急性高原暴露时肺动脉压变化对体能的影响及机制

摘要

Objective To investigate the effect and mechanism of pulmonary artery pressure on exercise capacity after acute high altitude exposure .Methods A total of 231 persons were recruited in this study , whose vital signs,SaO2 and physical working capacity ( PWC170 ) exercise capacity were collected .The difference between groups with normal and increased MPAP was observed .Results mean pulmonary artery pressure ( MPAP ) and right ventricle ( RV )-Tei index increased substantially after acute high altitude exposure ,while PWC170 was remarkably decreased .Furthermore,it was found that those whose MPAP increased(MPAP≥25 mmHg)had higher RV-Tei and lower PWC170(P<0.01) in acute high altitude exposure group .Correlation analysis suggested that there were different levels of correlation between MPAP, RV-Tei and PWC170(P<0.01).Conclusion After acute high altitude exposure , the increased pulmonary artery pressure is one of the main causes of lowered exercise capacity .The mechanism may be associated with the decrease of right heart functions .%目的：探讨急性高原暴露时肺动脉压变化对体能的影响及机制。方法2012年7～8月，以231名健康男性青年为研究对象，根据高原暴露情况分为平原组（n＝135）、急进高原组（n＝96），观察平均肺动脉压（MPAP）变化对体能（ PWC170）的影响并分析生命体征、心功能指标变化在其中的作用。结果①急进高原组MPAP、右心室（RV）-Tei指数较平原组显著升高[MPAP：（23．07±6．85）mmHg vs （14．93±3．88）mmHg，P＜0．01；RV-Tei：0．27±0．06 vs 0．19±0．05，P＜0．01]，PWC170较平原组显著降低[（807．86±133．22） kg· m/min vs （1003．33±168．11）kg· m/min，P＜0．01]；②急性高原暴露后肺动脉压增高组PWC170显著低于肺动脉压正常组[（726．97±102．47）kg· m/min vs （846．43±129．39）kg· m/min，P＜0．01]，RV-Tei显著高于肺动脉压正常组（0．31±0．07 vs 0．25±0．05， P＜0．01）。 PWC170与 MPAP 呈负相关：R ＝-0．41， P ＜0．01；PWC170与 RV-Tei 呈负相关：R＝-0．30，P＜0．01。结论急性高原暴露时肺动脉压增高是体能下降的重要原因之一，其机制可能与肺动脉压增高导致右心功能降低有关。