Background: Excessive elevation of arterial blood pressure(BP) at high altitude can be detrimental to our health due to acute mountain sickness(AMS) or some AMS symptoms. This prospective and observational study aimed...Background: Excessive elevation of arterial blood pressure(BP) at high altitude can be detrimental to our health due to acute mountain sickness(AMS) or some AMS symptoms. This prospective and observational study aimed to elucidate blood pressure changes induced by exposure to high-altitude hypoxia and the relationships of these changes with AMS prevalence, AMS severity, sleep quality and exercise condition in healthy young men.Methods: A prospective observational study was performed in 931 male young adults exposed to high altitude at 3,700 m(Lhasa) from low altitude(LA, 500 m). Blood pressure measurement and AMS symptom questionnaires were performed at LA and on day 1, 3, 5, and 7 of exposure to high altitude. Lake Louise criteria were used to diagnose AMS. Likewise, the Athens Insomnia Scale(AIS) and the Epworth Sleepiness Scale(ESS) were filled out at LA and on day 1, 3, and 7 of exposure to high altitude.Results: After acute exposure to 3,700 m, diastolic blood pressure(DBP) and mean arterial blood pressure(MABP) rose gradually and continually(P【0.05). Analysis showed a relationship with AMS for only MABP(P【0.05) but not for SBP and DBP(P】0.05). Poor sleeping quality was generally associated with higher SBP or DBP at high altitude, although inconsistent results were obtained at different time(P【0.05). SBP and Pulse BP increased noticeably after high-altitude exercise(P【0.05).Conclusions: Our data demonstrate notable blood pressure changes under exposure to different high-altitude conditions: 1) BP increased over time. 2) Higher BP generally accompanied poor sleeping quality and higher incidence of AMS. 3) SBP and Pulse BP were higher after high-altitude exercise. Therefore, we should put more effort into monitoring BP after exposure to high altitude in order to guard against excessive increases in BP.展开更多
Objective To assess the effect of altitude hypoxia on the elderly patients with coronary artery disease （CAD）. Methods Three subject groups were surveyed during their train trip on the highest railroad the Qinghai-T...Objective To assess the effect of altitude hypoxia on the elderly patients with coronary artery disease （CAD）. Methods Three subject groups were surveyed during their train trip on the highest railroad the Qinghai-Tibet Railway： 22 elderly individuals with documented CAD, 20 healthy elderly controls, and 20 healthy young controls, all of whom from Beijing near the sea level （76 m）, Survey questions addressed clinical features of their healthy conditions and aspects of their coronary disease. The baseline study was performed at Xining at an altitude of 2261m, and then during acute exposure to altitudes of 2808 m, 4768m, 5072 m and 4257 m by train for 24 hours. Resting pulse rate, blood pressure, oxygen saturation, electrocardiograph （ECG）, and cardiac work estimated by the heart rateblood pressure double product were obtained five times in each subject at different altitudes. Results On arrival to altitudes between 4768 m and 5072 m, the older passengers, especially those with preexisting coronary disease, had higher HR, higher BP, and lower SaO2, as well as more frequent abnormalities on ECG, as compared to the younger healthy subjects. As compared with the healthy elderly controls, incomplete right bundle branch block, left ventricular hypertrophy, and ST segment depression were more frequently seen in the elderly coronary patients （P〈0.01）. Cardiac work in group 1 was increased by 13% 12 hours after arrival to altitudes between 2808 m and 5072 m. Oxygen saturation decreased significantly with the altitude increasing by train ascent but improved after inhalation of oxygen. Most of the older subjects tolerated their sojourn at high altitude well except one who developed angina repeatedly with a significant ST segment depression. Conclusions Coronary events and ECG signs of myocardial ischemia are rare in elderly individuals with CAD who travel from sea level to moderate altitudes of 1500m to 2800 m. Patients with CAD who are well compensated at sea level generally tolerate this moderate altitude well. However, it would be prudent for patients with CAD going to altitude above 3000 m. The patients should consult their physician before undertaking a trip to such altitude （J Geriatr Cardio12009; 6：137-141）.展开更多
BACKGROUND Higher intraocular pressure(IOP)is a major risk factor for developing glaucoma,and the leading cause of irreversible blindness worldwide.High altitude(HA)may be involved in IOP,but the reported results were...BACKGROUND Higher intraocular pressure(IOP)is a major risk factor for developing glaucoma,and the leading cause of irreversible blindness worldwide.High altitude(HA)may be involved in IOP,but the reported results were conflicting.Ascent to HA directly by plane from low altitude regions is an acute,effortless exposure.However,the effects of such exposure to different altitudes on IOP have rarely been reported.AIM To investigate changes in IOP after rapid effortless exposure to HA in stages and compare it with systemic parameters.METHODS Fifty-eight healthy subjects(116 eyes)were divided into three groups:17 lowaltitude(LA)residents[44 m above sea level(ASL)],22 HA residents(2261 m ASL)and 19 very HA(VHA)residents(3750 m ASL).The LA group flew to HA first.Three days later,they flew with the HA group to VHA where both groups stayed for 2 d.Then,the LA group flew back to HA and stayed for 1 d before flying back to 44 m.IOP,oxygen saturation(SpO2)and pulse rate were measured.The linear mixed model was used to compare repeated measurements.RESULTS IOP in the LA group significantly decreased from 18.41±2.40 mmHg at 44 m to 13.60±3.68 mmHg at 2261 m ASL(P<0.001),and then to 11.85±2.48 mmHg at 3750 m ASL(P=0.036 compared to IOP at 2261 m ASL)and partially recovered to 13.47±2.57 mmHg upon return to 44 m.IOP in the LA group at HA and VHA was comparable to that in the local residents(12.2±2.4 mmHg for HA,11.5±1.8 mmHg for VHA).IOP was positively associated with SpO2 while negatively associated with pulse rate.CONCLUSION IOP in the LA group gradually reduced as altitude elevated in stages and became comparable to IOP in local residents.Hypoxia may be associated with IOP,which deserves further study.展开更多
目的观察健康中青年男性急进短期高原暴露(fast-advancing short-term high altitude exposure,FSHAE)前后机体的肝功能、血细胞、肺功能等主要相关指标的变化,并探讨FSHAE对肝脏、血细胞、肺功能的影响及可能机制。方法共纳入健康中青...目的观察健康中青年男性急进短期高原暴露(fast-advancing short-term high altitude exposure,FSHAE)前后机体的肝功能、血细胞、肺功能等主要相关指标的变化,并探讨FSHAE对肝脏、血细胞、肺功能的影响及可能机制。方法共纳入健康中青年志愿者男性48名,在进驻高原前1d(海拔100m)、FSHAE 15d(海拔3000m)采集研究对象的生理指标并检测肝功能、血细胞、肺功能相关指标。比较FSHAE前后各系统相关参数的差异。结果与进驻高原前比较,中青年男性FSHAE15d后生理参数指标:心率明显增快、呼吸频率增加、收缩压升高、平均动脉压升高、血氧饱和度下降、舒张压升高,差异均有统计学意义(P<0.05);肝功能指标:天冬氨酸转氨酶、丙氨酸转氨酶均升高、谷氨酰转肽酶、碱性磷酸酶、总胆汁酸均升高,总蛋白下降,差异均有统计学意义(P<0.05);血细胞相关指标:红细胞计数、红细胞压积、平均红细胞体积、平均血红蛋白量、平均血红蛋白浓度、血红蛋白均升高,血小板计数降低,差异均有统计学意义(P<0.01),虽然白细胞计数升高,但差异无统计学意义(P>0.05);肺功能相关指标:用力肺活量下降,差异有统计学意义(P<0.05);第1秒钟用力呼气容积下降、一秒用力呼气率升高,但差异均无统计学意义(P>0.05)。结论健康中青年男性FSHAE可导致机体出现氧化应激,可发生急性低氧性多系统性损伤,与此同时机体各系统出现缺氧适应性调节,各器官发生自我代偿修复,且各系统间可能存在相互影响的可能。展开更多
目的:采用彩色多普勒超声心动图估测初入高原儿童青少年游泳运动员肺动脉收缩压并测量心脏功能参数,探讨高原低氧暴露对儿童青少年游泳运动员肺动脉压及心脏功能的影响。方法:以儿童青少年游泳运动员共33人为研究对象,平均年龄12.25...目的:采用彩色多普勒超声心动图估测初入高原儿童青少年游泳运动员肺动脉收缩压并测量心脏功能参数,探讨高原低氧暴露对儿童青少年游泳运动员肺动脉压及心脏功能的影响。方法:以儿童青少年游泳运动员共33人为研究对象,平均年龄12.25±0.36岁。分别于高原前以及进入高原(海拔2366米)12小时采用彩色多普勒超声心动图估测肺动脉收缩压并测量心脏功能参数。彩超检查日晨起,肘正中静脉取血,测试血清内皮素(ET-1)和一氧化氮(NO)。于进入高原12小时进行急性高山病(AMS)评分并完成高原肺水肿(HAPE)早期症状问诊。结果:(1)33名运动员均未出现HAPE的相应症状;(2)初入高原儿童青少年游泳运动员肺动脉收缩压(PASP)显著高于高原前水平(20.32±3.71 vs 18.14±3.69 mm Hg,P<0.05)且与年龄呈负相关(r=-0.26,P<0.01),其最高值为29 mm Hg;(3)初入高原儿童青少年游泳运动员SV下降,心率升高而CO升高。左心室Tei指数以及右心室Tei指数均未发生显著变化(0.34±0.09 vs 0.32±0.06,P>0.05;0.28±0.04 vs0.24±0.09,P>0.05);(4)初入高原儿童青少年游泳运动员血清ET-1显著高于高原前水平(123.45±23.45 vs109.57±15.32 ng/l,P<0.05),且与PASP正相关(r=0.3,P=0.035)。血清NO显著低于高原前水平(120.78±32.55 vs 136.42±36.97μmol/l,P<0.05),且与PASP负相关(r=-0.306,P=0.042)。结论:(1)海拔2366米高原可以引起儿童青少年游泳运动员PASP升高,PASP升高与ET-1的释放增加以及NO合成减少有关,而PASP升高并未对心脏功能构成影响;(2)海拔2366米高原儿童青少年游泳运动员AMS以及HAPE的发生率较低。展开更多
目的探讨高原中重度OSAHS合并PAH的发生机制及CPAP的干预作用。方法 86例患者分为单纯OSAHS组(38例)和合并PAH组(48例)。所有患者监测PSG、mPAP、血浆ET-1、NO、血清8-isoPGF2α、SOD、T-AOC。合并PAH组在CPAP治疗13周后,重复以上测定...目的探讨高原中重度OSAHS合并PAH的发生机制及CPAP的干预作用。方法 86例患者分为单纯OSAHS组(38例)和合并PAH组(48例)。所有患者监测PSG、mPAP、血浆ET-1、NO、血清8-isoPGF2α、SOD、T-AOC。合并PAH组在CPAP治疗13周后,重复以上测定。结果与单纯OSAHS组比较,合并PAH组AHI、mPAP、血浆ET-1、血清8-iso-PGF2α明显增高,m Sa O2、血浆NO、SOD、T-AOC明显降低(均P<0.01)。mPAP与AHI、血浆ET-1、血清8-iso-PGF2α显著正相关,与睡眠m Sa O2、血浆NO、血清SOD、T-AOC显著负相关(均P<0.01)。合并PAH组经CPAP治疗后,AHI、mPAP、血浆ET-1和血清8-iso-PGF2α明显降低,睡眠m Sa O2、血浆NO、血清SOD、T-AOC明显升高。结论 OSAHS患者PAH的形成可能与CIH引起氧化应激、ET-1和NO比例失衡、内皮功能障碍有关。CPAP通气治疗能有效地消除睡眠呼吸暂停和CIH,减轻这些损害,从而降低PAH。展开更多
基金supported by grants from the Special Health Research Project, Ministry of Health of China (201002012)
文摘Background: Excessive elevation of arterial blood pressure(BP) at high altitude can be detrimental to our health due to acute mountain sickness(AMS) or some AMS symptoms. This prospective and observational study aimed to elucidate blood pressure changes induced by exposure to high-altitude hypoxia and the relationships of these changes with AMS prevalence, AMS severity, sleep quality and exercise condition in healthy young men.Methods: A prospective observational study was performed in 931 male young adults exposed to high altitude at 3,700 m(Lhasa) from low altitude(LA, 500 m). Blood pressure measurement and AMS symptom questionnaires were performed at LA and on day 1, 3, 5, and 7 of exposure to high altitude. Lake Louise criteria were used to diagnose AMS. Likewise, the Athens Insomnia Scale(AIS) and the Epworth Sleepiness Scale(ESS) were filled out at LA and on day 1, 3, and 7 of exposure to high altitude.Results: After acute exposure to 3,700 m, diastolic blood pressure(DBP) and mean arterial blood pressure(MABP) rose gradually and continually(P【0.05). Analysis showed a relationship with AMS for only MABP(P【0.05) but not for SBP and DBP(P】0.05). Poor sleeping quality was generally associated with higher SBP or DBP at high altitude, although inconsistent results were obtained at different time(P【0.05). SBP and Pulse BP increased noticeably after high-altitude exercise(P【0.05).Conclusions: Our data demonstrate notable blood pressure changes under exposure to different high-altitude conditions: 1) BP increased over time. 2) Higher BP generally accompanied poor sleeping quality and higher incidence of AMS. 3) SBP and Pulse BP were higher after high-altitude exercise. Therefore, we should put more effort into monitoring BP after exposure to high altitude in order to guard against excessive increases in BP.
文摘Objective To assess the effect of altitude hypoxia on the elderly patients with coronary artery disease （CAD）. Methods Three subject groups were surveyed during their train trip on the highest railroad the Qinghai-Tibet Railway： 22 elderly individuals with documented CAD, 20 healthy elderly controls, and 20 healthy young controls, all of whom from Beijing near the sea level （76 m）, Survey questions addressed clinical features of their healthy conditions and aspects of their coronary disease. The baseline study was performed at Xining at an altitude of 2261m, and then during acute exposure to altitudes of 2808 m, 4768m, 5072 m and 4257 m by train for 24 hours. Resting pulse rate, blood pressure, oxygen saturation, electrocardiograph （ECG）, and cardiac work estimated by the heart rateblood pressure double product were obtained five times in each subject at different altitudes. Results On arrival to altitudes between 4768 m and 5072 m, the older passengers, especially those with preexisting coronary disease, had higher HR, higher BP, and lower SaO2, as well as more frequent abnormalities on ECG, as compared to the younger healthy subjects. As compared with the healthy elderly controls, incomplete right bundle branch block, left ventricular hypertrophy, and ST segment depression were more frequently seen in the elderly coronary patients （P〈0.01）. Cardiac work in group 1 was increased by 13% 12 hours after arrival to altitudes between 2808 m and 5072 m. Oxygen saturation decreased significantly with the altitude increasing by train ascent but improved after inhalation of oxygen. Most of the older subjects tolerated their sojourn at high altitude well except one who developed angina repeatedly with a significant ST segment depression. Conclusions Coronary events and ECG signs of myocardial ischemia are rare in elderly individuals with CAD who travel from sea level to moderate altitudes of 1500m to 2800 m. Patients with CAD who are well compensated at sea level generally tolerate this moderate altitude well. However, it would be prudent for patients with CAD going to altitude above 3000 m. The patients should consult their physician before undertaking a trip to such altitude （J Geriatr Cardio12009; 6：137-141）.
基金Supported by the National Natural Science Foundation of China,No.81730027Beijing Natural Science Foundation,No.7162037The Capital Health Research and Development of Special Foundation,No.ZYLX201501
文摘BACKGROUND Higher intraocular pressure(IOP)is a major risk factor for developing glaucoma,and the leading cause of irreversible blindness worldwide.High altitude(HA)may be involved in IOP,but the reported results were conflicting.Ascent to HA directly by plane from low altitude regions is an acute,effortless exposure.However,the effects of such exposure to different altitudes on IOP have rarely been reported.AIM To investigate changes in IOP after rapid effortless exposure to HA in stages and compare it with systemic parameters.METHODS Fifty-eight healthy subjects(116 eyes)were divided into three groups:17 lowaltitude(LA)residents[44 m above sea level(ASL)],22 HA residents(2261 m ASL)and 19 very HA(VHA)residents(3750 m ASL).The LA group flew to HA first.Three days later,they flew with the HA group to VHA where both groups stayed for 2 d.Then,the LA group flew back to HA and stayed for 1 d before flying back to 44 m.IOP,oxygen saturation(SpO2)and pulse rate were measured.The linear mixed model was used to compare repeated measurements.RESULTS IOP in the LA group significantly decreased from 18.41±2.40 mmHg at 44 m to 13.60±3.68 mmHg at 2261 m ASL(P<0.001),and then to 11.85±2.48 mmHg at 3750 m ASL(P=0.036 compared to IOP at 2261 m ASL)and partially recovered to 13.47±2.57 mmHg upon return to 44 m.IOP in the LA group at HA and VHA was comparable to that in the local residents(12.2±2.4 mmHg for HA,11.5±1.8 mmHg for VHA).IOP was positively associated with SpO2 while negatively associated with pulse rate.CONCLUSION IOP in the LA group gradually reduced as altitude elevated in stages and became comparable to IOP in local residents.Hypoxia may be associated with IOP,which deserves further study.
文摘目的:采用彩色多普勒超声心动图估测初入高原儿童青少年游泳运动员肺动脉收缩压并测量心脏功能参数,探讨高原低氧暴露对儿童青少年游泳运动员肺动脉压及心脏功能的影响。方法:以儿童青少年游泳运动员共33人为研究对象,平均年龄12.25±0.36岁。分别于高原前以及进入高原(海拔2366米)12小时采用彩色多普勒超声心动图估测肺动脉收缩压并测量心脏功能参数。彩超检查日晨起,肘正中静脉取血,测试血清内皮素(ET-1)和一氧化氮(NO)。于进入高原12小时进行急性高山病(AMS)评分并完成高原肺水肿(HAPE)早期症状问诊。结果:(1)33名运动员均未出现HAPE的相应症状;(2)初入高原儿童青少年游泳运动员肺动脉收缩压(PASP)显著高于高原前水平(20.32±3.71 vs 18.14±3.69 mm Hg,P<0.05)且与年龄呈负相关(r=-0.26,P<0.01),其最高值为29 mm Hg;(3)初入高原儿童青少年游泳运动员SV下降,心率升高而CO升高。左心室Tei指数以及右心室Tei指数均未发生显著变化(0.34±0.09 vs 0.32±0.06,P>0.05;0.28±0.04 vs0.24±0.09,P>0.05);(4)初入高原儿童青少年游泳运动员血清ET-1显著高于高原前水平(123.45±23.45 vs109.57±15.32 ng/l,P<0.05),且与PASP正相关(r=0.3,P=0.035)。血清NO显著低于高原前水平(120.78±32.55 vs 136.42±36.97μmol/l,P<0.05),且与PASP负相关(r=-0.306,P=0.042)。结论:(1)海拔2366米高原可以引起儿童青少年游泳运动员PASP升高,PASP升高与ET-1的释放增加以及NO合成减少有关,而PASP升高并未对心脏功能构成影响;(2)海拔2366米高原儿童青少年游泳运动员AMS以及HAPE的发生率较低。
文摘目的探讨高原中重度OSAHS合并PAH的发生机制及CPAP的干预作用。方法 86例患者分为单纯OSAHS组(38例)和合并PAH组(48例)。所有患者监测PSG、mPAP、血浆ET-1、NO、血清8-isoPGF2α、SOD、T-AOC。合并PAH组在CPAP治疗13周后,重复以上测定。结果与单纯OSAHS组比较,合并PAH组AHI、mPAP、血浆ET-1、血清8-iso-PGF2α明显增高,m Sa O2、血浆NO、SOD、T-AOC明显降低(均P<0.01)。mPAP与AHI、血浆ET-1、血清8-iso-PGF2α显著正相关,与睡眠m Sa O2、血浆NO、血清SOD、T-AOC显著负相关(均P<0.01)。合并PAH组经CPAP治疗后,AHI、mPAP、血浆ET-1和血清8-iso-PGF2α明显降低,睡眠m Sa O2、血浆NO、血清SOD、T-AOC明显升高。结论 OSAHS患者PAH的形成可能与CIH引起氧化应激、ET-1和NO比例失衡、内皮功能障碍有关。CPAP通气治疗能有效地消除睡眠呼吸暂停和CIH,减轻这些损害,从而降低PAH。
