健康人群急进高原前后血生化免疫检测分析

An Analysis of the Blood Biochemical and Immune Test Results of Healthy People Before and After Rush into Plateau Areas

目的观察平原(海拔57m)成年健康人群急进到高原地区(海拔4300m)后其血生化、免疫等65项指标变化,并探讨其临床指标变化意义。方法15名平原成年健康人,分别采集他们身处平原地区和高原地区的静脉血,行血生化、免疫等检测,分析其检查结果。结果65项血生化、免疫检查指标中:(1)上高原后1周与在平原地区比较,变化指标共有12个,其中表现下降趋势的为血脂检查指标APOA(载脂蛋白A)、HDL(高密度脂蛋白)、肝功能检查指标ALB(血清白蛋白)、胰腺检查指标AMYL(α-淀粉酶)、血糖检查指标GLU(葡萄糖)5个指标,表现上升趋势的为内分泌激素检查指标CORT(皮质醇)、ProBNP(脑利钠肽前体)、C肽、炎症检查指标IL-6(白介素6)、肿瘤标志物检查指标HE4(人附睾蛋白4)、肝功能检查指标NH3(血氨)、心肌酶检查项目TNT-HS(超敏肌钙蛋白T)7个指标。(2)下高原后返回平原1周与在高原1周相比,变化指标有10个,其中表现下降趋势的为内分泌激素检查指标C肽、INSULIN(胰岛素)、肿瘤标志物检查指标HE4(人附睾蛋白4)、肝功能检查指标NH3(血氨)、心肌酶检查指标TNT-HS(超敏肌钙蛋白T)、LDH(乳酸脱氢酶)6个指标,表现上升趋势的为肝功能检查指标ALB(血清白蛋白)、胰腺检查指标AMY-P(胰淀粉酶)、AMY-L(α-淀粉酶)、血糖检查指标GLU(葡萄糖)4个指标。(3)平原人群在急进高原后指标呈下降趋势,在返回平原后逐渐上升的指标为肝功能检查指标ALB(血清白蛋白)、胰腺检查指标AMYL(α-淀粉酶)、血糖检查指标GLU(葡萄糖),差异有统计学意义(P<0.05);(4)平原人群在急进高原后呈上升趋势,在返回平原后逐渐下降的指标为内分泌激素检查指标C肽、肿瘤标志物检查指标HE4(人附睾蛋白4)、肝功能检查指标NH3(血氨)、心肌酶检查指标TNT-HS(超敏肌钙蛋白T),差异有统计学意义(P<0.05)。结论健康人群由平原急进到高原时,肝功能检查指标ALB、NH3的变化,反映了急进高原造成肝功能受损;胰腺检查指标AMYL和血糖检查指标GLU在急进高原后下降反映了机体消化吸收功能降低;而内分泌激素检查指标C肽、肿瘤标志物检查指标HE4、心肌酶检查指标TNT-HS急进高原后升高反映了高原低氧环境中应激激素分泌入血,体内出现不同程度的胰岛素抵抗,胰岛素分泌能力、肾功能以及心肌受损。机体的多项功能均有不同程度的受损,返回平原后指标恢复,机体可通过调节来适应高原环境,未对身体造成显著损害。

Objective To observe changes of 65 indexes of blood biochemistry and immunity of adult healthy people in plain(57 m)(4300m m),and to explore the significance of clinical indicators.Methods 15 adult and healthy plain people were selected for collecting their venous blood from the plain areas and plateau area,respectively,and we then analyzed the test results.Results 65 blood biochemical examination indicators showed as following:①After the plateau,there were 12 items changed:APOA,HDL,liver function test,ALB,AMYL,GLU,endocrine hormone,CORT,ProBNP,C-PEPTID,IL6,tumor markers HE4,liver function,NH 3,and TNT-HS;②A week after the plateau compared with a week,10 indicators changed,including the downward trend of endocrine hormone index C-PEPTID,INSULIN,tumor markers HE4,liver function index NH3,myocardial enzyme index TNT-HS,and LDIP,while rising trend of liver function index ALB,pancreatic index AMY-P,AMY-L,and blood glucose index GLU;③The index decreased after entering the plateau,and gradually rising after returning to the plain were liver function test ALB,pancreas AMYL and GLU,with statistical difference(P<0.05);④The indexes rising after entering the plateau were endocrine hormone test C-PEPTID,HE4,tumor marker NH 3,liver function and TNT-HS,with statistical significance(P<0.05).Conclusion ALB and NH 3 can reflect the impairment of liver function in the plateau,while AMYL and GLU,and the elevation of endocrine hormone C-PEPTID,HE4,and TNT-HS in the plateau,insulin resistance,insulin secretion capacity,kidney function and myocardial indicate damages in the body.After returning to the plain,the index is restored.The body can adapt to the plateau environment through adjustment,without causing significant damage to the body.