急性高原病患者Q—T离散度变化的研究

Research of the change of Q-T dispersion of the AHAD(acute high-altitude disease)patients

为了解急性高原病 (AHAD)患者在急性缺氧条件下 ,Q—T离散度 (QTd)的变化 ,对 40 1例AHAD患者QTd进行统计分析 ,并以 30 0例平原健康人作为对照。比较A HAD组与平原健康人组 ,急性高原肺水肿(AHPE)组与急性高原反应 (AHR)组两个亚组QTd值 ,分别比较AHAD组 ,两亚组男女之间QTd值。结果 :AHAD组QTd值均显著长于平原健康人组 (P均 <0 0 1 )。AHPE组心率 (HR)显著快于AHR组 (P <0 0 1 ) ,Q—Tcd两组相近 (P >0 0 5) ,其余各指标均显著短于AHR组 (P分别 <0 0 1 )。AHAD组及两亚组男女之间的比较 ,除AHPE组与AHR组JTd相近 (P >0 0 5)外 ,其余QTd值各组均为男性显著短于女性 (P均分别 <0 0 0 1或 <0 0 5)。结论 :①在急性缺氧条件下 ,AHAD患者均存在严重的心肌复极不均一性和心电不稳定性。②AHPE和AHR患者QTd值的变化受患者HR快慢和合并其它心血管疾病检出率的影响。③各组男女性别之间的比较提示 ,是否存在女性患者对急性缺氧的耐受性更差 ,使心肌复极不均一性和心电不稳定性更为突出 。

Objective:To understand the change of QTd(Q-T dispersion)of AHAD patients under the condition of oxygen-lack. Methods:We have counted and analyzed 401 AHAD patients'QTd,which have been compared with those of healthy flatlands people.We have also compared AHAD group with the group of healthy flatlands people.The QTd of AHPE(Acute high altitude pulmonary edema).subgroup and that of AHR(acutc high-altitude reaction)subgroup have been compared.The QTd of malc and female in two subgroups and that of AHAD group and that of AHAD group have also been compared. Result:The QTd value of AHAD group is remarkably larger than that of healthy flatlands people's group(P<0.01).The HR(heart rate)of AHPE group is remarkably faster than of AHR group(P<0.01),while the Q-Tcd of both groups are close and other targets of AHPE group are all remarkably smaller than that of AHR group(P<0.01).In the comparison between male and female of the AHAD group and the two subgroups,only the J-Td of AHPE group and AHR group are close,other QTd values of male are all remarkably smaller than that of female(P<0.001 or <0.05). Conclusion:①Under the condition of acute oxygen-lack,all AHAD patients have serious inequality of myocardial repolarization and instability of electrocardiogram.②The change of QTd value of AHPE patients and AHR patients is effected by the speed of HR and the combinative inspective rate of all other kinds of vascular diseases.③The comparison of each group between male and female points out that whether female patients have worse endurance of acute oxygen-lack which makes the inequality of myocardial repolarization and the instability of electrocardiogram more outstanding.It needs further research in future.