目的分析高温环境下高强度训练对作战训练(作训)人员心脏的影响。方法选择解放军252医院于2015年7月1日~2016年8月31日收治的因高温高强度训练出现不适的作训人员38例,均为男性,年龄18~23(20±1.8)岁。所有患者人院后均检测血常规、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、肌酐(Cr)、丙氨酸氨基转移酶(ALT)、N末端脑钠肽前体(NT-proBNP)等,诊断并分析患者临床症状。结果出现心脏相关症状胸闷、气短12例(31.6%),心悸10例(26.3%)。此外,9例(23.7%)在出现不适症状时血压偏低。12例(31.6%)出现心电图改变,7例(18.4%)诊断为心律失常。5例(13.2%)出现心肌损伤,6例(15.8%)考虑存在多器官功能损害。20例(52.6%)诊断为中暑,其中6例(15.8%)同时存在肝肾功能受损,考虑为热射病。患者人院后给予补液及相应对症支持治疗,均好转出院,肝肾功能指标及心肌酶均恢复正常,无明显后遗症。结论高温环境下的高强度训练会引起作训人员心脏等器官损伤,应科学合理设计训练,使作训人员提高对高温环境高强度训练的适应能力,减少心肌损伤,提高部队战斗力。
Objective To analyze the influence of high intensity training on heart in personnel with combatdrill under high temperature condition.Methods The male trainers(n=38,aged from18to23and average age=20±1.8)with discomfort due to high intensity training under high temperature condition were chosen from ChinesePLA252Hospital from Jul.1,2015to Aug.31,2016.The blood routine items,creatine kinase(CK),creatinekinase MB(CK-MB),cardiac troponin I(cTnl),creatinine(Cr),alamine aminotransferase(ALT)and N-term inalp ro-b rain natriuretic peptide(N T-proBNP)were detected in all patients after hospitalization.The clinicalsymptoms were diagnosed and analyzed in all patients.Results There were12cases(31.6%)with symptomsrelated to heart including chest distress and breathe hard,10(26.3%)with palpitation,and in addition9(23.7%)with hypotension and discomfort.There were12cases(31.6%)with ECG changes,7(18.4%)diagnosed witharrhythmia,5(13.2%)with myocardial injury and6(15.8%)with possible functional lesions of m ultiple organs.There were20cases(52.6%)diagnosed with siriasis,and among them6(15.8%)with functional lesions of liverand kidney who were considered for suffering from thermoplegia.After hospitalization,all cases were given fluidinfusion and symptomatic and supportive treatment,and all of them were cured and discharged from hospital withrecovered functional indexes of liver,kidney and myocardial enzyme and without sequelas.Conclusion Highstrength training under high temperature condition may cause the injury of heart and other organs in trainers.Thetraining should be designed scientifically and reasonably for improving adaptive capacity to high strength trainingunder high temperature condition,relieving myocardial lesions and promoting combat effectiveness.