高原寒环境暴露对急进入高原健康人群肾功能的影响

Impact of High Altitude Cold Environment on the Renal Function of Healthy Population

目的:探讨高原低压低氧寒环境对急进高原的平原健康人群肾功能的影响。方法:选取30例长期居住兰州地区急进高原(海拔3300米、日平均气温-4度)健康人群,对比分析所有受试者进驻高原前和进驻高原后第24 h、72 h、7天、14天、28天尿IL-18(白介素-18)、尿NAGL(中性粒细胞明胶酶相关性脂质运载蛋白)、尿KIM-1(肾损伤因子-1)及血肌酐水平的变化。结果:共28人完成全部6次尿液及血标本采集并检测,其中2名女性因某次采集点处于月经期剔除,其中男性17人、女性11人,平均年龄26.8±3.2岁(男性28.3±4.2岁,女性24.8±2.6岁)。进入高原前和进驻高原后第24 h、72 h、7天、14天、28天尿IL-18检测值分别为3.62±0.32 ng/L、11.20±0.65 ng/L(P<0.001,较进入前组比较)、6.32±0.46 ng/L(P<0.001)、4.36±0.68 ng/L(P<0.05)、3.58±0.71 ng/L、3.32±0.46 ng/L;尿NAGL水平分别为0.126±0.20μg/L、0.513±0.003μg/L(P<0.001)、0.116±0.006μg/L、0.009±0.001μg/L、0.121±0.010μg/L、0.632±0.009μg/L;尿KIM-1水平分别为2.61±0.22 ng/L、18.20±0.69 ng/L(P<0.001)、6.32±0.46 ng/L(P<0.001)、6.36±0.68 ng/L(P<0.001)、2.58±0.31 ng/L、2.32±0.26 ng/L;血肌酐水平分别为61.0±9.16μmol/L、58.5±8.13μmol/L、80.3±10.38μmol/L(P<0.05)、76.5±12.04μmol/L(P<0.05)、62.6±10.14μmol/l、62.3±8.18μmol/L。结论:急进高原健康入群早期肾功能有改变,其中尿IL-18、尿KIM-1、尿NAGL水平较血肌酐水平变化更早、更敏感。

Objective:To investigate the effect of high altitude and low oxygen cold environment on the levels of renal function in healthy Population.Methods:30 healthy people living in Lanzhou area who radical into the plate(3300 meters above sea level and-4 degrees Celsius daily mean temperature)were selected and compared.All subjects were entered the plateau before and after 24 h,72 h,7 d,14 d and 28 d.Urinary IL-18,urine NAGL,urinary KIM-1 and Scr were measured.Results:A total of 28 people completed all six urine and blood samples were collected and tested,of which two women removed due to a collection of points in a menstrual period.Including17 males and 11 females,the average age was 26.8±3.2 years(male 28.3±4.2 years,24.8±2.6 years).The levels of urinary IL-18 were 3.62±0.32 ng/L,11.20±0.65 ng/L(P<0.001),6.32±0.46 ng/L(P<0.001),4.36±0.68 ng/L(P<0.05),3.58±0.71 ng/L,3.32±0.46 ng/L at before and after entering the plateau 24 h,72 h,7 d,14 d and 28 d.The levels of urinary NAGL were 0.126±0.20μg/L,0.513±0.003μg/L(P<0.001),0.116±0.006μg/L,0.009±0.001μg/L,0.121±0.010μg/L,0.632±0.009μg/L at before and after entering the plateau 24 h,72 h,7 d,14 d and 28 d.The levels of urinary KIM-1 were 2.61±0.22 ng/L,18.20±0.69 ng/L(P<0.001),6.32±0.46 ng/L(P<0.001),6.36±0.68 ng/L(P<0.001),2.58±0.31 ng/L,2.32±0.26 ng/L at before and after entering the plateau 24 h,72 h,7 d,14 d and28 d,The levels of serum creatinine(Scr)were 61.0±9.16μmol/L,58.5±8.13μmol/L,80.3±10.38μmol/L(P<0.05),76.5±12.04μmol/L(P<0.05),62.6±10.14μmol/L 62.3±8.18μmol/L before and at 24 h,72 h,7 d,14 d and 28 d after entering the plateau.Conclusions:The renal function of healthy Population who rapidly entered the high altitude cold environment was severely damaged,and the urine IL-18,KIM-1,NAGL levels changed early and were more sensitivity than Serum creatinine.