急进海拔5400m20天X线胸片追踪观察

X-RAY STUDY OF ADULT SUBJECTS DURING ACUTE EXPOSURE HIGH ALTITUDE(5 400m)

目的：为进一步探讨高原肺水肿的发病机理，为预防和治疗提供理论依据；方法：对进驻特高海拔地区的32名青年在上高原前（海拔1400m）和急进（4天）海拔5400m第3、8、20天分别拍摄后前往X线胸片，测量心肺12项指标并进行自身对照分析；结果：急进海拔5400m第3～20天内，心脏横径、心脏长径、心脏面积逐渐缩小；肺动脉干横径、肺动脉段突度、右肺下动脉横径、升主动脉横径、主动脉结横径、降支与气管比值逐渐增大；胸宽径和肺面积在第3天及第8天时缩小非常明显（P＜0．001及P＜0．01），在第20天基本习服后较上高原前稍有增大（P＞0．05）；结论：人体进入特高海拔地区第3～8天由于心脏代偿性排出增高及肺部反应性瘀血使两肺明显缩小，此阶段是高原肺水肿发病的高峰期。

Objecive:To explore the pathogenic mechanism of high altitude pulmonary edema for prevention and treatment. Methods: Transverse diameter of heart (TDh), longitudinal diameter of heart(LDh), cardiac area (CA), transverse diameter of main pulmonary artery (TDpa), projection ofpulmonary artery segment (Pas), transverse diameter of,main pulmonary artery (TDpa),projection of pulmonary artery segment (Pas), transverse Diameter of right lower pulmonary artery (TDrpa),etc in 32 adults were measured on chest films before and after 3,8 and 20 days of exposing to 5 400m altitude. Results: TDh,LDh,HA, were descresed slowly. TDpa, Pas and TDrpa wereincreased during acute exposure altitude,but width of chest and area of lung reduced significantly on third and sib days (P＜0. 001,P＜0．01). Conclusions: HAPE was a sharp incidence during ～20 days of exposure altitude (5 400m) because of increased heart output and pulmonary hypermia.