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目的:调查高原慢性习服群体公路护路职工的牙龈出血患病率,揭示其血液细胞、心电图的特征性改变极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 179名。症状获取:采用临床医学问诊法与物理体检;血液Rbc检测:采用Beckman-Coulter公司的diff-2三分类血细胞分析仪及配套试剂;心电图检测:采用德国产mac1200型12导心电图机。结果:人群总患病率40.8%,随海拔梯度增加(P<0.05);与高原血小板减少症相偕患病率38.4%;与未患病组对照、相关、Binary Logistic回归分析显示高原牙龈出血密切关联着特征性的BPC减少、aVR、R、S比值≥1以及QRS心电轴明显右偏,与无出血组比较还常伴有较高的Rbc、Hb、Hct增高率。结论:在高原低氧环境中从事劳动强度较大护路人群有较高高原牙龈出血患病率;提示高原牙龈出血是高原慢性低氧损害全身变化的局部病理表现。
OBJECTIVE: To investigate the prevalence of gingival bleeding in road care workers of high-altitude chronic adherence groups and to reveal the characteristic changes of blood cells and electrocardiogram, which are extremely related to the pathophysiology. Methods: 179 randomly selected m altitude (2 800 ~ 2 900 m), (3 600 ~ 3 740 m) and (4 250 ~ 4 300 m) were randomly selected. Symptom acquisition: using clinical medical interrogation and physical examination; blood Rbc detection: using the Beckman-Coulter’s diff-2 three class blood cell analyzer and ancillary reagents; ECG detection: the use of the German-made mac1200 12-lead ECG machine. Results: The total prevalence of the population was 40.8%, with the increase of altitude gradient (P <0.05), the relative incidence of thrombocytopenia with plateau was 38.4% .Binary Logistic regression analysis showed that the high altitude gingival bleeding Closely associated with the characteristic reduction of BPC, aVR, R, S ratio of 1 and QRS axis significant right deviation, compared with non-bleeding group often accompanied by higher Rbc, Hb, Hct increased rate. CONCLUSION: The prevalence of gingival bleeding in plateau patients with high labor intensity is higher than that in high altitude hypoxia. It is suggested that the high altitude bleeding is the local pathological manifestation of systemic changes of chronic hypoxia injury in the plateau.