Research On Changes Of Myocardial Markers In Patients With Acute High Altitude Pulmonary Edema

Objective To explore the correlation between the severity of acute high altitude pulmonary edema and myocardial injury and increase of myocardial load by retrospectively analyzing the changes of myocardial markers and other related indicators in patients with acute high altitude pulmonary edema.Methods According to strict inclusion and exclusion criteria,246 patients with acute high altitude pulmonary edema admitted to Tibet Autonomous Region People’s Hospital from 2010 to 2018 were selected as experimental group(HAPE group),and 283 patients with only acute high altitude reaction as control group(AMS group).1.Collecting Research Indicators(1)General information: sex,age,history of smoking and drinking,history of entering Tibet,number of days of entering Tibet this time,history of past diseases;(2)General vital signs: heart rate at rest(rest for more than 30 minutes),blood pressure,breathing,pulse,oxygen saturation of finger artery without oxygen inhalation;(3)Laboratory test indicators: hemoglobin(HGB),white blood cell count(WBC),blood glucose(Glu),cardiac troponin I(CTNI),creatine kinase isoenzyme(CK-MB),myoglobin(MYO),brain natriuretic peptide(BNP)/N-terminal pro-brain natriuretic peptide(NT-proBNP);(4)Echocardiographic parameters: left ventricular ejection fraction(LVEF),pulmonary artery pressure(PSAP),etc.2.Calculating the BMI、MAP and PSAP of patients.3.Statistical analysis of the above research indicatorsResults Compared with AMS group,BNP(NT-proBNP),CTNI,MYO,CK-MB,PSAP increased significantly in HAPE group(P < 0.05),left ventricular ejection fraction(LVEF)decreased significantly(P < 0.05);For HAPE group at hospitalization day,BNP(NT-proBNP),CTNI,MYO,CK-MB,PSAP,CLU,HB,WBC,Glu were significantly higher than the normal value before treatment,and decreased significantly after treatment(P< 0.05).Re-examination of vital signs showed that general vital signs were significantly better than those before treatment after 30 minutes of oxygen cessation on discharge day(P < 0.05).Through the analysis of basic diseases in HAPE group,it was found that the relative risk factors of coronary heart disease were > 1,and the significant level was < 0.05.Therefore,coronary heart disease was the relative risk factor of acute high altitude pulmonary edema.Through the analysis of living habits in HAPE group,it was found that the patients with previous smoking history had relative risk > 1,significant level < 0.05,we could conclude that smoking was the relative risk factor of acute high altitude pulmonary edema;through grouping the patients with acute high altitude pulmonary edema with previous basic diseases,the experimental group was the patients with previous basic diseases,and thecontrol group was the patients without previous basic diseases,we could find that the BNP(NT-proBNP),CTNI,MYO,CK-MB,PSAP in the experimental group are higher than those in the control group(P < 0.05).LVEF was significantly lower than that of the control group(P < 0.05)Conclusion 1.Acute high altitude pulmonary edema is not only a single non-cardiogenic pulmonary edema,but also has cardiogenic manifestations such as myocardial injury and increased myocardial load.2.After treatment,myocardial injury gradually improved and myocardial load gradually decreased with the gradual absorption of edema.3.Previous history of coronary heart disease and smoking is the relative risk of acute high altitude pulmonary edema.4.Myocardial injury and myocardial load in patients with high altitude pulmonary edema with basic diseases were more severe than those without basic diseases.