平原移居高原战士运动后心肌酶和心室功能的变化及高压氧预处理的干预作用

摘要

目的 探讨高原缺氧对平原移居高原战士运动后心功能的影响及高压氧(hyperbaric oxygen,HBO)预处理的干预作用.方法 6名健康成年战士,从平原移居到3800m高原生活0.5 ～2.0年,分别检测对照组、HBO 5天组和HBO 7天组安静和负荷后的心功能指标:心肌作功指数(Tei index)、左心室射血分数(LVEF)、血清肌酸激酶同工酶-MB(CK-MB)和心肌肌钙蛋白Ⅰ(cTnⅠ).体力负荷:节拍器控制的5min蹬阶运动,频率25次/分,台阶高30cm,负荷强度650(kg·m)/min,为中等强度的体力负荷.结果 HBO预处理7天安静时的Tei指数较对照组明显降低,差异有统计学意义(P＜0.05);HBO预处理5天、7天运动后的Tei指数较对照组均明显降低,LVEF较对照组均明显升高,差异均有统计学意义(P均＜0.01);HBO预处理5天、7天运动后的血清CK-MB、cTnⅠ水平较预处理前的对照组均明显降低,差异均有统计学意义(P均＜0.01).结论 平原移居高原人在中等强度体力负荷后出现心功能下降现象,HBO预处理可明显减轻运动后心肌损伤从而增强心功能.%Objective To investigate the changes of myocardial enzyme and cardiac function in soldiers after load exercise from plain to plateau and intervention effects of hyperbaric oxygen(HBO) pretreatment.Methods Six healthy male soldiers lived at 3800m high altitude for 0.5 to 2.0 years.The Tei index,left ventricular ejection fraction(LVEF),serum creatine kinase isoenzymes-MB(CK-MB) and cardiac troponin Ⅰ (cTnⅠ) were determined pre-exercise and post-exercise among control group,HBO 5days group and HBO 7days group.Results After 7days HBO pretreatment,the Tei index were significantly decreased compared with the control value (P ＜ 0.05).After 5days anf 7days HBO pretreatment,the Tei index was significantly decreased and the LVET increased after load exercise compared with quiescent condition (both P ＜ 0.01).After 5days and 7days HBO pretreatment,the serum CK-MB and cTnⅠ were significantly decreased after exercise compared with the control group (both P ＜0.01).Conclusion Myocardial damage and cardiac function reduction were marked on condition of medium intensity exercise in plateau soldiers.HBO intervention can abate postexercise myocardial damage and enhance cardiac function.