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目的:探索高原红细胞增多症患者(high altitude polycythemia,HAPC)的临床治疗方案。方法:采用随机对照开放原则对确诊的HAPC患者进行疗效研究。治疗方案分为3类,分别为厄贝沙坦、无创呼吸机、厄贝沙坦+无创呼吸机,研究主要指标及分析方法为治疗前后的血红蛋白(hemoglobin,Hb)以及各组之间Hb的下降幅度进行比较。结果:共75例HAPC患者进入本研究,经过2~3周的治疗,Hb水平在厄贝沙坦组由治疗前236.15±22.02g/L下降到226.19±22.27 g/L(p<0.05);无创呼吸机组由241.36±18.71 g/L下降到227.66±24.90g/L(p<0.05);厄贝沙坦+无创呼吸机组由237.34±19.29 g/L下降到222.92±18.68g/L(p<0.05),各组之间Hb下降幅度没有达到无显著差异。结论:HAPC的治疗是高原医学的难点和瓶颈,本研究表明厄贝沙坦、无创呼吸机、厄贝沙坦+无创呼吸机对HAPC患者能够起到短期的降低Hb的作用,为探索HAPC的规范治疗提供重要依据。
Objective: To explore the clinical treatment of patients with high altitude polycythemia (HAPC). Methods: The randomized controlled open principle of HAPC patients diagnosed efficacy study. The treatment regimens were divided into three groups: irbesartan, non-invasive ventilator and irbesartan + noninvasive ventilator. The main indexes and analysis methods were hemoglobin (Hb) before and after treatment and Hb Drop rate to compare. Results: A total of 75 HAPC patients were enrolled in this study. After 2 to 3 weeks of treatment, the Hb level decreased from 236.15 ± 22.02 g / L to 226.19 ± 22.27 g / L in irbesartan group (p <0.05). Noninvasive ventilator decreased from 241.36 ± 18.71 g / L to 227.66 ± 24.90 g / L (p <0.05); irbesartan + noninvasive ventilator decreased from 237.34 ± 19.29 g / L to 222.92 ± 18.68 g / L (p < 0.05), Hb decline between the groups did not reach no significant difference. Conclusion: The treatment of HAPC is the difficulty and bottleneck of plateau medicine. This study shows that irbesartan, noninvasive ventilator and irbesartan + noninvasive ventilator can play a role in reducing Hb in short term in HAPC patients. To explore the effect of HAPC Standardized treatment provides an important basis.