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目的观察高原重体力劳动对心功能的影响及返回低海拔地区后心功能的恢复情况。方法 96名快速进入高海拔(3700m)地区的男性官兵按照我国急性高原反应(AHAR)症状学计分方法进行评分和分度,并在从事重体力劳动50d及返回低海拔(1500m)后第2、15天清晨分别进行血清肌酸激酶同工酶(CK-MB)、乳酸脱氢酶同工酶(LDH-1)、Tei指数、左心室射血分数(LVEF)和左心室短轴缩短率(LVFS)测定,并与低海拔(1500m)地区的50名健康官兵(对照组)进行比较。结果 96名快速进入高海拔地区的男性官兵中共71例发生AHAR,其中重度24例,轻中度47例,其余25例未发生AHAR。血清CK-MB、LDH-1水平及Tei指数比较,重度AHAR组>轻中度AHAR组>无AHAR组>对照组,LVEF、LVFS比较,重度AHAR组<轻中度AHAR组<无AHAR组<对照组,组间两两比较差异均有统计学意义(P<0.01)。直线相关分析显示,海拔3700m暴露50d时,血清CK-MB、LDH-1与Tei指数呈显著正相关(r=0.625、0.598),与LVEF呈显著负相关(r=-0.716、-0.639),与LVFS亦呈显著负相关(r=-0.658、-0.727),差异均有统计学意义(P<0.01)。海拔3700m暴露50d时,血清CK-MB、LDH-1水平及Tei指数显著高于返回低海拔后第2天、第15天和对照组,且返回低海拔后第2天显著高于返回低海拔后第15天和对照组,LVEF、LVFS显著低于返回低海拔后第2天、第15天和对照组,且返回低海拔后第2天显著低于返回低海拔后第15天和对照组(P<0.01),返回低海拔后15d与对照组之间各指标无显著差异(P>0.05)。结论高原重体力劳动对部队官兵的心功能有明显损害,且随着AHAR程度的加重而加重,但返回低海拔后第2天即有显著改善,返回后第15天即恢复到正常水平。
Objective To observe the effect of heavy manual labor on cardiac function and the recovery of cardiac function after returning to low altitude. Methods Ninety-six male officers and men who were rapidly entering the high altitude (3700m) region were scored and indexed according to the AHAR Symptom Score Method, and were assessed after gravitation-related physical work for 50 days and return to low altitude (1500m) Serum creatine kinase (CK-MB), lactate dehydrogenase isoenzyme (LDH-1), Tei index, left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) and compared with 50 healthy officers and soldiers (control group) in the low altitude (1500m) area. Results A total of 71 AHAR patients were detected in 96 male officers and men who were rapidly entering the high altitude area. Among them, 24 were severe and 47 were mild and moderate. AHAR did not occur in the remaining 25 patients. Serum levels of CK-MB, LDH-1 and Tei index were compared between severe AHAR group> mild AHAR group> no AHAR group> control group, LVEF, LVFS, severe AHAR group 0.05). CONCLUSIONS: Heavy manual labor at the plateau significantly impaired the heart function of the officers and soldiers of the armed forces, and aggravated the degree of AHAR. However, it returned to normal level on the second day after returning to low altitude.