多普勒超声心动图评价不同海拔高原驻守官兵心功能

Evaluation of the heart function of officers and soldiers stationed on high plateau at different altitude with Doppler echocardiography

目的比较驻守海拔2800 m官兵与海拔4820 m官兵的左心功能及右心参数变化差异,探讨海拔高度对高原驻守官兵心脏的影响。方法利用飞利浦便携CX50型超声诊断仪,对驻守海拔2800 m官兵33名(A组)和海拔4820 m官兵25名(B组)行超声心动图检查,重点检查左室短轴舒张末内径(LVDd)、左房收缩末左右径(LASd)、右房收缩末左右径(RASd)、右室舒张末左右径(RVDd)、肺动脉内径(PAd)、二尖瓣口E峰与A峰血流速度(MVE、MVA)、二尖瓣环舒张早期速度(E')、二尖瓣环舒张晚期速度(A')、肺动脉加速时间(PVAT)、肺动脉平均压力(PAMP)。结果 B组的MVE、MVA、E'、E'/A'均低于A组,LVDd小于A组,PAd及A'大于A组,PVAT明显小于A组,PAMP明显高于A组(P<0.05),两组RASd、RVDd无显著差异(P>0.05)。结论与低海拔高原驻守官兵比较,驻守超高海拔高原官兵左室舒张功能减低,PAd增宽,PVAT缩短,PAMP增加,表明超高海拔高原环境对驻守官兵的心脏有一定影响,应该制定相应的健康保障策略,以切实防止或减轻超高海拔高原对官兵健康的影响。

Objective To discuss the effects of high altitude on heart function of the officers and soldiers stationed on plateau by comparing the heart function parameter of officers and soldiers stationed at the altitude of 2800 m above sea level and the altitude of 4820 m above sea level. Methods Philips CX50 portable ultrasonic diagnostic scanner was applied to perform echocardiogram for 33 officers and soldiers stationed at the altitude of 2800 m（ group A）and 25 officers and soldiers stationed at the altitude of 4820 m（ group B）,the main focus was set on left ventricular end-diastolic diameter（ LVDd）,left atrium end-systolic diameter（ LASd）,right atrium end-systolic diameter（ RASd）,right ventricle end-diastolic diameter（ RVDd）,pulmonary artery inner diameter（ PAd）,mitral valve flow peak E velocity and peak A velocity（ MVE,MVA）,early diastolic mitral annulus velocity（ E′）,late diastolic mitral annulus velocity（ A′）,acceleration time（ PVAT）of pulmonary artery,mean pulmonary artery pressure（ PAMP）. Results The MVE,MVA,E′,and E′/A′of the officers and soldiers in group B were lower than those of officers and soldiers in group A;LVDd in group B was smaller than that in group A;PAd and A′in group B were bigger than those in group A（P﹤0. 05）;there existed no difference of inner diameter of RASd and RVDd between the 2 groups;the acceleration time（ PVAT ）in group B was obviously shorter than that in group A;the mean pulmonary artery pressure（PAMP）in group B was obviously higher than that in group A（P﹤0. 05）. Conclusions The left ventricular diastolic function of the officers and soldiers stationed at high altitude decreases with PAd broadened,PVAT shortened and PAMP increased,which indicates that super-high altitude is of certain negative impact on the heart function;certain health care measures should be made and taken.