高原世居藏族及移居汉族缺氧性肺动脉增压反应的对比观察

The observation of hypoxic pulmonary pressure response in native Tibetans and immigrant Han nationalities

目的:探讨高原世居人及高原移居人缺氧性肺动脉高压及缺氧性肺动脉增压反应。方法:采用右心漂浮导管术,观察了5例高原世居藏族及5例移居汉族在静息吸入室内空气、100.0%纯氧及14.0%低氧后的肺动脉压变化。结果:5例高原世居者及4例高原移居者的静息肺动脉压在平原值的正常范围内,仅有1例高原移居者出现低氧性肺动脉高压;吸入14.0%低氧时,世居藏族及移居汉族均存在缺氧性肺动脉增压反应,其中移居汉族在吸入低氧1min时,肺动脉压即明显升高;而世居藏族在吸入低氧3min后,肺动脉压才开始上升。相反,世居藏族在停止吸入低氧1min后,增高的肺动脉压迅速恢复到正常水平,而移居汉族在停止吸入低氧10min后,增高的肺动脉压才恢复正常。结论:适应良好的高原世居藏族及移居汉族未发现有低氧性肺动脉高压,而高原世居者及移居者均存在低氧性肺动脉增压反应,但二者的这种增压反应存在着明显的种族差异。

Objective： To investigate the characteristics of the hypuxic pulmonary hypertension （HPH） and hypuxic pulmonary pressure response （HPPR） in native Tibetans and immigrant Han nationalities at high altitude. Method： The hemodynamic parameters and pulmonary arterial pressure were measured in 5 native Tibetans and 5 immigrant Han nationalities at rest, and after breathing 100% O2 or 14% O2. Result： Resting pulmonary arterial pressure （mPAP） of 5 native Tibetans and 4 immigrant Han nationalities was within .sea - level ranges and only one immigrant Han subject had HPH. The mPAP of all natives and immigrants increased while these subjects breathed a hypoxic gas mixture, but the elevation of mPAP became significant at 1 minute in Han nationalities and did significant at 3 minute in the natives, The mPAP of the natives returned to normal level after they stopped breathing hypoxic gas 1 minute, but the Han subjects needed 10 minutes, Conclusion： The pulmonary arterial pressures of the native Tibetans and well - adapted immigrant Ran subjects are similar to that of the healthy plain people, but all of these subjects have HPPR. The HPPR shows a racial variability between the native Tibetans and immigrant Han nationalities.