在高海拔地区的适应低地人群中血管血栓的流行病学和病理生理学:一项前性的纵向研究
Velu Nair1,2,3, Surinderpal Singh4,5, Mohammad Zahid Ashraf6,7
1Department of the Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
The Lancet regional health. Southeast Asia
|June 29, 2023
概括
高海拔 (HA) 逗留增加了健康士兵的血栓形成风险,原因是炎症和内皮功能障碍. 这项研究量化了HA血栓发生率和相关的前血栓性因素.
科学领域:
- 高度医学 高度医学
- 心血管生理学心血管生理学
- 血液学 血液学 血液学
背景情况:
- 之前的文献表明,高海拔 (HA) 低地居民的血栓形成风险更高.
- 在HA中血栓形成的流行病学仍然不太了解.
- 这项研究调查了HA的健康士兵的血栓发生率和病理生理学.
研究的目的:
- 确定在HA的健康士兵中静脉和动脉血栓的发生率.
- 阐明HA中血栓形成与凝血标志物,抗凝血,纤维溶解,炎症和内皮功能障碍之间的关联.
主要方法:
- 对750名健康的男性士兵进行了一项观察性前性纵向研究,这些士兵在15000英尺以上的高度上升.
- 临床检查,血液图和凝血图在多个时间点进行.
- 血栓形成被放射学证实;指数病例 (ICs) 与匹配的健康队列 (CG) 相比较.
主要成果:
- 在HA的静脉和动脉血栓的发病率分别为5,926和1,482每10个5人年.
- 索引病例显示凝血增强,自然抗凝剂 (血栓模块素,TFPI) 减少,纤维素分解减弱.
- 在ICs中观察到内皮功能障碍和炎症标志物 (VCAM-1,ICAM-1,VEGFR-3,P-Selectin,CD40连接体,hsCRP,MPO) 的显著增加.
结论:
- 在HA的健康人群中,血栓形成的发生率高于海平面附近.
- 与HA相关的血栓形成与炎症,内皮功能障碍,前血栓状况和抑制纤维素分解有关.
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