军事人员进驻高原肺动脉压力指数变化观察

Observation of pulmonary arterial pressure index of military personnel stationed on plateau

目的探讨军事人员空运进驻高原前后及不同时间段肺动脉压和右心相关参数的变化,为空运进驻高原航卫保障提供参考依据。方法测试23名健康军事人员进驻高原前1周及进驻高原后肺动脉血流加速时间(acceleration time,ACT)、右心室射血时间(right ventricular ejection time,RVET)、右心室射血前期(right ventricular pre-ejection period,RVPEP),并计算肺动脉收缩压和平均肺动脉压;测量右心室流出道内径(right ventricular outflow tract,RVOT)、主肺动脉内径(main pulmonary artery diameter,MPAD)、右室舒张末期内径(right ventricular diameter,RVD)、右心房左右径(right atrium diameter,RAD)。根据进驻不同时间(2个月10人、3个月7人、8个月6人),比较军事人员进驻高原不同时间,以及进驻高原前后肺动脉压的变化。结果与进驻高原前相比,受试者进入高原后肺动脉血流ACT显著缩短(F=3.25,P<0.01);RVPEP明显增大,差异有统计学意义(F=4.51,P<0.05);肺动脉收缩压和平均肺动脉压明显升高,差异有统计学意义(F=4.19、2.69,P<0.01)。与进驻前比较,进驻高原2个月后受试者ROVT、RVD均增大,差异有统计学意义(t=1.442、2.643,P<0.05);MPAD、RAD差异无统计学意义(P>0.05)。结论①缺氧、低压的高原环境导致受试者肺动脉压力较在平原地区时明显升高,右心室结构也发生相应变化;②随着高原进驻时间的增加,身体习服性的适应,肺动脉压的变化无明显差异;③肺动脉高压发生在进驻高原初期,因此进驻高原初期预防或减轻肺动脉高压的发生是保持空运投送军事人员健康的重要措施。

Objective To provide the reference for aeromedical support to long-distance delivery to plateau by comparing the changes of pulmonary artery pressure and right heart correlation parameters of military personnel between the states of pre-entering and different time periods on plateau.Methods The correlation indexes on pulmonary artery pressure of 23 healthy military personnel were measured before and after entering plateau,including blood flow acceleration time(ACT)of pulmonary artery,right ventricular ejection time(RVET)and right ventricular pre-ejection period(RVPEP).The systolic pulmonary artery pressure(SPAP)and mean pulmonary artery pressure(MPAP)were calculated.The right ventricular outflow tract(RVOT),main pulmonary artery diameter(MPAD),right ventricular diameter(RVD)and right atrium diameter(RAD)were measured.According to the different stationed time,the military personnel were divided into 3 groups:10 cases for 2 months,7 cases for 3 months and 6 cases for 8 months.The changes of pulmonary artery pressure of military personnel were compared among the different time periods,as well as before and after stationed on plateau for each group that distinguished the states on plain and plateau.Results After entering plateau,ACT of subjects was significantly reduced(F=3.25,P<0.01),RVPEP was increased,the difference was significant(F=4.51,P<0.05),SPAP and MPAP were significantly increased,and the differences were statistically significant(F=4.19,2.69,P<0.01).Two months after entering plateau,ROVT and RVD of subjects were significantly increased(t=1.442,2.643,P<0.05),but the MPAD and RAD were not different as compared those before entering plateau(P>0.05).Conclusions①The hypoxic and low-pressure in plateau areas cause the significantly higher pulmonary artery pressure of military personnel than that in plain areas,and the right ventricular structure is also changed accordingly.②The pulmonary artery pressure shows insignificant difference with the progresses of body adaptation and the time stationed on plateau.③Pulmonary hypertension occurs in the early stage of stationing on plateau.So preventing or alleviating the occurrence of pulmonary hypertension at the early stage of plateau stationing is important for the military personnel assigned via air delivery.