高海拔跨度运输司乘人员红血球压积与心电图变化及相关性

The Changes of Leve1 of Hematocrit and ECG in Driver Between 3080m and 5072m Altitudes

目的:探讨高原施工中高海拔跨度运输作业对司乘人员红血球压积与心电图变化的影响及相关性.方法:利用SPSS11.0版统计软件对2003年参加青藏铁路建设司乘人员工前、工中、工后体检资料中的红血球压积和心电图进行统计分析,并与同时间段在固定海拔的施工者进行比较.结果:在一个施工年内高海拔跨度作业司乘人员红血球压积缓慢持续升高至工后达最高水平(P＜0.01),而此时心电图异常率则显著下降(P＜0.05);红血球压积在45.12%～52.24%之间,达到52%时心电图异常率得到显著改善,并且相关分析在此红血球压积范围心电图改变与红血球压积密切负相关(P＜0.05).结论:高海拔跨度作业司乘人员虽然长期对环境处于较高水平的应激状态而使血液红血球压积持续升高,但最终达到较合理红血球压积代偿使之处于'Hct最适宜'状态,从而改善了组织、器官的灌流状态,使心肌组织氧供达到最佳代偿从而使心电图异常率得到了显著改善.

Objective： To observe the changes of level of hematocrit and ECG and its clinical signiFicance in drivers and workers under high altitude condition. Methods： The data were collected from the drivers and workers to had taken part in Qing - tibet railway constructure before, during and after labor in 2003. The documents inclucling the hematocrit and ECG examination were reviewed and calculated by 11SPSS .0 software. The results were compared with matched subjects worked at 4 500m -5 000m for long - term. Results： The level of hematocrit was increased gradually from prior working to finish in the drivers and workers labored dynamically at high altitude, but the ECG abnormal rate was significantly decreased. When the level of hematocrit was up to 45.1% -52.24% the ECG showed less abnormal and there was a negative relation between the hematocrit and the ECG （P 〈 0,05 ）. Conclusions： The drivers and workers labored dynamically between 3 080m - 5 072m altitudes can finally develop a “Hematocrit adaptation”from alternative high level of hematocrit, and making the ECG to less abnorma too.