彩色多普勒超声心动图评价急速进藏新兵心功能及血流早期变化的研究

Evaluation of cardiac function and early changes of blood flow by color doppler echocardiograpby in recruits in tibet

目的 研究高原缺氧环境对急速进藏新兵的心功能参数及血流动力学的早期变化规律,为选择高原部队新兵最佳训练时间,预防高原肺水肿的发生提供科学依据。方法 随机选择60名乘飞机进藏新兵,应用彩色多普勒超声于进藏第1、2、3、4周分别进行27项心功能及心内血流速度参数及心率等检测,根据体表面积将所测值与平原对照值进行对比研究。结果(1)进藏当天多项左心功能指标均显示左室收缩功能减低,1月内未恢复致平原对照值水平;左室舒张功能无明显变化。(2)右心室和肺动脉内径随进藏时间增加呈逐渐增宽趋势,肺动脉瓣、三尖瓣峰值流速明显增快。结论缺氧直接导致急速进藏新兵心功能及血流参数的明显改变,说明心功能在第1个月内处于调节性适应期,为防止高原肺水肿的发生,急速进藏新兵1月内不宜进行强度训练。

Objective To investigate the cardiac function and early changes of hemodynamics in recruits who reached Tibet speedily in the condition of hypoxia on plateau without preconditioning, and to provide scientific basis for prevention of pulmonary edema caused by mountain sickness, and choice of proper program of military training for recruits. Methods Sixty recruits who went to Tibet by plane were selected randomly,and examined.Twenty-seven parameters of cardiac function and intracardiac rbeology were obtained by using color Doppler echocar-diogram. The examinations were performed at 1,2,3 and 4 days after they reached Tibet. The parameters included left ventricular end - diastolie volume( LVEDV) , ejection fraction( EF), stroke volume( SV) , cardiac output( CO), peak velocity of each valve, heart rate, etc. According to the body surface area, we compared the data obtained with those controls on plain. Results In the first week after the recruits reached Tibet, a few of indexes, related to left cardiac function showed that left ventricular systolic function decreased. After 1 month, they recovered to the lever on plain. However, the left ventricular diastolie function had no significant change. (2) The bore of right ventricle and pulmonary artery widned gradually with increasing time in Tibet.The peak velocity of tricuspid valve and pulmonary valve increased obviously. Conclusion Hypoxia directly leads to obvious changes of cardiac function and parameters of blood flow in recruits who went to Tibet speedily without preconditioning. To prevent pulmonary edema on plateau, it is not appropriate to frain the recruits intensively in the first month.