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目的:探讨全身炎症反应综合征(SIRS)和急性高原反应综合征(AHARS)相关关系。方法:随机将实验动物分为平原组(FG)、中度高原组(MHG)、高原组(HG)。分别制备绵羊肺淋巴造瘘、兔及鼠盲肠结扎穿孔、30%Ⅲ度烧伤SD大鼠等SIRS/MODS动物模型,比较同类指标参数在不同海拔高度的差异;临床研究将符合MODS标准的540例分为FG、MHG1、MHG2、HG组,比较MODS指标评分在不同高度上的差异,检验MODS预测结局的准确性。结果:动物模型组PAP、PAWP、QL、PS、PC、TXB2、PGF ia、ET-1、CGRP、L-ENK、HSP70等指标在不同高度差异显著(P<0.05)。临床资料有与动物模型近似的变化(P<0.05),高原评分标准优于平原通用标准(P<0.05)。结论:高原缺氧为主的暴露因素与各种外源性致伤因素介导的SIRS/ARDS/MODS可能与AHARS有共同的病生基础,均可导致急性全身炎症反应。建立一体化的评分系统可能有利早期诊断治疗、提高治愈率、降低死亡率。
Objective: To investigate the relationship between systemic inflammatory response syndrome (SIRS) and acute altitude sickness syndrome (AHARS). Methods: The experimental animals were randomly divided into three groups: the plain group (FG), the moderate plateau group (MHG) and the plateau group (HG). SIRS / MODS animal models such as sheep lung lymphatic fistula, cecal ligation and puncture in rabbits and mice, and SD rats of 30% third degree burn were prepared, and the differences of the parameters of the same kind of animals at different altitudes were compared. 540 cases The patients were divided into FG, MHG1, MHG2 and HG groups. The differences of MODS index scores at different heights were compared to test the accuracy of MODS predictive outcome. Results: The indexes of PAP, PAWP, QL, PS, PC, TXB2, PGF ia, ET-1, CGRP, L-ENK and HSP70 in animal model group were significantly different at different heights (P <0.05). The clinical data had similar changes with the animal model (P <0.05), and the plateau score was superior to the plain standard (P <0.05). CONCLUSIONS: Exposure to the hypoxia at the plateau and various extrinsic traumatic factors may contribute to the acute systemic inflammatory response. SIRS / ARDS / MODS may have a common disease basis with AHARS. The establishment of an integrated scoring system may be advantageous early diagnosis and treatment, improve the cure rate, reduce mortality.