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[快速和渐进性攀登至青藏高原对中国南极昆仑站考察预选队员心血管功能及应激因素的影响]

[Effects of rapid and progressive ascent to Tibet plateau on cardiovascular function and stress factors of pre-selected expeditioners for Chinese Antarctic expedition for Kunlun station].

作者信息

Lu Yan-Hua, Xiong Yan-Lei, Fang Lu, Chen Nan, Xu Cheng-Li

机构信息

Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing 100005, China.

出版信息

Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2020 Sep;36(5):419-424. doi: 10.12047/j.cjap.5910.2020.089.

Abstract

To explore the different effects of rapid and progressive ascent to Tibet plateau on cardiovascular function and stress factors in pre-selected expeditioners for the 31, 32 and 33 Chinese Antarctic expedition for inland station, to provide a scientific basis for the selection of qualified expeditioners. A total of 85 pre-selected expeditioners for the 31, 32 and 33 Chinese Antarctic expedition for Kunlun station were enrolled in this study. According to the different manners of entering the plateau, they were divided into the rapid ascent group by aircraft (RAG, =55) and the progressive ascent group by train (PAG, =30). Hemodynamics and electrocardiogram were examined at 4 m (Shanghai), areas at altitude of 3 658 m (Lhasa) and 4 300 m(Yangbajain), respectively. Saliva levels of stress factors, including testosterone (T), cortisol (COR) and immunoglobulin A (IgA), were tested by ELISA. The heart rates (HR) were increased significantly, while the SpO was decreased significantly in the two groups within 24 hours at altitudes of 3 658 m and 4 300 m (<0.05), while there was no significant difference between the two groups at the same altitude. Compared with 4 m, the blood pressure (BP) of the two groups at 3 658 m and 4 300 m was significantly increased (<0.05), and some indexes of myocardial contraction and pumping function were significantly reduced (<0.05). However, due to the increase of HR, there was no significant change in Cardiac Output (CO). At 4 300 m, the Thoracic Fluid Content (TFC) of the rapid ascent group was significantly higher than that of the progressive ascent group (<0.05). Compared with 4m, there was no significant difference in salivary testosterone change between the two groups at 3 658 m above sea level (>0.05), while COR and IgA changes in the rapid ascent group were significantly higher than those in another group (<0.05). Compared with the progressive ascent by train,expeditioners that rapid ascent to high altitude have significant effects on cardiovascular function and the stress hormones and immunoglobulin levels in saliva. It's suggested that hypoxia adaptation before Antarctic expediting for Kunlun Station could ensure the selected expeditioners' physical and psychological health, so that the mission could be finished smoothly.

摘要

为探讨快速和渐进式进入青藏高原对入选第31次、第32次和第33次中国南极内陆考察队队员心血管功能和应激因子的不同影响,为选拔合格考察队员提供科学依据。本研究共纳入85名入选第31次、第32次和第33次中国南极昆仑站考察队的队员。根据进入高原的不同方式,将他们分为乘飞机快速上升组(RAG,n = 55)和乘火车渐进上升组(PAG,n = 30)。分别在海拔4米(上海)、3658米(拉萨)和4300米(羊八井)地区进行血流动力学和心电图检查。采用酶联免疫吸附测定法检测唾液中应激因子睾酮(T)、皮质醇(COR)和免疫球蛋白A(IgA)的水平。在海拔3658米和4300米处,两组心率(HR)在24小时内显著升高,而血氧饱和度(SpO)显著降低(P<0.05),但在同一海拔高度两组间无显著差异。与海拔4米相比,两组在海拔3658米和4300米处血压(BP)显著升高(P<0.05),心肌收缩和泵血功能的一些指标显著降低(P<0.05)。然而,由于心率增加,心输出量(CO)无显著变化。在海拔4300米处,快速上升组的胸液含量(TFC)显著高于渐进上升组(P<0.05)。与海拔4米相比,两组在海拔3658米以上唾液睾酮变化无显著差异(P>0.05),而快速上升组COR和IgA变化显著高于另一组(P<0.05)。与乘火车渐进上升相比,快速上升到高海拔对考察队员心血管功能以及唾液中应激激素和免疫球蛋白水平有显著影响。建议昆仑站南极考察前进行低氧适应,以确保入选考察队员身心健康,从而顺利完成任务。

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