急进不同海拔地区健康成人动脉血气变化研究

目的：通过对急进不同高海拔地区健康成年人动脉血气变化的研究,探讨高原地区血气变化规律及机体调节习服机制。方法：对急进到海拔2260m和4600m地区共计56名身体健康成年人进行随机抽样分组,分急进后的第1天、7天和15天3个时间段检测血气各项指标,使用SPSS12.0进行统计学分析。结果：①急进高原后1天、7天、15天各血气指标对比PaO2在第1天和第15天存在差异,其它各项指标均无差异性。各时间段均存在着轻度的低氧血症。多数急进者存在着轻度的碱血症;②急进海拔2260m与急进海拔4600m15天后进行血气分析对比,pH、PaO2、AB有差异,PaCO2有显著性差异,而SaO2无差异;④急进海拔2260m15天与海平面地区进行血气分析对比,pH无差异、PaO2有差异,而AB、PaCO2、SaO2、BEB均有显著性差异。急进海拔4600m15天与海平面地区进行血气分析对比,pH、PaO2、AB、PaCO2、BEB均有显著性差异,而SaO2有差异;⑤急进海拔4600m组和当地正常人群组相比,除了SaO2无差异性,其它各血气指标均存在差异和显著性差异。急进组pH、PaCO2、PaO2、AB、BE均略高于当地组。结论：①急进高原后,人体动脉血气在短时间内迅速通过肺功能的应激性调节、血液各缓冲系统的作用等机制达到一个新的平衡,在血气变化方面有着一定的＂高原调节储备＂;②急进高原健康人和当地久居或移居者之间的血气调节机制和＂调节储备＂都是不同的;③SaO2在筛选急性高原反应易感人群时,可能具有一定的价值。

The Changes of Arterial Blood Gas in Healthy Adults under Acute Exposure to Different High Altitudes Condition

Objective：To determine the relation between the changes of arterial blood gas and acclimation mechanisms in healthy adults who were exposed acutely to different high altitudes. Methods： 56 eligible adults, who were exposed acutely to 2 260m and 4,600m altitudes, were enrolled in this study. And their blood gas indexes, pH,PaO2,AB,PaCO2 ,BEB and SaO2, were measured on the 1st, 7th and 15th day after exposing altitude. The results were statistically analyzed with the SPSS 12. 0 software. Results： ① There was a difference on PaO2 between the first and 15th day; no difference on others indices. The all subjects had mild hypoxemia during three times, and most of them suffered from mild alkalemia. ② On the 15th post--altitude day, level of pH, PaO2, and AB had a difference between both altitude; while PaCO2 had significant difference and no difference of SaO2. ③There was a significant difference on AB, PaO2, SaO2, BEB on the 15th day at 2 260m compared with those in sea--level; the PaCh had a difference. The level of pH, PaO2, AB, PaCO2 and BEB on the 15th day at 4 600m had significantly difference compared with sea--level, but little difference on the SaO2. ④While compared with local healthy adults, the level of pH, PaCO2, PaO2, AB and BEB were higher at 4 600m but the SaO2 ; moreover, other indexes had/or significant differences. Conclusions：①The new balance of the change of arterial blood gas in healthy persons after post--altitude could be realized by a high altitude ＂operated store＂ in a short period. QThe blood gas regulative mechanism and store are different between healthy adults acutely exposed altitude and natives or the persistent migrants. ③The SaO2 index is valuable for screening the susceptibility of acute altitude response.