人工缺氧作为降低急性高原病负面影响的方法

Arthur F. Makarov, Yulia V. Tkachuk, Anton A. Tonshin, Igor V. Bukhtiyarov
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引用次数: 1

摘要

介绍。在海拔8公里以上发生急性高山(高原)病的关键阶段,表现为意识丧失、抽搐、呼吸暂停和死亡风险高。急性中枢神经系统缺氧伴显著低压缺氧是急性高山病关键期的主要机制。登山运动员和专业向导、极限运动员是主要的危险群体。建议通过降低代谢水平(人工低氧诱导)来防止急性低压缺氧对中枢神经系统的负面影响。本研究旨在评估急性低压缺氧时代谢率降低对机体负面影响预防的效果。材料和方法。研究分为两个阶段。第一,定义了采用人工缺氧模型的可能性。第二部分-模型效率定义。研究选用体重90 ~ 110 g的叙利亚仓鼠。5组,每组8只。两个实验组(1 -第一阶段和1 -第二阶段)动物肌肉注射1 g/kg甲基多巴(CAS编号555-30-6)。动物对照组(1 -在第1阶段,2 -在第2阶段)NaCl含量为0.9%。第一阶段采用间接量热法。每组动物分别于肌内注射前和注射后3 h测定耗氧量和二氧化碳消除速度2次。第二阶段为急性高山(高原)反应关键期。肌肉注射后3小时,将各组动物置于低压腔中。对照组1动物欠压30 kPa,对照组2动物和实验组动物欠压20 kPa,速度- 1.25 kPa/s。为避免CO2积累,采用连续的室内气流。进行连续目视观察。记录意识、姿势维持时间、抽搐发作、呼吸异常和呼吸暂停。第一阶段。实验组动物肌肉注射后平均基础耗氧速度为4.04±0.3 ml/ 100g /min, 2.70±0.11 ml/ 100g /min (p < 0.01)。,二氧化碳消除速度分别为3.17±0.27 ml/ 100g /min和2.26±0.09 ml/ 100g /min (p< 0.01)。对照组动物肌内注射后平均基础耗氧速度分别为3.80±0.43 ml/ 100g /min和3.88±0.37 ml/ 100g /min,二氧化碳消除速度分别为2.95±0.31 ml/ 100g /min和2.92±0.2 ml/ 100g /min。第二阶段。20 kPa对照组:自暴露开始动物平均姿势维持时间3±2 s,第一次惊厥时间- 20±3 s,第二次惊厥时间- 56±5 s,无性呼吸开始- 52±9 s,呼吸暂停- 114±26 s。所有动物均出现意识缺失。实验组:各项参数均无登记观察。所有动物都有意识,主动恢复姿势,而房间倾斜。暴露持续了20分钟。30 kPa对照组:8只动物中1只在暴露20分钟后56 s出现惊厥。在其他动物中没有观察到任何值得记录的参数。所有动物都有意识,主动恢复姿势,而房间倾斜。结论。降低代谢率对预防急性低压缺氧患者意识丧失和全身性惊厥的有效性已被实验证明;在人工缺氧状态下,在缺氧环境中安全停留的时间增加了20倍以上。道德。这项研究是按照《赫尔辛基宣言》的伦理原则进行的。临床研究方案在当地伦理委员会FSBSI IRIOH会议上进行了审查。
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Artificial hypobiosis as a method of acute altitude illness negative impact reduction
Introduction. Critical stage of acute mountain (altitude) sickness, manifesting by loss of consciousness, convulsions, apnea and high risk of death, develops at altitudes above 8 km. Acute oxygen starvation of the central nervous system while significant hypobaric hypoxia is the main mechanism of critical stage of acute mountain sickness. Alpinists and professional guides, extreme athletes are the main risk group. It is proposed to reduce the level of metabolism (artificial hypobiosis induction) to prevent the negative impact of acute hypobaric hypoxia on central nervous system. The study aims to assess the efficiency of the metabolic rate reduction for the organism negative impact prevention while acute hypobaric hypoxia. Materials and methods. Study had 2 stages. The 1st - definition of the possibility of using artificial hypobiosis model. The 2nd - the model efficiency definition. Syrian hamsters 90-110 g weight were used in the study. 5 groups, 8 animals in each. Animals of two experimental groups (1 - on the 1st stage and 1 - is on the 2nd) had intramuscular injections of 1 g/kg Methyldopa (CAS Number 555-30-6). Animals control groups (1 - on the 1st stage and 2 - is on the 2nd) had 0,9% NaCl. Indirect calorimetry was performed on the 1st stage. Oxygen consumption and carbon dioxide elimination speed were measured in each animal group twice: before intramuscular injection and 3 hours after. Critical stage of acute mountain (altitude) sickness was performed on the 2nd stage. In 3 hours after intramuscular injection animals of each group had been placed in hypobaric chamber. 30 kPa underpressure for control group #1 animals and 20 kPa for control group #2 and experimental group animals, speed - 1,25 kPa/s. To avoid CO2 accumulation continuous chamber air flow was made. Continuous visual observation carried out. Consciousness, posture maintenance time, convulsive seizures, agonal breathing, and apnea were registered. Results. 1st stage. Experimental group animals’ mean base oxygen consumption speed was 4,04±0,3 ml/100 g/min, and 2,70±0,11 ml/100 g/min (p<0,01) after intramuscular injection., carbon dioxide elimination speed was 3,17±0,27 ml/100 g/min and 2,26±0,09 ml/100 g/min (p<0,01) respectively. Control group animals’ mean base oxygen consumption speed was 3,80±0,43 ml/100 g/min, and 3,88±0,37 ml/100 g/min after intramuscular injection, carbon dioxide elimination speed was 2,95±0,31 ml/100 g/min and 2,92±0,2 ml/100 g/min, respectively. 2nd stage. 20 kPa control group: since start of exposure the average animal posture maintenance time was 3±2 s, the first convulsion time - 20±3 s, the second convulsion - 56±5 s, agonal breath start - 52±9 s, apnea - 114±26 s. Consciousness absence in all animal was observed. Experimental group: none of the parameters is to register were observed. All animals had consciousness, actively restored their position, while chamber was tilted. The exposure lasted for 20 minutes. 30 kPa control group: 1 animal of 8 had convulsions on 56 s of 20-minute exposure. None of the parameters is to register were observed in other animals. All animals had consciousness, actively restored their position, while chamber was tilted. Conclusions. The effectiveness of lowering the metabolic rate for the prevention of loss of consciousness and the development of generalized convulsions in acute hypobaric hypoxia has been experimentally proven; in a state of artificial hypobiosis, the time of safe stay in a hypoxic environment increases by more than 20 times. Ethics. The study was carried out in accordance with the ethical principles of the Declaration of Helsinki. The Clinical Study Protocol was reviewed at a meeting of the local Ethics Committee FSBSI IRIOH.
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Meditsina truda i promyshlennaia ekologiia
Meditsina truda i promyshlennaia ekologiia Medicine-Public Health, Environmental and Occupational Health
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