地震伤员藏族人群在急进平原治疗前后红细胞及相关参数的分析
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摘要
目的了解该次地震中受伤的世居藏族人群在急进平原治疗前后,其红细胞及其参数的变化情况。方法测定来该院紧急救治的地震藏族伤员治疗前后的红细胞(RBC)、血红蛋白(Hb)、红细胞比容(HCT)、红细胞平均容积(MCV)、红细胞平均血红蛋白含量(MCH)、红细胞平均血红蛋白浓度(MCHC)、红细胞体积分布宽度(RDW),分析其统计学意义。结果地震伤员治疗前后比较,MCV低于治疗后(P<0.01);治疗前后与世居高原的健康对照组比较,RBC、Hb、HCT均低于高原组(P<0.01);藏族伤员治疗前后与平原组相比较,RBC、Hb、HCT、MCV均低于健康对照组(P<0.01);RDW高于健康对照组(P<0.05);世居高原与平原组相比较,MCV低于平原组(P<0.05),MCHC、RDW高于平原组(P<0.05)。结论与平原组相比,世居高原的藏族人群都未出现RBC和Hb增多,而是在形态上都表现出类似于缺铁贫的小细胞非均一性,提示在治疗过程中要考虑合理的饮食,以富含铁的食品为宜。
Objective To understand the changes of red blood cells and related parameters in resident Tibetan population,with earthquake injury,before and after treatment after being rapidly transported into plain area.Methods Red blood cells(RBC),hemoglobin (HB),hematocrit(HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin (MCH),mean corpuscular hemoglobin concentration (MCHC) and red blood cell volume distribution width (RDW) were detected in Tibetan earthquake casualties,rapidly transported into this hospital,before and after treatment.Results For earthquake casualties,MCV decreased,compared with results after treatment (P<0.01).Compared with healthy controls,resident in plateau area for generations,RBC,Hb and HCT of transported Tibetan casualties were lower(P<0.01).For Tibetan casualties,RBC,Hb,HCT and MCV,detected before or after treatment,were all lower (P<0.01),but RDW was higher(P<0.05) than healthy controls,resident in plain area for generations.Comparison between healthy controls,resident in plateau or plain area for generations,indicated that MCV of the former was lower(P<0.01),but MCHC and RDW were higher (P<0.05).Conclusion Compared with plain group,Tibetan population,resident in plateau area for generations,did not show the increase of RBC and Hb,but with small-cell non poor uniformity,similar with iron deficiency anemia,for the morphology of RBC,indicating that,during the treatment of Tibetan casualties,reasonable prandium,especially those sufficient with iron,should be considered.
Objective To understand the changes of red blood cells and related parameters in resident Tibetan population,with earthquake injury,before and after treatment after being rapidly transported into plain area.Methods Red blood cells(RBC),hemoglobin (HB),hematocrit(HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin (MCH),mean corpuscular hemoglobin concentration (MCHC) and red blood cell volume distribution width (RDW) were detected in Tibetan earthquake casualties,rapidly transported into this hospital,before and after treatment.Results For earthquake casualties,MCV decreased,compared with results after treatment (P<0.01).Compared with healthy controls,resident in plateau area for generations,RBC,Hb and HCT of transported Tibetan casualties were lower(P<0.01).For Tibetan casualties,RBC,Hb,HCT and MCV,detected before or after treatment,were all lower (P<0.01),but RDW was higher(P<0.05) than healthy controls,resident in plain area for generations.Comparison between healthy controls,resident in plateau or plain area for generations,indicated that MCV of the former was lower(P<0.01),but MCHC and RDW were higher (P<0.05).Conclusion Compared with plain group,Tibetan population,resident in plateau area for generations,did not show the increase of RBC and Hb,but with small-cell non poor uniformity,similar with iron deficiency anemia,for the morphology of RBC,indicating that,during the treatment of Tibetan casualties,reasonable prandium,especially those sufficient with iron,should be considered.
引文
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[2]李崎,余海,刘斌,等.居高原超重小儿平原手术发生心跳骤停抢救1例[J].华西医学,2003,18(3):399.
[3]周永伟,盛风莲,王宇.高原病患者平原手术麻醉处理体会[J].临床麻醉学杂志,2006,22(3):234-235.
[4]董宏彬,洪欣.血红蛋白与高原低氧适应[J].国外医学卫生学分册,2004,31(4):220-223.
[5]Wu TY.Life on the high Tibetan plateau[J].High Alt Med Biol,2004,5(1):1-2.
[6]Beall CM.An ethiopian pattern of human adaptation to high alti-tude hypoxia[J].PNAS,2002,99(26):17215-17218.
[7]Bigham A,Bauchet M.Identifying signatures of natural selection in Tibetan and Andean populations using dense genome scan data[J].Plos Genet,2010,6(9):e1001116.
[8]Simonson TS,Yang Y.Genetic evidence for high-altitude adapta-tion in Tibet[J].Science,2010,329(5987):72-75.
[9]Peng Y,Yang Z,Zhang H,et al.Genetic variations in Tibetan populations and high-altitude adaptation at the Himalayas[J].Mol Biol Evol,2011,28(2):1075-1081.
[10]余满堂,王晓勤,陈秋红,等.高原平原人群基因多态性及低氧相关基因的研究[J].中华医药杂志,2006,6(5):137.
[11]徐红萍,张燕燕,张敏.红细胞体积和分布宽度在妊娠合并缺铁性贫血诊断中的价值[J].检验医学与临床,2007,4(9):102.
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