玉树灾后重建参建工人高原睡眠的研究——平原与高原对比

Sleep Structure and Impaired Oxygenation in Healthy Lowlanders:Comparison between Sea Level and 3 750m Altitude

目的:平原工人进入玉树灾区重建期间普遍出现睡眠障碍,为此对比研究其在海平面和在高原的睡眠结构和血氧饱和变化。方法:对10名健康男性工人先在济南(50m)和在结古(3 750m)习服5个月后进行睡眠研究。应用多导睡眠监测仪(PSG)经行睡眠监测,按国际统一的睡眠监测方法实施。同时测定动脉血氧分压及动脉血氧饱和度。结果:在平原表现为正常的睡眠结构并有较高的睡眠血氧饱和能力。但到高原后出现明显的睡眠结构改变,总睡眠时间(TST,min)明显减少,1期非快眼动睡眠时间%(1-nREM)显著增加,而2nREM及3+4期快眼动睡眠时间%(REM)明显减少,反应处于浅睡眠状态。同时周期性呼吸活跃,伴有明显的睡眠低氧血症。但存在个体差异。在高原5个月后,受试工人的动脉血氧水平仍较低,而血红蛋白值则明显增高。结论:本研究证实平原健康工人尽管在海拔3 750m高原初步习服了5个月,但其睡眠生理结构仍未恢复至平原正常状态,长期处于浅睡眠使机体机能活动受到影响,而睡眠低氧血症导致高原红细胞增多是发生慢性高原病的病理途径。改善高原睡眠十分重要。

Objective：To compare the sleep structure and impaired oxygenation in lowlanders between sea level and high altitude.Methods：We performed two full polysomnography（PSG） in 10 male healthy workers who have been living in Jinan（50m altitude）,average aged 31±6.6 yr.After 5 months of acceleration to 50m（Jinan） and 3 750m altitude（Yushu） respectively,the sleep study,PaO2 and SaO2 were conducted.Results：The sleep structure was good with a higher arterial oxygenation at sea level.However,after the workers had worked at 3 750 m for 5 months,the number of awakenings ＋ arousals were increased,they presented a shorter sleep time,a longer stage 1 nREM sleep,and a shorter stage 2 nREM sleep with a lower PaO2 and SaO2 as compared with sea level.Periodic breathing（PB） appeared mainly during nREM sleep and maintained stable through the study period.After five months altitude exposure,the hemoglobing concentration（Hb） increased and some of them presented as polycythemia,but there was an individual variability.Conclusion：Our data suggest that the sleep structure changed significantly in lowlands veterans exposed to high altitude,even if they has been initially acclimatized to high altitude for 5 months.