Strapazzon Giacomo, Pun Matiram, Cappello Tomas Dal, Procter Emily, Lochner Piergiorgio, Brugger Hermann, Piccoli Antonio
1 EURAC Institute of Mountain Emergency Medicine , Bolzano, Italy .
2 Department of Neurology, Saarland University Medical Center , Homburg, Germany .
High Alt Med Biol. 2017 Dec;18(4):384-391. doi: 10.1089/ham.2017.0056. Epub 2017 Oct 16.
Strapazzon, Giacomo, Matiram Pun, Tomas Dal Cappello, Emily Procter, Piergiorgio Lochner, Hermann Brugger, and Antonio Piccoli. Total body water dynamics estimated with bioelectrical impedance vector analysis and B-type natriuretic peptide after exposure to hypobaric hypoxia: A field study. High Alt Med Biol. 18:384-391, 2017.-The relationship between total body water (TBW) dynamics and N-terminal pro-B-type natriuretic peptide (NT-proBNP), a stable metabolite of B-type natriuretic peptide, during acute high altitude exposure is not known. To investigate this, we transported 19 healthy lowland subjects to 3830 m with a helicopter after baseline measurements (262 m). The physiological measurements and clinical assessments were taken at 9, 24, 48, and 72 hours and on the eighth day of altitude exposure. A bioelectrical impedance vector analysis (BIVA) from height corrected Resistance-Reactance (R-Xc graph) was used to estimate TBW status. NT-proBNP was measured from venous blood samples. The changes in impedance vector were lengthened at 9 (p = 0.011), 48 (p = 0.033), and 72 hours (p = 0.015) indicating dehydration compared to baseline. However, there was no dehydration at 24 hours (p > 0.05) from the baseline and the subjects trended to get euhydrated from 9 to 24 hours (p = 0.097). The maximum percent changes in vector length from the baseline were within 10%-15%. There was a significant increase of natural logarithm (ln)(NT-proBNP) after ascent with a peak at 24 hours, although similarly to BIVA values, ln(NT-proBNP) returned to baseline after 8 days of altitude exposure. The changes in impedance vector length were not correlated with the changes in ln(NT-proBNP) (r = -0.101, p = 0.656). In conclusion, the dehydration at high altitude as reflected by 10%-15% vector lengthening falls within "appropriate dehydration" in healthy lowland subjects. NT-proBNP does not simply reflect the TBW status during acute high altitude exposure and needs further investigation.
斯特拉帕宗、贾科莫、马蒂拉姆·蓬、托马斯·达尔·卡佩洛、艾米丽·普罗克特、皮尔乔吉奥·洛赫纳、赫尔曼·布鲁格和安东尼奥·皮科利。低压缺氧暴露后通过生物电阻抗矢量分析和B型利钠肽评估全身水动力学：一项现场研究。《高海拔医学与生物学》。2017年第18卷：384 - 391页。——急性高原暴露期间，全身水（TBW）动力学与B型利钠肽的稳定代谢产物N末端前B型利钠肽（NT - proBNP）之间的关系尚不清楚。为了研究这一关系，我们在基线测量（262米）后，用直升机将19名健康的低地受试者运送至3830米处。在海拔暴露的第9、24、48和72小时以及第8天进行生理测量和临床评估。利用基于身高校正的电阻 - 电抗（R - Xc图）进行生物电阻抗矢量分析（BIVA）来评估TBW状态。从静脉血样本中测量NT - proBNP。与基线相比，阻抗矢量在第9小时（p = 0.011）、第48小时（p = 0.033）和第72小时（p = 0.015）延长，表明存在脱水。然而，第24小时与基线相比无脱水（p > 0.05），且受试者在第9至24小时有趋于水合正常的趋势（p = 0.097）。矢量长度相对于基线的最大百分比变化在10% - 15%以内。上升后自然对数（ln）（NT - proBNP）显著增加，在24小时达到峰值，尽管与BIVA值类似，ln（NT - proBNP）在海拔暴露8天后恢复到基线水平。阻抗矢量长度的变化与ln（NT - proBNP）的变化不相关（r = - 0.101，p = 0.656）。总之，10% - 15%的矢量延长所反映的高原脱水属于健康低地受试者的“适当脱水”。NT - proBNP在急性高原暴露期间不能简单地反映TBW状态，需要进一步研究。
