长期氧疗对移居海拔5000 m以上地区男性青年的影响

Impacts of long-term oxygen therapy on young men who immigrated to High Altitude above sea level 5000 m

目的探讨长期氧疗对移居海拔5000 m以上地区男性青年的影响。方法 344名男性青年移居5000 m以上地区半年后,依据慢性高原病(CMS)诊断标准进行CMS症状评分,将总分>5分的147名纳入试验,随机分为氧疗组(n=74)和对照组(n=73)。氧疗组采用双鼻导管吸氧,流量2~3 L/min,60 min/次,2次/d;对照组不吸氧。半年后调查匹兹堡睡眠质量指数(PSQI)和CMS症状评分,测量血压(BP)、心率(HR)和血氧饱和度(Sa O2),检查心电图和超声心动图,抽取静脉血检测血红蛋白(Hb)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血尿素氮(BUN)、肌酐(CR)等指标。结果试验过程中,脱落13名,氧疗组66名和对照组68名纳入分析。半年后,与对照组比较,氧疗组CMS症状总分、PSQI总分、HR、Hb、ALT和BUN降低,Sa O2升高(P<0.05~P<0.01),但两组血压异常率无显著差异(P>0.05);氧疗组异常心电图和右室肥厚降低(P<0.01),右室内径、右房内径、三尖瓣反流压差、右室流出道及其异常率降低(P<0.05~P<0.01),二尖瓣舒张期E峰和A峰比值增高(P<0.05~P<0.01)。结论氧疗能改善5000 m以上地区青年睡眠质量,减轻CMS症状,减少高原红细胞增多症和高原心脏病的发生。

Objective To explore the impacts of long-term oxygen therapy on young men who once immigrated to High Altitude above sea level 5000 m. Methods A total of 344 young men who had immigrated to regions above 5000 m for half a year received chronic high altitude sickness（CMS） symptom scoring according to the diagnostic criteria of CMS. Totally 147 young men with scores 5 points were included in the experiment and randomly divided into an oxygen therapy group（n =74） and control group（n =73）.Oxygen-absorbing by nasal trachea was applied to the oxygen therapy group, flow 2-3 L/min, 60 min/time, 2 times/d; the control group did not absorb oxygen. Half a year later, Pittsburgh sleep quality index（PSQI） and CMS symptom score were surveyed. The blood pressure（BP）, heart rate（HR） and oxyhemoglobin saturation（Sa O2） were measured, and ECG and echocardiography were inspected.Venous blood was sampled to detect such indexes as haemoglobin（Hb）, alanine transaminase（ALT）, aspartate transaminase（AST）, blood urea nitrogen（BUN） and creatinine（CR）. Results In the process of experiment, the device for 13 young men fell off. Totally 66 young men in the oxygen therapy group and 68 in the control group were included in the analysis. Half a year later, compared with the control group, the aggregate CMS symptom score, aggregate PSQI score, HR, Hb, ALT and BUN in the oxygen therapy group decreased and Sa O2 increased（P 〈 0.05~P 〈 0.01）, but there was no significant difference in the abnormal rate of BP between the two groups（P 〈 0.05）;half a year later, compared with the control group, the abnormal ECG and right ventricular hypertrophy（RVH） in the oxygen therapy group decreased（P 〈 0.01）, and the inner diameter of the right ventricle, the inner diameter of the right atrium, the tricuspid regurgitation pressure difference, the outflow channel of the right ventricle and its abnormal rate decreased（P 〈 0.05-P 〈 0.01）, while the ratio of peak A and peak E in mitral diastolic phase increased（P 〈 0.05-P 〈 0.01）. Conclusion Oxygen therapy can improve the sleep quality, reduce CMS symptoms and lower the incidence of high altitude polycythemia（HAPC） and high altitude heart disease（HAHD）among young men in regions above 5000 m.