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目的:探讨长期氧疗(LTOT)对移居海拔5 000 m以上青年慢性高原病(CMS)预防作用。方法:对进驻海拔5 070 m、5 200 m和5 380 m的96例男性青年,在进入高原后每人每天持续鼻管吸氧(2 L/min)1 h(LTOT组),驻守1年根据国际CMS诊断标准进行CMS流行病学调查,采用超声诊断仪检测右室舒张末前后径(RVED)、右室前壁厚度(RVAW)、右室流出道(RVOT)、肺动脉主干内径(MPA)和左室后壁收缩末内径(LVSD),同时采血检测丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(γ-GT)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)及一氧化氮合酶(NOS)和氧饱和度(SaO2)的含量,并与2008年驻守相同海拔高度1年的同一群体91例青年(未采用任何干预措施,对照组)作对照。结果:①CMS流行病学调查显示,LTOT组较对照组SaO2增高,有显著性差异(P<0.05);CMS患病率降低,有显著性差异(P<0.05)。②超声心动图结果显示,LTOT组较对照组RVAW、RVED、RVOT降低,有显著性差异(P<0.05,P<0.01),LVSD、MPA无统计学差异(P>0.05)。③生化指标结果显示,LTOT组较对照组SOD、NO、NOS增加,有显著性差异(P<0.05,P<0.01),MDA、ALT、AST、LDH降低,有显著性差异(P<0.05,P<0.01),γ-GT、CK无统计学差异(P>0.05)。结论:在高海拔地区LTOT能减轻脂质过氧化反应,改善缺氧造成的重要脏器损伤及保护线粒体氧化呼吸功能,对预防慢性高原病的发生有重要作用。
Objective: To investigate the preventive effect of long-term oxygen therapy (LTOT) on young people with chronic high altitude disease (CMS) above 5000m above sea level. Methods: A total of 96 male youths who were stationed at 5 070 m, 5 200 m and 5 380 m above sea level were enrolled in the study. One day after nasal inhalation (2 L / min) for 1 h (LTOT group) According to the international CMS diagnostic criteria for CMS epidemiological investigation, the right ventricular diastolic anteroposterior diameter (RVED), right ventricular anterior wall thickness (RVAW), right ventricular outflow tract (RVOT), pulmonary artery trunk diameter (MPA) And left ventricular end-systolic diameter (LVSD). Meanwhile, blood samples were collected for the detection of alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (γ- CK, LDH, MDA, NO, NOS and oxygen saturation (SaO2), and compared with 91 young people of the same population (no interventions, no control group) in the same population stationed at the same altitude for 1 year in 2008. Results: ①CMS epidemiological survey showed that the SaO2 in LTOT group was significantly higher than that in control group (P <0.05); the prevalence of CMS was decreased with significant difference (P <0.05). ② Echocardiography showed that there were significant differences in RVAW, RVED and RVOT between the LTOT group and the control group (P <0.05, P <0.01) and no significant difference between the LVSD and MPA (P> 0.05). (3) The biochemical indexes showed that there was significant difference (P <0.05, P <0.01), MDA, ALT, AST and LDH decreased in LTOT group compared with control group (P <0.05, P <0.01), γ-GT, CK no significant difference (P> 0.05). CONCLUSION: LTOT can reduce lipid peroxidation, improve the damage of vital organs caused by hypoxia and protect mitochondria from oxidative respiration in high altitude areas, and play an important role in preventing the occurrence of chronic mountain sickness.