急进高原个体机体炎性改变及其胃肠黏膜屏障损伤情况分析

Analysis of inflammation change and damage of gastrointestinal mucosal barrier in individuals after fast entering plateau

目的:探讨急进高原个体机体炎性改变及其胃肠黏膜屏障损伤的特点。方法:对20例由平原急进高原个体于进入高原前、进入高原第三天和第七天进行胃镜检查,并对进入高原后消化系统的症状发生情况进行调查,同步抽取血液标本,做血常规的白细胞总数(WBC)、中性粒细胞(N)、淋巴细胞(L)及白介素-1(IL-1)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血小板活化因子(PAF)等炎症介子的含量进行检测。结果:20例平原个体急进高原后血常规WBC、N及IL-1、IL-6、TNF-α、PAF等炎症介子均较平原显著升高,L较平原显著降低,均以进入高原第三天改变最为显著,与进入前比较P<0.01,与第七天比较P<0.05,L为第三天与进入前比较P<0.05、与第七天比较P>0.05。胃镜检查者,进入高原第三天及第七天胃镜检查阳性例数分别为17例(约85%)和10例(50%),与进入高原前比较差异均具有显著性(P<0.01),胃镜下主要表现有胃黏膜出血、充血、淤血、糜烂、溃疡及胆汁反流等,13例存在不同程度的消化系统症状(占65%)。结论:高原缺氧对急进高原个体肠道黏膜屏障存在明显的损伤,并引发机体的炎性改变。而机体的这种炎性改变又可能进一步加重胃肠道的黏膜屏障损伤。

Objective：To analyze the inflammation change and damage of gastrointestinal mucosal barrier in individuals after fast entering plateau.Methods：20 individuals entering plateau rapidly from plain were peribrmed the gastroscopic examination before entering plateau,on 3,7 d after entering plateau.The occurrence status of digesting symptoms after entering plateau was investigated.The blood samples were synchronously collected for detecting the plasma levels of WBC ,neutrophil（N）,lymphocytes （L）,interleukin-1 （IL-1）,interleukin-6 （IL-6）,tmnor necrosis factor-α （TNF-α） and platelet activating factor （PAF）.Results ：The plasma levels of WBC,N,IL-I,IL-6, TNF-α and PAF after fast entering plateau were significantly increased compared with those in plain, while L was obviously lower than those in plain, in which the changes on 3 d after entering plateau were most remarkable.Among them,WBC,N,IL-1,IL-6,TNF-α and PAF showed P〈0.01 on 3 d and P〈0.05 on 7 d. L showed P〈0.05 on 3 d and P〉0.05 on 7 d. In the gastroseopic examination,the positive results were 17 cases on 3 d （85%） and 10 cases on 7 d（50%）, showing significant difference compared with those before entering plateau （P〈0.01）. The gastroscopic manifestations were bleeding,hyperemia ,erosion and ulcer of stomach mucosa and biliary reflux. 13 cases had different degrees of digesting symptoms （65%）.Conclusion：Hypoxia in plateau can not only obviously damage the gastrointestinal mueosal barrier,but also result in inflammation change of body,and this kind of inflammation change could further aggravate the damage of gastrointestinal mueosa.