高海拔环境暴露对移居健康成人心电活动的影响和原因分析

Effects and Mechanism of Exposure to High Altitude Environment on ECG Activity in Migrating Healthy Adults

目的:研究高海拔低氧环境对移居健康成人长时程心电活动的影响。方法:入选2021年10月-11月由广东派驻西藏林芝(平均海拔3000 m)进行援建工作的健康成人66名,其中男性44名,女性22名,受试者佩戴长程动态心电记录仪,分析不同移居时间和年龄阶段心电参数的特点。结果:按高海拔环境暴露时间分成移居30个月(36名)组和移居6个月(30名)组,佩戴时长分别是(177.6±32.2)小时和(164.0±29.8)小时,平均年龄(42.1±5.9)岁和(41.7±7.0)岁;移居30月组最慢心率显著低于移居6月受试者(P<0.05),心律失常和ST段下移发生率均显著高于移居6月组(P<0.05);同等高海拔环境暴露时间下,41-60岁组心律失常发生率显著高于20-40岁组(P<0.05);移居30月组41-60岁组ST段下移发生率显著高于20-40岁组(P<0.05),移居6月组各年龄阶段ST段下移发生率无显著差异(P>0.05)。结论:高海拔和年龄均可促进移居健康成人心律失常的发生,心电生理的改变有可能早于心血管的改变。

Objective:To study the effects of high altitude and low oxygen environment on long-term ECG activity in migrating healthy adults. Methods:From October to November 2021,66 healthy adults were selected from Guangdong to Nyingchi,Tibet(with an average altitude of 3000m),including 44 males and 22 females,all wore longrange Holter ECG recorders to analyze the characteristics of ECG parameters at different migration time and age stages.Results:According to the exposure time of high-altitude environment,it was divided into the 30-month migration(36)group and the 6-month migration(30)group,wearing time(177.6±32.2)hours and(164.0±29.8)hours,with average ages(42.1±5.9)years and(41.7±7.0)years.The slowest heart rate in the 30-month migration group was significantly lower than that of the 6-month-moving subjects(P<0.05),and the incidence of arrhythmias and ST-segment descent was significantly higher than that in the 6-month migration group(P<0.05). Under the same high altitude environmental exposure time,the incidence of arrhythmias was significantly higher in the 41-60 age group than in the 20-40 age group(P<0.05),and the incidence of ST-segment descent in the 41-60 years old group in the 30-month migration group was significantly higher than that in the 20-40 year old group(P<0.05),and there was no significant difference in the incidence of ST-segment descent in the 6-month group(P>0.05). Conclusion:Both altitude and age can promote the occurrence of arrhythmias in migrating healthy adults, and changes in cardiac electrophysiology may predate cardiovascular changes.