青年高血压1级患者进驻高原高寒地区后血压变化及其可能机制

Influence and analysis of blood pressure in young soldiers with first-stage hypertension during plateau encampment

目的研究高原高寒地区短期驻训对罹患高血压Ⅰ级青年官兵血压的影响并分析其可能机制。方法测定13名高血压Ⅰ级青年官兵基础血压和高原驻训期间血压和心率(驻训10,30,60 d),并采集相应时间点血样检测血管紧张素Ⅰ、血管紧张素Ⅱ、醛固酮和皮质醇水平。结果进驻高原10 d后官兵收缩压和舒张压均较基线水平显著升高(P<0.05),此后驻训30 d和驻训60 d患者收缩、舒张压数值均高于基线水平(P<0.05)。比较驻训高原前后全天平均心率未见组间明显差异。分析机制发现,高原驻训10 d起血管紧张素Ⅰ和血管紧张素Ⅱ水平均较驻训前显著升高(P<0.05),且此后持续高于驻训前水平(P<0.05),而血清醛固酮和皮质醇水平在驻训60 d时较驻训前显著升高(P<0.05)。结论高原高寒环境作为应激刺激会导致高血压1级青年官兵血压出现持续升高,其机制可能与肾素-血管紧张素-醛固酮系统激活及应激激素水平升高相关。

AIM To investigate the influence of blood pressure （BP） on young soldiers with first-stage hypertension during plateau encampment and to analyze the underlying mechanisms. METHODS BP of 13 young soldiers with first-stage hypertension was recorded at different time points （before arriving at plateau and 10 days, 30 days, 60 days after plateau encampment） and blood samples at corresponding time points were obtained for analysis of hormone levels. RESULTS BP on llth, 31st and 61st day of plateau encampment was significantly higher than baseline （P 〈 0. 05 ）. Hormone levels of angiotensin II were consistently higher than baseline from the 11 th day of plateau encampment, and aldosterone and cortisol contents were significantly higher on the 61st day of encampment than at baseline. CONCLUSION During plateau encampment, high blood pressure of soldiers suffering first-stage hypertension deteriorates, which is probably related to activation of the renin-angiotensin-aldosterone system and elevation of stress hormone levels.