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目的:观察氧化应激在高原重体力劳动过程中急性高原反应(AHAR)发生中的作用。方法:由低海拔(1500 m)快速进入高原(3 700 m)并从事重体力劳动的男性官兵96名,年龄18～35岁。根据AHAR症状评分,分为重度AHAR组(A组,n=24)、轻中度AHAR组(B组,n=47)和无AHAR组(C组,n=25),在该高度逗留50 d后下撤前及返回低海拔(1 500 m)后12 h、15 d分别测定血清8-异前列腺素F2α(8-iso-PGF2α)、超氧化物歧化酶(SOD)、丙二醛(MDA),并与低海拔(1 500 m)50名健康官兵(D组)比较。结果:A组血清8-iso-PGF2α、MDA[分别为(9.53±0.47)μg/L、(8.91±0.39)μmol/L]水平显著高于B组[分别为(8.34±0.42)μg/L、(7.31±0.32)μmol/L]、C组[分别为(7.02±0.48)μg/L、(6.41±0.23)μmol/L和D组[分别为(5.13±0.56)μg/L、(5.48±0.33)μmol/L](均P<0.01),SOD(52.08±3.44)μ/mL水平显著低于B组(62.27±2.54)μ/mL、C组(71.99±3.35)μ/mL和D组(80.78±3.44)μ/mL,(均P<0.01),B组与C组之间和C组与D组之间亦有显著性差异(均P<0.01)。海拔3 700 m AHAR总计分与血清8-iso-PGF2α、MDA呈显著正相关(均P<0.01),与血清SOD显著负相关(P<0.01);8-iso-PGF2α、MDA与SOD显著负相关(均P<0.01)。海拔3 700 m 50 d,血清8-iso-PGF2α、MDA水平显著高于,SOD水平显著低于海拔1 500 m 12h、15 d和D组(均P<0.01),海拔1 500 m 12 h与15 d之间有显著性差异(均P<0.01),海拔1 500 m 15 d与D组之间无显著性差异。结论:人体在高原低氧并重体力时氧化应激和氧化-抗氧化失衡与AHAR的发病和程度有密切关系,氧化应激和氧化-抗氧化失衡越严重,AHAR越重。返回低海拔后12 h有显著改善,15 d恢复到正常水平。
Objective: To observe the role of oxidative stress in the development of acute altitude sickness (AHAR) during heavy manual labor. Methods: A total of 96 male officers and men, aged 18-35, who entered the plateau (3 700 m) and engaged in heavy physical labor from low altitude (1500 m) quickly. According to AHAR symptom scores, patients were divided into severe AHAR group (group A, n = 24), mild to moderate AHAR group (group B, n = 47) and no AHAR group (group C, n = 25) The levels of 8-iso-PGF2α, SOD, MDA (malondialdehyde) and malondialdehyde (MDA) in serum were measured before 12 d and 15 d after returning to low altitude (1 500 m) MDA) and compared with 50 healthy officers and soldiers (Group D) at low altitude (1 500 m). Results: The levels of 8-iso-PGF2α and MDA in group A were significantly higher than those in group B [(8.33 ± 0.47) μg / L and (8.91 ± 0.39) μmol / L, , (7.31 ± 0.32) μmol / L] in group C [(7.02 ± 0.48) μg / L vs 6.41 ± 0.23 μmol / (P <0.01). The level of SOD (52.08 ± 3.44) μ / mL in group B was significantly lower than that in group B (62.27 ± 2.54) μ / mL and group C (71.99 ± 3.35) μ / Group (80.78 ± 3.44) μ / mL, (all P <0.01). There was also significant difference between group B and group C and between group C and group D (all P <0.01). The AHAR total score at 3 700 m altitude was positively correlated with serum 8-iso-PGF2α and MDA (all P <0.01), but negatively correlated with serum SOD (P <0.01) (All P <0.01). The levels of serum 8-iso-PGF2α and MDA were significantly higher than those of the normal control group at 3 700 m 50 d, and the levels of SOD were significantly lower than those at 1 500 m 12h, 15 d and D (P <0.01) 15 d (all P <0.01). There was no significant difference between D 15 and D 15 500 m 15 d. CONCLUSION: The body oxidative-stress and oxidative-antioxidant imbalance are closely related to the onset and degree of AHAR when the body is exposed to hypoxia and physical stress on the plateau. The more severe the oxidative stress and oxidation-antioxidant imbalance, the more severe the AHAR. After 12 hours of return to low altitude, there was a significant improvement, 15 days returned to normal levels.