慢性间歇性进入高原对铁路乘务人员血液生化学的影响

The Influence of Long-Term Intermittent Altitude Hypoxia on Blood Biochemical Level in Qinghai-Tibet Railway Crew

目的:探讨长期间断性往返高原—平原环境工作的铁路列车员血液生化改变。方法:平原地区健康青年男性30人,分别测定了平原、规律间断往返平原—高原工作环境8个月、2年的血常规、血生化水平。结果:RBC、Hb、HCT随工作周期的延长,呈先上升后下降的变化,两年组RBC、Hb、HCT仍高于基线水平,但都在临床诊断标准的正常范围内。ALT、AST活性在间断进入高原8个月时增加最明显,2年时ALT、AST则有下降,趋于基线水平。高原暴露时SDB、SDT水平明显高于基线水平,并随着工作时间的延长而呈增加趋势。随着往返高原时间的延长BUN、Cr是升高的,TC、TG较基线值无显著差异。结论:两年间断性往返于平原—高原工作未对青藏铁路乘务人员身体产生明显影响,说明青藏铁路现行的轮班制度及机车低氧防护措施对乘务人员的健康防护是有效的,降低了高原低氧对乘务人员的损伤。

Objective：To investigate the changes of blood biochemical level at long-term intermittent altitude exposure in Qinghai-Tibet railway crew.Methods：30 healthy young men （mean 23.93±1.36 year old） who born and have been lived in the plain areas,and long-term work from Beijing-Lhasa,were recruited in this study. The blood samples were collected at 6 o＇clock in morning,and the routine blood test and analysis of blood biochemistry were done before going to the plateau （as baseline） and after round-trip work for 8 months and 2 years.Results：Level of RBC,Hb and HCT increased and then decreased with shorter and longer cycle; level of RBC,Hb and HCT after 2 years work was higher than baseline,but the levels were within normal range of the clinical diagnostic criteria. Activity of ALT and AST were significantly increased after 8 months round-trip,and decreased approaching baseline after round-trip work for 2 years. Level of SDB and SDT was significantly higher than baseline at high altitude and extended with elevating altitude.Conclusions：No obvious changes on blood biochemical level were found in duration of intermittent work from plain- plateau in Qinghai-Tibet railway crew. The results show that the current shift system and measures on health protection for passengers in railway operation are effective.