高原铁路血红蛋白增高职工血中一氧化氮检测结果

Detection results of nitric oxide in blood of workers with high hemoglobin in plateau railway

目的对青藏高原铁路运营期血红蛋白增高职工不同工作及生活方式情况下血中一氧化氮浓度与血红蛋白不增高职工进行对照研究,探讨利用血中一氧化氮浓度预防早期慢性高原病的方法。方法在2015年高原健康检查的2 017名职工中随机均衡选取血红蛋白升高的62名男性作为研究组,血红蛋白正常的63名男性作为对照组,对这些职工在健康检查时同时进行血中一氧化氮、血红蛋白等指标测定,并进行工作及生活方式调查。对研究组、对照组按照不同情况进行方差分析或t检验。结果研究组血中一氧化氮[(72.48±43.7)μmol/L]、血红蛋白[(194.55±13.77)g/L]高于对照组(均P<0.05);研究组年龄40~49岁[(97.12±45.43)μmol/L]、20~29年工龄[(82.15±57.31)μmol/L]、在高原工作4~6年[(85.14±49.49)μmol/L],无规律轮休[(87.16±31.27)μmol/L]、无轮休人群[(107.61±46.46)μmol/L]、经常鼻孔插管吸氧人群[(83.47±53.22)μmol/L]、每日抽半包烟人群[(78.86±52.38)μmol/L]血中一氧化氮高于对照组(均P<0.05)。结论青藏高原铁路运营期血红蛋白增高职工血中一氧化氮要高于血红蛋白不增高职工,且血中一氧化氮浓度因不同工作与生活方式有所不同。为早期预防慢性高原病的发生,建议血红蛋白增高人员在高原健康检查中增加血一氧化氮检测指标,同时需要特别关注年龄40~49岁、工龄10~29年、上高原工作4~6年且血红蛋白增高的人群,在高原工作中提倡禁烟、避免不规律的轮休。

[Objective] To investigate the nitric oxide concentration in blood of workers with high hemoglobin at different working and life styles during operation period of the Qinghai Tibet Plateau Railway, compare with the workers with normal hemoglobin, and explore the possibility of preventing chronic altitude disease by using nitric oxide in blood. [Methods] A total of 62 male workers with high hemoglobin were randomly collected from 2 017 employees who have received the health examination in 2015 as the study group, and 63 male workers with normal hemoglobin were enrolled in the control group. The nitric oxide and I hemoglobin in blood were detected while the health examination, and the working and life styles of the workers were investigated at the same time. Statistical analysis was made between study group and control group by variance analysis and t test. [Results] At the study group, the nitric oxide [（72.48±43.7） μmol/L] and hemoglobin [（194.55±13.77） g/L] blood were higher than those in the control group （both P〈0.05）. It was showed that the nitric oxide in blood in study group workers, who were 40-49 years old [ （97.12±45.43 ） μmol/L], had 20-29 years of working age [ （82.15 ±57.31 ） μmol/L], had worked on the plateau for 4-6 years [（85.14±49.49） μmol/L], worked in shifts irregularly [（87.16±31.27） μmol/L], without rest day [（107.61±46.46）μmol/L],often took oxygen inhalation by nostril cannula [（83.47±53.22） μmol/L], and smoked half a pack of cigarettes a day [（78.86± 52,38） μmol/L], was higher than that in control group （all P〈0.05）. [Conclusion] During operation period of the Qinghai Tibet Plateau Railway, the nitric oxide concentration in blood of workers with high hemoglobin is higher than that in those with normal hemoglobin, and the nitric oxide concentrations in blood are diverse in workers with different working and life styles. For early preventing chronic altitude disease, it is suggested that the detection of nitric oxide should be included in the physical examination for people with high hemoglobin. At the same time, special attention should be paid to people aged 40-49 years old, with working age of 10-29 years, working on the plateau for 4-6 years and has high hemoglobin. In the plateau work, it is necessary to advocate smoking ban and avoid irregular working shifts.