汉族人群移居高原后其心脏结构、心功能和肺动脉压等变化的研究

目的：研究汉族人群移居高原后其心脏结构、心功能、肺动脉压变化。方法：随机选取从内地平原移居至西藏高原多年（移居高原时间：28．88年±9．76年）的汉族人群，经病史及相关检查排除其他原因引起疾病共67例为移居高原组，并随机选取内地平原健康者61例为平原对照组。分别检测其心脏结构、心脏功能、肺动脉压和瓣膜口血流速度等指标，并进行统计分析探讨高原心血管适应问题。结果：移居高原组右心房、右心室和左心房内径；肺动脉收缩压、肺动脉内径、右肺动脉内径，均显著大于平原对照组（P〈0．001），而且移居高原组内肺动脉收缩压与右心房、右心室内径存在正相关关系（r=0．370，P=0．011；r=0．403，P=0．005）。移居高原组左室射血分数显著高于平原对照组（P=0．018）、而心脏指数明显低于平原对照组（P=0．036）、每搏输出量和心输出量值两组无明显差异。移居高原组二尖瓣舒张期血流E峰、二尖瓣舒张期血流A峰、三尖瓣舒张期血流E峰、三尖瓣舒张期血流A峰均明显高于平原对照组（P=0．000）。结论：本研究表明，汉族人群移居高原多年后其心脏结构、心功能、肺动脉压、瓣口血流速度等指标均发生了显著的高原适应性变化；而且研究表明移居高原者心脏增大与肺动脉收缩压升高之间存在关联。

Study on the changes of cardiac structure,heart function and pulmonary arterial pressure of the Chinese Hans after them moved to the Tibetan Plateau

Objective：To Study the changes of cardiac structure, heart function and pulmonary arterial pressure of the Chinese Hans after them moved to the Tibetan Plateau. Methods：RandomLy select 67 cases of Chinese Hans who have moved to the Tibetan Plateau many years （time of moved to the plateau： 28.88 ± 9.76 years）, and been examined to make sure they have no disease caused by other factors, against 61 healthy persons residence in the plain area as the control. The cardiac structure, heart function and pulmonary arterial pressure and valve flow velocity were examined. Then the differences of high altitude reaction analyzed by statistics. Results： The values of diameter of the right atrium（ RA）, right ventricular（RV） and left atrium（LA） ; pulmonary artery systolic pressure （PASP） ; the diameter of pulmonary artery （PA） and the right pulmonary artery（RPA） of the plateau group were significantly bigger or higher than those from control group （ P 〈 0.001 ）, And there was a positive correlation between PASP and RA or RV of the plateau group （ r = 0. 370, P = 0.011 ; r = 0.403, P = 0.005 ）. The values of left ventricular ejection fraction（EF） was significantly higher than those of control group（P =0. 018） ,and cardiac in- dex（CI） significantly lower than those of control group（ P = 0. 036）. There was no significant difference between Stroke volume （SV） and cardiac output （CO） value of the plateau group and the control. Mitral flow velocity of E peak （ MV E peak）, Mitral flow velocity of A peak （ MV A peak）, Tricuspid blood flow velocity of E peak （ TV E peak ）, and Tricuspid blood flow velocity of A peak （ TV A peak） of the Plateau group were significantly higher than those of control group（P 〈 0.001 ）. Conclusions： Cardiac structure and function, pulmonary artery pressure and mitral valve flow velocity have undergone significant changes in Chinese Hans migrated to plateau for many years during the course of acclimatization and ther