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中国应用生理学杂志 ›› 2020, Vol. 36 ›› Issue (5): 419-424.doi: 10.12047/j.cjap.5910.2020.089

• 研究论文 • 上一篇    下一篇

急进和渐进西藏对南极考察昆仑站预选队员心血管功能及其应激因子的影响*

卢艳花, 熊艳蕾, 方露, 陈楠, 徐成丽   

  1. 中国医学科学院基础医学研究所/北京协和医学院基础学院, 北京 100005
  • 收稿日期:2019-07-22 修回日期:2020-06-09 发布日期:2021-02-25
  • 通讯作者: Tel: 010-69156924; E-mail: xuchengli@pumc.edu.cn
  • 基金资助:
    *中国医学科学院中央级公益性科研院所基本科研业务费(2017PT31009);国家海洋局极地办南北极环境综合考察与评估专项(CHINARE 02-01)

Effects of rapid and progressive ascent to Tibet plateau on cardiovascular function and stress factors of pre-selected expeditioners for Chinese Antarctic expedition for Kunlun station

LU Yan-hua, XIONG Yan-lei, FANG Lu, CHEN Nan, XU Cheng-li   

  1. Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing 100005, China
  • Received:2019-07-22 Revised:2020-06-09 Published:2021-02-25

摘要: 目的: 分析急进和渐进西藏高原对拟进入中国南极考察昆仑站的第31、32和 33次预选队员的心血管功能及其相关应激因子水平的影响,为选拔合格的内陆考察队员提供科学依据。方法: 以 2014~2016 年第 31、32 和33次队共 85名中国南极考察昆仑站预选队员为研究对象,依据进入高原方式分为乘飞机急进高原组(急进组,n=55)和乘火车渐进高原组(渐进组,n=30),分别在上海出发(海拔 4 m)、到达拉萨(海拔 3 658 m)和进入更高海拔的羊八井(海拔 4 300 m)3个时间点,采用心功能仪和心电图仪动态检测预选队员的心血管功能,并同步采集队员的唾液样本,采用 ELISA法检测唾液中应激因子睾酮(T)、皮质醇(COR)和免疫球蛋白A(IgA)水平。结果: 与海拔 4 m 相比,两组队员在到达海拔 3 658 m、4 300 m 高原时,心率(HR)显著升高(P<0.05),指端静脉血氧饱和度(SpO2)显著下降(P<0.05),但两组间在相同海拔高度上无显著差异;两组间心电传导异常率无显著差异;与海拔4 m相比,到达 3 658 m和 4 300 m处两组队员的血压均显著升高(P<0.05),部分心肌收缩和泵血功能指标均显著降低(P<0.05),但由于心率增加代偿,心输出量(CO)无显著变化。在海拔4 300 m时,急进组的肺水指数(TFC)显著高于渐进组(P<0.01)。进入高原后与出发水平的差值比较,两组在海拔3 658 m 处 T变化量无显著性差异(P>0.05),急进组 COR 和IgA变化量显著高于渐进组(P<0.05);在海拔 4 300 m 处急进组 IgA变化量显著高于渐进组(P<0.05)。结论: 对比渐进高原,急进高原对南极考察昆仑站预选队员的心血管功能及唾液中的应激激素和免疫球蛋白水平均有更明显影响。提示应在岗前严格选拔能适应南极昆仑站低氧环境的考察队员,保障南极考察队员身心健康,确保南极考察任务顺利实施。

关键词: 西藏高原, 中国南极考察预选队员, 心血管功能, 应激因子

Abstract: Objective: To explore the different effects of rapid and progressive ascent to Tibet plateau on cardiovascular function and stress factors in pre-selected expeditioners for the 31st, 32nd and 33rd Chinese Antarctic expedition for inland station, to provide a scientific basis for the selection of qualified expeditioners. Methods: A total of 85 pre-selected expeditioners for the 31st, 32nd and 33rd Chinese Antarctic expedition for Kunlun station were enrolled in this study. According to the different manners of entering the plateau, they were divided into the rapid ascent group by aircraft (RAG, n=55) and the progressive ascent group by train (PAG, n=30). Hemodynamics and electrocardiogram were examined at 4 m (Shanghai), areas at altitude of 3 658 m (Lhasa) and 4 300 m(Yangbajain), respectively. Saliva levels of stress factors, including testosterone (T), cortisol (COR) and immunoglobulin A (IgA), were tested by ELISA. Results: The heart rates (HR) were increased significantly, while the SpO2 was decreased significantly in the two groups within 24 hours at altitudes of 3 658 m and 4 300 m (P<0.05), while there was no significant difference between the two groups at the same altitude. Compared with 4 m, the blood pressure (BP) of the two groups at 3 658 m and 4 300 m was significantly increased (P<0.05), and some indexes of myocardial contraction and pumping function were significantly reduced (P<0.05). However, due to the increase of HR, there was no significant change in Cardiac Output (CO). At 4 300 m, the Thoracic Fluid Content (TFC) of the rapid ascent group was significantly higher than that of the progressive ascent group (P<0.05). Compared with 4m, there was no significant difference in salivary testosterone change between the two groups at 3 658 m above sea level (P>0.05), while COR and IgA changes in the rapid ascent group were significantly higher than those in another group (P<0.05). Conclusion: Compared with the progressive ascent by train,expeditioners that rapid ascent to high altitude have significant effects on cardiovascular function and the stress hormones and immunoglobulin levels in saliva. It's suggested that hypoxia adaptation before Antarctic expediting for Kunlun Station could ensure the selected expeditioners' physical and psychological health, so that the mission could be finished smoothly.

Key words: Tibet plateau, pre-selected Chinese Antarctic expenditioners, cardiovascular function, stress factors

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