目的: 观察健康中青年男性急进短期高原暴露前后,机体的心肌酶学、神经内分泌及心功能主要相关指标的变化;并探讨急进短期高原暴露对心脏组织细胞功能及神经内分泌的影响及可能机制。方法: 随机选取健康中青年志愿者男性50名,在进驻高原前1天（海拔100 m）、急进短期高原暴露15天后（海拔3 000 m）的清晨7∶00,空腹、坐位采集心率（HR）、呼吸频率（R）、收缩压（SBP）、舒张压（DBP）、动脉血氧饱和度（SaO2）;使用全自动生化分析仪检测肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、肌红蛋白（Mb）、高敏肌钙蛋白T（cTnT）、羟丁酸脱氢酶（α-HBDH）、缺血修饰蛋白（IMA）及高敏C反应蛋白（hs-CRP）;使用电化学发光免疫分析仪检测促甲状腺激素（TSH）、总甲状腺素（TT4）、游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）、总三碘甲状腺原氨酸（TT3）、皮质醇（CORT）;采用彩色多普勒超声诊断仪检查右室内径（RV）、右房内径（RA）、左室舒张内径（LV）、左房内径（LA）、主动脉根部内径（AO）、肺动脉内径（PA）、左室长轴缩短率（LVFS）、左心室射血分数（LVEF）、每搏输出量（SV）、左心室舒张末期容积（LVEDV）。比较急进短期高原暴露前后各指标的差异。结果: 与进驻高原前相比,中青年男性急进短期高原暴露15天后生理参数指标：HR明显增快,R增加,SBP升高、SaO2下降、DBP升高、MAP升高;心肌酶学指标：LDH、CK-MB、CK、HBDH、IMA、Mb、cTnT、hs-CRP均显著升高;神经内分泌相关指标：TSH、TT4、FT4、FT3、TT3、CORT均显著升高;心功能指标：RV、RA、LV、LA、LVFS、LVEF、SV、LVEDV均降低,AO、PA均升高,差异均具有统计学意义。结论: 急进短期高原暴露可导致急进高原缺氧心肌损伤,主要表现为氧化应激反应,导致心肌细胞膜出现损伤,相关心肌酶外流出心肌细胞膜,在一定程度上引起心功能代偿能力降低。

Objective To observe the changes of myocardial enzymology, neuroendocrine and cardiac function in healthy young and middle-aged men before and after acute short-term plateau exposure; and to explore the effects and possible mechanisms of acute short-term plateau exposure on cardiac tissue cell function and neuroendocrine. Methods 50 healthy young and middle-aged male volunteers were randomly selected to collect physiological indices: heart rate (HR), respiratory rate (R), systolic blood pressure (SBP), diastolic blood pressure (DBP), and oxygen saturation (SaO2) at 7: 00 am 1 day before entering plateau (100 m above sea level), and 15 days after short-term exposure to plateau in an acute condition (3 000 m above sea level) in a fasting and seated position; cardiac enzymology and neuroendocrine function of cardiac tissues and cardiovascular function of cardiac tissues and cardiac cells were detected by using a fully automated biochemical analyzer. Neuroendocrine-related indexes: thyroid stimulating hormone (TSH), total thyroxine (TT4), free thyroxine (FT4), free tri-iodothyronine (FT3), total tri-iodothyronine (TT3), and cortisol (CORT); and color Doppler ultrasound diagnostic instrument was used to check the cardiac function indexes: right ventricular internal diameter (RV), right atrial internal diameter (RA), left ventricular diastolic internal diameter (LV), and left atrial internal diameter (LA). (LV), left atrial internal diameter (LA), aortic root internal diameter (AO), pulmonary artery internal diameter (PA), left ventricular long-axis shortening (LVFS), left ventricular ejection fraction (LVEF), stroke volume (SV), and left ventricular end-diastolic volume (LVEDV), comparing differences in indicators before and after acute short-term plateau exposure. Results Compared with before entering the plateau, the physiological parameter indicators of young and middle-aged men after 15 days of acute short-term plateau exposure: HR increased significantly, R increased, SBP increased, SaO2 decreased, DBP increased, and MAP increased, and the differences were statistically significant; cardiac enzyme indicators: LDH, CK-MB, CK, HBDH, IMA, Mb, cTnT, and hs-CRP were significantly elevated, and the differences were all statistically significant; neuroendocrine-related indices: TSH, TT4, FT4, FT3, TT3, and CORT were significantly elevated; and cardiac function indices: RV, RA, LV, LA, LVFS, LVEF, and SV, LVEDV were all decreased, and AO and PA were all increased, and the differences were all statistically significant. Conclusion Short-term acute plateau exposure can lead to acute plateau hypoxic myocardial injury, which is mainly manifested as oxidative stress, resulting in damage to myocardial cell membranes and outflow of relevant cardiac enzymes from myocardial cell membranes, which to a certain extent caused a decrease in cardiac compensatory capacity.