中国全科医学 ›› 2023, Vol. 26 ›› Issue (29): 3640-3644.DOI: 10.12114/j.issn.1007-9572.2023.0164

• 论著 • 上一篇    下一篇

间歇性低氧训练预防急性低氧损伤有效性和安全性的研究

黄丹1, 张琪涵2, 宋歌3, 王晴2, 李瑀1, 吉训明4,*(), 王媛2,*()   

  1. 1.102211 北京市,北京小汤山医院发展协调办公室
    2.100053 北京市,首都医科大学宣武医院神经内科
    3.102211 北京市,北京小汤山医院物理治疗科
    4.100053 北京市,首都医科大学宣武医院神经外科
  • 收稿日期:2023-03-06 修回日期:2023-05-15 出版日期:2023-10-15 发布日期:2023-05-18
  • 通讯作者: 吉训明, 王媛

  • 作者贡献:黄丹提出主要研究目标,负责研究的构思与设计,研究的实施,撰写论文;张琪涵、宋歌、王晴、李瑀进行数据的收集与整理,统计学处理,图、表的绘制与展示;吉训明负责文章的质量控制与审查,监督管理;王媛进行论文的修订,对文章整体负责。
  • 基金资助:
    国家重点研发计划(2022YFC3501005)

Efficacy and Safety of Intermittent Hypoxic Training in the Prevention of Acute Hypoxic Injury

HUANG Dan1, ZHANG Qihan2, SONG Ge3, WANG Qing2, LI Yu1, JI Xunming4,*(), WANG Yuan2,*()   

  1. 1. Development Coordination Office, Beijing Xiaotangshan Hospital, Beijing 102211, China
    2. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
    3. Department of Physical Therapy, Beijing Xiaotangshan Hospital, Beijing 102211, China
    4. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
  • Received:2023-03-06 Revised:2023-05-15 Published:2023-10-15 Online:2023-05-18
  • Contact: JI Xunming, WANG Yuan

摘要: 背景 急进高原会引起急性低氧损伤,出现不同程度的临床症状,有些可能发展成急性重症高原反应。然而目前防治方法有限,缺乏安全有效的预防及减轻其严重程度的方法。 目的 通过模拟4 400 m海拔低氧环境,探讨间歇性低氧训练(IH)预防急性低氧损伤的有效性和安全性。 方法 于2022-08-01—10-31在北京小汤山医院采用公开募集的方式招募受试者40名为研究对象,将受试者随机分为两组:IH组(试验组,n=20)和假训练组(对照组,n=20)。试验组接受10 min低氧(氧浓度13%,模拟海拔3 800 m)间隔5 min常氧(氧浓度21%),共4个循环,总持续时间为55 min的IH暴露干预,2次/d,连续干预5 d。对照组接受同时长的常压常氧干预。IH干预训练结束后的第1天,受试者进入模拟高原低氧环境6 h,设置氧浓度为12%(相当于海拔4 400 m)。采用路易斯湖评分(LLS)评估受试者急性高原病(AMS)的严重程度。收集受试者基线、急性高原低氧环境模拟前、急性高原低氧环境模拟6 h后外周血氧饱和度(SpO2)、脑组织氧饱和度(ScO2)和颅内压(ICP)。 结果 急性高原低氧环境模拟6 h后,试验组AMS发生率及LLS总分低于对照组(P<0.05)。急性高原低氧环境模拟6 h后试验组SpO2高于对照组(P<0.05)。组内比较结果显示,两组受试者在急性高原低氧环境模拟6 h后的SpO2及ScO2均较基线及急性高原低氧环境模拟前下降(P<0.05),试验组的急性高原低氧环境模拟6 h后较急性高原低氧环境模拟前SpO2下降幅度小于对照组〔(9.30±4.31)%与(13.10±6.66)%,P=0.039〕。对照组急性高原低氧环境模拟6 h后ICP较急性高原低氧环境模拟前升高(P<0.05)。 结论 IH训练可以提高机体的耐缺氧能力,有效降低急性高原反应发生率及严重程度。

关键词: 高原病, 急性高原病, 低氧血症, 间歇性低氧训练, 有效性, 安全性

Abstract:

Background

Acute hypoxic injury caused by acute altitude exposure is manifested by different degrees of clinical symptoms, some of which may develop into acute mountain sickness (AMS). However, the current prevention and treatment methods are limited and there is a lack of safe and effective methods to prevent and reduce the severity.

Objective

To investigate the efficacy and safety of intermittent hypoxic (IH) training in preventing acute hypoxic injury by simulating hypoxic environment at an altitude of 4 400 meters.

Methods

A total of 40 subjects were recruited by public recruitment in Beijing Xiaotangshan Hospital from 2022-08-01 to 10-31 and randomly divided into the IH group (experimental group, n=20) and sham training group (control group, n=20). The experimental group received the IH exposure intervention with the total duration of 55 min twice a day for 5 d, including 10 min of low oxygen (oxygen concentration of 13%, simulated altitude of 3 800 m), 5 min of normoxia (oxygen concentration of 21%). The control group received the simultaneous long normoxia intervention. On the first day after the IH intervention training, the subjects entered into the simulated high-altitude hypoxia environment for 6 h, and the oxygen concentration was set at 12% (equivalent to the altitude of 4 400 m). The Lake Louise Scale (LLS) was used to assess the severity of AMS. Peripheral oxygen saturation (SpO2), cerebral oxygen saturation (ScO2) and intracranial pressure (ICP) were collected at baseline, before and 6 h after the simulated high-altitude hypoxia environment.

Results

After 6 h of acute high-altitude hypoxia environment simulation, the incidence of AMS and LLS in the experimental group were significantly lower than those in the control group (P<0.05), SpO2 in the experimental group was significantly higher than that in the control group (P<0.05). The results of intra-group comparison showed that SpO2 and ScO2 of subjects in both groups decreased significantly after 6 h of acute high-altitude hypoxia environment simulation compared with baseline and before acute high-altitude hypoxia environment simulation (P<0.05), the decrease level of SpO2 after 6 h of acute high-altitude hypoxia environment simulation compared to before acute high-altitude hypoxia environment simulation in the experimental group was lower than the control group〔 (9.30±4.31 ) % vs. (13.10±6.66) %, P=0.039〕. The ICP was significantly increased after 6 h of acute high-altitude hypoxia environment simulation compared with before acute high-altitude hypoxia environment simulation in the control group (P<0.05) .

Conclusion

IH training can improve the to hypoxia tolerance of body, effectively reduce the incidence and severity of AMS.

Key words: Altitude sickness, Acute high altitude sickness, Anoxemia, Intermittent hypoxic training, Efficacy, Safety