舰艇官兵长航致部分生理指标改变后的干预措施研究

Effects of prolonged escort mission on the physiological indexes of navy afloat personnel and research of intervention measures

目的探讨长时间远洋护航对舰艇官兵部分生理指标的影响及干预措施的效果。方法选择2013年7-12月赴索马里海域护航官兵287名,年龄19～44岁,均为男性,出航前经医院全面体检身体合格。其中A舰161名官兵为干预组,B舰126名官兵为非干预组。对2组官兵护航前及护航后血液中的钾、钠、氯、钙、铁、铜、磷、镁、谷丙转氨酶（ALT）、谷草转氨酶（AST）、肌酸激酶（CK）、磷酸肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、尿酸（UA）、总蛋白（TP）、白蛋白（ALB）、低密度脂蛋白胆固醇（LDL-C）、脂蛋白a（Lpa）及肌钙蛋白l（c Tnl）指标进行检测。结果护航后非干预组与护航前相比,钾、钙、铁、铜、磷、镁、TP、ALB下降差异有统计学意义（P〈0.05或P〈0.01）;钠、氯、ALT、AST、CK、CK-MB、LDH、UA、Lpa、LDL-C上升差异有统计学意义（P〈0.05或P〈0.01）;c Tl差异无统计学意义（P〉0.05）。护航后干预组与护航前相比：钾、钠、氯、钙、铁、铜、磷、镁、UA、TP、ALB、LDL-C、Lpa、LDH、c Tl差异无统计学意义（P〉0.05）;ALT、AST、CK、CK-MB差异有统计学意义（P〈0.05或P〈0.01）。结论综合干预后钾、钠、氯、钙、铁、铜、磷、镁、UA、TP、ALB、LDL-C、Lpa得到纠正;ALT、AST、CK、CK-MB得到改善,但未达到完全纠正的预期目标,经对心肌损伤特异性标志物c Tl检测证实,心肌未受明显损伤,认为酶类升高是强训和疲劳后引起含这些酶类细胞破坏的集中反应。

Objective To explore the effects of prolonged escort mission on the physiological indexes of navy afloat personnel and research of intervention measures. Methods A total of 287 male soldiers,with an age between 19 and 44,who participated in the escort mission off Somalia from July to December,2013,were selected as research subjects. One hundred and sixty-one from vessel A were designated as the intervention group,and 126 from vessel B were assigned as the non-intervention group. Physical examination before deployment indicated that they were all fit for the mission. Detections were made on the levels of K,Na,Cl,Ca,Fe,Cu,P,Mg,alanine aminotransferase（ ALT）,aspartate aminotransferase（ AST）,creatine kinase（ CK）,CK-MB,lactate dehydrogenase（ LDH）,uric acid（ UA）,total protein（ TP）,albumin（ ALB）,low density lipoprotein cholesterol（ LDL-C）,lipoprotein a（ Lpa） and cardiac troponin（ c Tn I） in the afloat personnel of the 2 groups both before and after the escort mission. The intervention group received dietary,drug and psychological intervention measures. Results After the escort mission,serum concentration levels of K,Ca,Fe,Cu,P,Mg,TP and ALB in the non-intervention group were decreased with statistical significance,as compared with those of the before the escort mission（ P〈0. 05 or P〈0. 01）. The levels of Na,CL,ALT,AST,CK,CK-MB,LDH,UA,Lpa,LDL-C were all increased with statistical significance（ P〈0. 05 or P〈0. 01）. However,no differences could be seen in the levels of c Tl（ P〉0. 05）. For the intervention group,upon completion of the mission,no differences could be noted in the serum concentration levels of K,Na,Cl,Ca,Fe,Cu,P,Mg,UA,TP,AL B,LDL-C,Lpa,LDH and c Tl,without statistical significance,as compared with those before the escort mission（ P〉0. 05）. However,statistical significance could be found in the levels of ALT,AST,CK,CK-MB（ P〈0. 05 or P〈0. 01）.Conclusion In accordance with the changes in the physiological indexes of prolonged deployed navy afloat personnel,comprehensive intervention could recover the serum levels of K,Na,Cl,Ca,Fe,Cu,P,Mg,UA,TP,ALB,LDL-C and Lpa. The levels of ALT,AST,CK,CK-MB were improved,but failed to recover to the predicted levels. Detection of c Tl,a specific myocardial injury biomarker,indicated that no obvious cardiac damage was done to cardiac mussel,suggesting that the elevated levels of enzymes were a reflection of enzyme damage induced by high-intensity training and fatigue.