远程缺血预处理可改善年轻男性在急性高原暴露期间的空间记忆和睡眠。
Remote ischemic preconditioning improves spatial memory and sleep of young males during acute high-altitude exposure.
机构信息
Department of High Altitude Operational Medicine, College of High Altitude Military Medicine, Army Medical University, Chongqing, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Army Medical University, Chongqing, China; Key Laboratory of High Altitude Medicine, Army Medical University, Chongqing, China.
Department of Health, The 12th Integrated Training Base of Army, Chongqing, China.
出版信息
Travel Med Infect Dis. 2023 May-Jun;53:102576. doi: 10.1016/j.tmaid.2023.102576. Epub 2023 Apr 15.
OBJECTIVE
The high-altitude hypoxia environment will cause poor acclimatization in a portion of the population. Remote ischemic preconditioning（RIPC）has been demonstrated to prevent cardiovascular and cerebrovascular diseases under ischemic or hypoxic conditions. However, its role in improving acclimatization and preventing acute mountain sickness (AMS) at high altitude has been undetermined. This study aims to estimate the effect of RIPC on acclimatization of individuals exposed to high altitude.
METHODS
The project was designed as a randomized controlled trial with 82 healthy young males, who received RIPC training once a day for 7 consecutive days. Then they were transported by aircraft to a high altitude (3680 m) and examined for 6 days. Lake Louise Score(LLS) of AMS, physiological index, self-reported sleep pattern, and Pittsburgh Sleep Quality Index（PSQI）score were applied to assess the acclimatization to the high altitude. Five neurobehavioral tests were conducted to assess cognitive function.
RESULTS
The result showed that the RIPC group had a significantly lower AMSscore than the control group (2.43 ± 1.58 vs 3.29 ± 2.03, respectively; adjusted mean difference-0.84, 95% confidence interval-1.61 to -0.06, P = 0.036). and there was no significant difference in AMS incidence between the two groups (25.0% vs 28.57%, P = 0.555). The RIPC group performed better than the control group in spatial memory span score (11[9-12] vs 10[7.5-11], P=0.025) and the passing digit (7[6-7.5] vs 6[5-7], P= 0.001). Spatial memory was significantly higher in the high-altitude RIPC group than in the low-altitude RIPC group (P＜0.01). And the RIPC group obtained significantly lower self-reported sleep quality score (P = 0.024) and PSQI score (P = 0.031).
CONCLUSIONS
The RIPC treatment improved spatial memory and sleep quality in subjects exposed to acute hypoxic exposure and this may lead to improved performance at high altitude.
目的
高原缺氧环境会导致部分人群适应不良。远程缺血预处理（RIPC）已被证明可预防缺血或缺氧条件下的心脑血管疾病。然而，其在改善高原适应和预防急性高原病（AMS）方面的作用尚未确定。本研究旨在评估 RIPC 对暴露于高原人群适应的影响。
方法
该项目设计为一项随机对照试验，82 名健康年轻男性每天接受 RIPC 训练一次，连续 7 天。然后，他们乘飞机被运往海拔 3680 米的高原，并在 6 天内进行检查。采用洛矶山评分（LLS）、生理指标、自我报告的睡眠模式和匹兹堡睡眠质量指数（PSQI）评分评估对高原的适应情况。进行了五项神经行为测试以评估认知功能。
结果
结果显示，RIPC 组的 AMS 评分明显低于对照组（分别为 2.43±1.58 和 3.29±2.03；调整平均差值-0.84，95%置信区间-1.61 至-0.06，P=0.036）。两组 AMS 发生率无显著差异（分别为 25.0%和 28.57%，P=0.555）。RIPC 组在空间记忆广度评分（11[9-12]与 10[7.5-11]，P=0.025）和通过数字评分（7[6-7.5]与 6[5-7]，P=0.001）方面的表现优于对照组。在高原 RIPC 组中，空间记忆明显高于低海拔 RIPC 组（P＜0.01）。RIPC 组自我报告的睡眠质量评分（P=0.024）和 PSQI 评分（P=0.031）明显较低。
结论
RIPC 治疗可改善急性低氧暴露受试者的空间记忆和睡眠质量，这可能导致在高海拔地区表现提高。
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