健康青年男性急进高原肺动脉高压危险因素分析

摘要

Objective To investigate the risk factors of pulmonary hypertension (PH) after rapid ascent to high altitude in healthy young Chinese men .Methods A total of 552 non high altitude natives ( healthy young Chinese men ) were recruited in the study between June to August in 2012.The subjects were delivered to high altitude (3700 m) in 2 h by plane from low altitude (450 m).Demographic data including smoking , alcohol consumption , high altitude exposure histo-ry, body mass index (BMI) and age were collected within 24 h after arrival at 3700 m.Furthermore, the oxygen saturation ( SaO2 ) , blood pressure , heart rate , pulmonary artery systolic pressure were measured using the echocardiography system . Analysis of risk factors of PH was performed by logistic regressions .Results The incidence of PH was 23.10%.SaO2 was significantly lower in the higher-pulmonary artery systolic pressure group (higher-PASP)[(86.10 ±3.34)%] than that in the normal-PASP group [(89.09 ±2.65)%, P<0.01].Smoking, alcohol consumption, high altitude exposure history, BMI, age, systolic blood pressure , diastolic blood pressure , heart rate were not significantly different between the two groups mentioned above .Logistic regressions revealed that lower SaO 2 (OR:0.711,95% CI:0.647-0.782, P<0.01) was an independent risks factor of PH .Conclusion Low SaO2 is an independent risk factor of PH upon rapid arrival at 3700 m in healthy young Chinese men .However, smoking, alcohol consumption , high altitude exposure history , BMI, age, blood pressure and heart rate are not risk of PH .These observations will provide valuable clues to theoretical studies on PH and prevention of PH .%目的：研究急性高原暴露条件下肺动脉高压（ pulmonary hypertension ，PH ）的危险因素。方法从2012年6～8月共纳入552例世居平原非藏族健康青年男性，乘飞机（2 h）从海拔450 m平原地区急进到海拔3700 m地区，收集24 h内人口学资料（吸烟、饮酒、高原暴露史、身高、体质量、年龄），测定血氧饱和度（ arterial oxygen satura-tion，SaO2）、血压、心率，通过彩色多普勒超声心动图检测肺动脉收缩压（ pulmonary artery systolic pressure ，PASP），采用logistic回归分析PH的危险因素。结果 PH发生率为23．10％，PASP升高组与正常组相比，SaO2[（86．10±3．44）％vs（89．09±2．65）％]显著性降低（P＜0．01），而吸烟、饮酒、高原暴露史、体质量指数（21．48±2．34）kg/m2 vs（21．55±2．21）kg/m2、年龄（22．45±4．08）岁vs（22．78±4．00）岁、收缩压（118．70±10．28）mmHg vs（118．21±11．17）mmHg、舒张压（78．68±9．17） mmHg vs（78．15±9．87） mmHg、心率（85．66±15．40）次/min vs（85．41±12．61）次/min均无显著性差异（P＞0．05）；Logistic回归分析发现SaO2降低（OR：0．711，95％CI：0．647～0．782，P＜0．01）是PH的危险因素。结论非藏族健康青年男性急性高原暴露后，SaO2降低是PH的危险因素，而吸烟、饮酒、高原暴露史、体质量指数、年龄、血压、心率并不是PH的危险因素，为筛选、预防PH提供理论依据。