高原藏族青年人群移居平原后心脏结构和肺动脉压变化的研究

Investigation of the changes of cardiac structure and pulmonary arterial pressure 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其心脏结构、肺动脉变化以及与进入平原时间的关系。方法随机选取从久居西藏高原移居内地居住的藏族青年,经病史及相关检查排除其他原因引起疾病共60例、并随机选取健康内地大学生60例为对照组。在初入平原、进入平原1年、进入平原3年三个时间点分别检测心房心室、肺动脉等指标。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学分析。结果研究数据显示,初入平原组、进入平原1年组与进入平原3年组右心房(RA)和右心室(RV)内径明显大于对照组(P<0.05),尤其右心室内径增大最为显著(P<0.001)。值得注意的是,初入平原组、进入平原1年组与进入平原3年组右心房和右心室内径没有明显差异,即增大了的右心没有随着进入平原时间的延长而改变。研究对象左心房、左心室内径(LA、LV)各实验组间以及与对照组之间无明显差别,即,研究对象左心结构未发生高原适应性和脱适应性的改变。初入平原组肺动脉收缩压(PASP)值为32.35±5.20 mmHg明显高于其他各组和对照(P<0.001),而且随进入平原时间延长其值逐步减小至对照水平。而主肺动脉内径(MPA)、右肺动脉内径(RPA)各实验组间及与对照组没有明显差异。结论本研究表明,当进入平原肺动脉压逐步恢复正常;各实验组研究对象(即初入平原组,进入平原1年组,进入平原3年组)心脏结构尤其右心房室内径均明显大于对照组,而各实验组之间无明显差别,即心脏结构未随进入平原时间的延长而发生恢复性改变。

Objective To study the changes of cardiac structure and pulmonary arterial pressure happened to the Tibetan youths after their movement to the plain as well as the relations between the changes and time when they moved. Methods 60 cases were randomly chosen 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 60 healthy students randomly chosen. Examine their heart structure and pulmonary arterial pressure 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 anteroposterior diameter of the right atrium （RA） and right ventricular（RV） , from the experimental groups（just to the plain, one -year stay and three -year stay. ）, are significantly higher than those from control group（ P 〈 0.05 ）, particularly that of right ventricular（ P 〈 0. 001 ）. It is worthwhile to note that these indicators exist no significant differences between experimental groups,namely there are no restorative changes happened to the expanded right heart structure as the time extension to the plain. The values of left cardiac structure （LV and LA） between experimental and control groups exist no significant differences. PASP from the group just to the plain is 32.35 ±5.20, significantly higher than that from other groups （P 〈0. 001 ）, and gradually becomes less to the standard of the control group longer on the plain. Conclusions The study showed that, after movement to the plain, pulmonary arterial pressure gradually restore common. The values of anteroposterior diameter of the right atrium （RA） and right ventricular （RV） from the experimental groups, are significantly higher than those from control group. But there are no differences of RA and RV between the experimental groups, suggesting that no restorative changes happened to the expanded right heart structure as the time extension to the plain.