有一定的变化，其中反映机体缺氧程度的Pa02、Sa02的变化显著。结论①平原健康人群进入高原后由于小支气管与细支气管扩张，外周气道阻力降低，肺通气能力增强。缺氧导致用力肺活量及1秒钟用力呼气容积降低。其变化程度受海拔高度、年龄和吸烟量的影响。②海拔越高反映机体缺氧程度的Pa02、SaO2下降越明显。

Survey research of lung function and arterial blood gas changes for network workers in plateau

Objective To research the effect of altitude on lung function and arterial blood gas changes for network workers and define the dynamics of lung function and blood gas in plateau and the regulating mechanism in human body. Methods 468 consecutive network workers, working at an elevation around 2 960-4 200 meters （Xindu bridge-Ganzi county- along Shiqu）, were enrolled. Pulmonary function tests and blood gas analyses were performed on them. Results （~） After staying in plateau for 2-3 months, forced vital capacity（FVC） and forced expiratory volume in one second（FEVl） were reduced significantly. A second rate （FEVrJFVC）, peak expiratory flow （PEF）, maximal ventilatory volume （MVV）, 25% vital capacity maximal expiratory flow rate （FEF25%）, FEF50% and FEF75% increased significantly. @）Pulmonary function changed depending on altitude, the higher the altitude, the more the PEF and FEF＇/5% increased,the less the MVV increased. （~）Smoking greatly affected pulmonary function at highland, the more the smoking, the more the FEVa.0 and FVC decreased, the less the FEVrd FVC ,FEF25% and MVV increased. （~）Pulmonary function in plateau was influenced by age. The older the patients, the less the FEVjFVC and MVV increased, the more the FVC decreased. Oxygen pressure （PaO2） and oxygen saturation （SaO2） de- creased significantly. Conclusion When the plainsman stay in plateau, bronchia and bronchiole dilates, resistance of pe- ripheral airways decreases, the pulmonary ventilation increases. Hypoxia leads to lower FVC and FEV. The pulmonary function is affected by altitude, age and smoking. The higher the altitude, the more the PaO2 and SaO2 decreased.