汶川地震救援者球结膜微循环的改变∗

摘要

Objective:To observe the changes of bulbar conjunctiva microcirculation in rescuers 2 years after Wenchuan earthquake.Method:A total of 84 male rescuers in Wenchuan earthquake were collected and assessed for bulbar conjunctiva microcirculation with microcirculation detector (type ZL104)and microcirculation image analysis system.Twenty healthy volunteers from the same troop matched for age and sex,were set as the control group.Re-sults:Compared with the control group,the number of bulbar conjunctiva capillaries decreased (6.10±1.1 7/mm vs 5.14±1.00/mm,P <0.01);the number of capillaries with uneven thickness increased (1.10±0.91/mm vs 2.00± 0.81/mm,P <0.01);pipe diameter of venule and arteriole became thinner (25.20 ± 3.05μm vs 23.39 ± 3.05μm, P <0.05;9.50±1.1 5μm vs 8.33 ± 1.43μm,P <0.01,respectively);the percentage of cystic dilation capillaries was higher (5% vs.39.3%,P <0.01 ).The blood flow velocity of capillaries in rescuers group was slower than that of the control group (536.60±5 1.28 μm/s vs.500.23±55.05 μm/s,P <0.01).The erythrocyte aggregation was severe in the rescuers group as compared with the control group (P < 0.05 ).The prevalence of microaneu-rysms,ischemic region and hemosiderosis was higher in the rescuers than those in the control group,while there was no statistical significance(P >0.05).Conclusion:The morphology and blood flow state of bulbar conjunctiva mi-crocirculation on rescuers 2 years after Wenchuan earthquake presented different changes.%目的：：观察汶川地震救援者任务完成后2年时球结膜微循环变化。方法：随机选取84例汶川抗震救灾男战士为救灾组,以20例同一部队,年龄、性别匹配,未参与抗震救灾的健康男战士为对照组,采用 ZL-104型微循环检测仪和微循环图像分析系统平行检测两组球结膜微血管形态、数目和管径、微循环血流速度、红细胞聚集及含铁血黄素沉着等的变化,并比较其统计学差异。结果：与对照组比较,救灾组微血管管袢数目减少(6.10±1.17条/mm2 vs 5.14±1.00条/mm2,P <0.01)、粗细不均增多(1.10±0.91条/mm2 vs 2.00±0.81条/mm2,P <0.01)、细静脉和细动脉管径变细(25.20±3.05μm vs 23.39±3.05μm,9.50±1.15μm vs 8.33±1.43μm,P <0.05)；球结膜微血管囊状扩张明显增多(5.00% vs 39.29%,P <0.01),微血管内血流速度减慢(536.60±51.28μm/s vs 500.23±55.05μm/s,P <0.01),红细胞聚集明显(20.00% vs 45.24%,P <0.05)。而微血管瘤、缺血区和含铁血黄素沉着救灾组虽多于对照组,但差异无统计学意义(P >0.05)。结论：抗震救援战士完成任务后两年仍存在不同程度微循环损害。