初次和再次进入高原的高原肺水肿患者治疗前后心脏结构的变化

The changes of heart structure of patients with first entrance or re-entrance plateau pneumonedema before and after therapy

目的 观察高原肺水肿治疗前后心脏结构的变化 ,探讨高原肺水肿的发生机制。方法 2 8例急性高原肺水肿患者 ,分为初次进入高原组 (R组 )和再次进入高原组 (R组 ) ,分别观察治疗前后的生命体征、血常规 ,并采用彩色多谱勒超声心动图对心脏结构进行观察。结果 两组的体温、心率、血压和白细胞总数治愈后均较治疗前显著降低。无论F组或R组 ,右房左右径、右室前后径、主肺动脉内径及肺动脉收缩压治愈后均较治疗前显著降低。但治愈后R组右室前后径和主肺动脉内径显著高于F组。结论 再次进入高原人群发生高原肺水肿的原因可能与个体敏感性及慢性心功能损害有关。

Objective To observe the changes of heart structure of patients with plateau pneumonedema before and after therapy and to explore the mechanism of plateau pneumonedema.Methods Twenty eight patients of plateau pneumonedema were divided into first entrance plateau group(group F)and re entrance plateau group(group R).Their vital signs,blood routine test and heart structure by color doppler echocardiogram were observed.Results The body temperature,heart ratio,blood pressure and white cells number were significantly reduced in both of group F and group R after treatment than that before.The right atrium diameter from left to right,occipitofrontal diameter of right ventricle,main pulmonary atery bore and pulmonary artery systolic pressure were also reduced after treatment than that before in both groups,but after treatment,occipitofrontal diameter of right ventricle,main pumonary artery bore of group R were significangtly higher than that of group F.Conclusion The reason of plateau pneumonedema for re entrance plateau people may be related to individual sensibility and chronic lesion of cardiac function.