Brito Julio, Siqués Patricia, León-Velarde Fabiola, De La Cruz Juan José, López Vasthi, Herruzo Rafael
Instituto de Estudios de Salud, Universidad Arturo Prat, Iquique, Chile.
High Alt Med Biol. 2007 Fall;8(3):236-44. doi: 10.1089/ham.2007.8310.
The aim of this cross-sectional study was to assess the health status of subjects weekly commuting between sea level and 3550-m altitude for at least 12 yr (average 22.1 +/- 5.8). We studied 50 healthy army men (aged 48.7 +/- 2.0) working 4 days in Putre at 3550-m altitude, with 3 days rest at sea level (SL) at Arica, Chile. Blood pressure, heart rate, Sa(O(2) ), and altitude symptoms (AMS score and sleep status) were measured at altitude (days 1, 2, and 4) and at SL (days 1, 2, and 3). Hematological parameters, lipid profile, renal function, and echocardiography were performed at SL on day 1. The results showed signs of acute exposure to hypoxia (tachycardia, high blood pressure, low Sa(O(2) )), AMS symptoms, and sleep disturbances on day 1, which rapidly decreased on day 2. In addition, echocardiographic findings showed pulmonary hypertension (PAPm > 25 mmHg, RV and RA enlargement) in 2 subjects (4%), a PAPm > 20 mmHg in 14%, and a right ventricle thickness >40 mm in 12%. Hematocrit (45 +/- 2.7) and hemoglobin (15 +/- 1.0) were elevated, but lower than in permanent residents. There was a remarkably high triglyceride level (238 +/- 162) and a mild decrease of glomerular filtration rate (34% under 90 mL/min and 8% under 80 mL/min of creatinine clearance). In conclusion, in these preliminary results, in chronic intermittent hypoxia exposure even over longer periods, most subjects still show symptoms of acute altitude illnesses, but a faster recovery. Findings in triglycerides, in the pulmonary circulation and in renal function, are also a matter of concern.
这项横断面研究的目的是评估那些每周在海平面和海拔3550米之间通勤至少12年（平均22.1±5.8年）的受试者的健康状况。我们研究了50名健康的军人（年龄48.7±2.0岁），他们在智利阿里卡海拔3550米的普特雷工作4天，然后在海平面（SL）的阿里卡休息3天。在海拔高度（第1、2和4天）和海平面（第1、2和3天）测量血压、心率、血氧饱和度（Sa(O₂)）以及高原症状（急性高原病评分和睡眠状况）。在第1天的海平面进行血液学参数、血脂谱、肾功能和超声心动图检查。结果显示，在第1天有急性缺氧暴露的迹象（心动过速、高血压、低血氧饱和度）、急性高原病症状和睡眠障碍，在第2天迅速减轻。此外，超声心动图检查结果显示，2名受试者（4%）出现肺动脉高压（平均肺动脉压>PAPm>25 mmHg，右心室和右心房扩大），14%的受试者PAPm>20 mmHg，12%的受试者右心室厚度>40 mm。血细胞比容（45±2.7）和血红蛋白（15±1.0）升高，但低于长期居住者。甘油三酯水平显著升高（238±162），肾小球滤过率轻度下降（肌酐清除率低于90 mL/min的占34%，低于80 mL/min的占8%）。总之，在这些初步结果中，即使在长期慢性间歇性缺氧暴露的情况下，大多数受试者仍表现出急性高原病症状，但恢复较快。甘油三酯、肺循环和肾功能方面的发现也令人担忧。
