高原藏族青年人群移居平原后心电图变化的研究

Study of the changes of ECG performance happened to the Tibetan youths after their movement to the plain

目的:研究高原藏族青年人群移居平原后心电图变化及其与进入平原时间的关系。方法:随机选取世居西藏高原考入西藏民族学院的藏族青年大学生80例,经病史及相关检查排除其他原因引起的疾病,随机选取内地健康大学生80例为对照。在初入平原、进入平原1年、进入平原3年3个时间点分别检测研究对象和对照心电图R-R、P波时限、P波振幅、QRS波时限、Rv1、Sv5、Rv1+Sv5、Rv1/Sv1、T波时限、QT间期、电轴、Ⅰ导联S波振幅等指标。通过不同时间各项指标的差异对高原脱适应相关问题进行统计分析。结果:初入平原组R-R值和QT间期值明显大于进入平原1年组、进入平原3年组和对照组(P<0.001),这一变化同心率变化差异一致,而且随进入平原时间的延长QT间期值有逐渐减小的趋势。对照组的P波振幅显著低于各实验组(P<0.001),各实验组间P波振幅差异无统计学意义;对照组的S1值为(0.122±0.113)mV,明显低于各实验组(P<0.001),各实验组间S1值差异无统计学意义;对照组的T波时限明显高于各实验组(P<0.001)。结论:各实验组心电图R-R值和QT间期值变化与心率变化一致。各实验组的P波振幅和S1值明显高于对照组,而各实验组间P波振幅和S1值无差异,提示研究对象在刚进入平原时就可能已经存在右心结构的潜在改变,这种改变没有随进入平原时间的延长而恢复至对照水平。

Objective： To study the changes of electrocardiogram（ ECG） performance happened to the Tibetan youths after their movement to the plain as well as the relations between the changes and the time when they moved. Methods： Randomly choose 80 cases out of the Tibetan youths who have moved to the plain from their native Tibetan Plateau,and have been examined to make sure they have no disease caused by other factors,against 80 healthy students randomly chosen. Examine their ECG performance at three time points： just to the plain,one-year stay and three-year stay. Then make statistical analysis of high altitude deadaptation reaction according to the differences. Results： The values of R-R and QT interval,from the group just to the plain,were significantly higher than those from other experimental groups（ one-year stay and three-year stay at the plain groups） and control group（ P 0. 001）,and the changes were consistent with the heart rate variability in experimental groups,the values of QT interval gradually became less longer on the plain. The values of P wave amplitude and S 1 from experimental groups were significantly higher than that from control group（ P 0. 001）,and the values of P wave amplitude and S 1 existed no significant difference between experimental groups. T-wave duration from control group was significantly higher than that from experimental groups（ P 0. 001）. Conclusion： This study indicates that the values of R-R and QT interval are consistent with the heart rate variability in experimental groups. P wave amplitude and S 1 from experimental groups are significantly higher than that from control group,and these indicators（ P wave amplitude and S 1） exist no significant differences between experimental groups,which suggests that just into the plains,the potential change of the right heart structure in experimental subjects may already exist,and compared with the control group,there are no restorative changes of expanded right heart structure to the time extension to the plain.