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投稿时间：2015-10-19 修订日期：2016-08-30
投稿时间：2015-10-19 修订日期：2016-08-30
中文摘要: 通过中等强度冷空气活动对人群血压及生化指标水平的影响实验研究，探讨冷空气对心血管疾病的影响。选取甘肃省张掖市为实验地点，经健康筛查及血液学检查，于现场研究前，选择30例心脑血管疾病患者为病例组，40例健康人为对照组。在2013年4月27—28日冷空气发生的过程中进行了科学实验，分别于冷空气暴露前24 h（4月26日上午）、过境时（气温降至最低，4月28日07:00—08:00）和过境后24 h（4月29日上午）对70名研究对象进行血脂、全血黏度、心肌肌钙蛋白I、肌红蛋白和血管内皮素 1检查，分析各个生化指标水平在冷空气过境前、中、后的变化。结果表明，受冷空气影响，可使心脑血管患者和健康人的全血黏度低切和中切、全血还原低切和高切均显著升高，使血液处于高凝、高聚和高黏状态；可使心脑血管患者血清TG、VLDL C呈显著上升，HDL C、ApoA1呈显著下降，导致血液黏稠，沉积在血管壁的胆固醇、血小板颗粒增加，动脉粥样硬化进一步加重；可使血管内皮素 1浓度在冷空气过境时显著升高，可使肌红蛋白和肌钙蛋白I无论是冷空气发生时还是影响结束后均呈持续升高，导致血管收缩、心肌细胞受损。主要结论：受冷空气影响，无论是健康人还是心脑血管病人，一是均可使血液处于高凝、高聚和高黏状态，影响其流动性；二是可使动脉粥样硬化发生或加重；三是可导致血管收缩、心肌细胞受损。从三个方面探讨了冷空气对人群心脑血管疾病危险因素影响的事实及机理。
Abstract:The effects of cold air on cardiovascular disease were investigated in an experimental research examining blood pressure and biochemical indicators in humans. Zhangye City, Gansu Province was selected as the experimental site. After conducting health screening and blood tests, 30 cardiovascular disease patients and 40 healthy subjects were recruited as case and control groups, respectively. The experiment was performed during cold air exposure in 27-28 April 2013. Blood lipid, whole blood viscosity, cardiac troponin I, myoglobin (Mb), and endothelin 1 in all subjects were evaluated 24 h before (morning of 26 April 2013), during the process (temperature dropped to the lowest in 07:00-08:00 BT 28 April 2013), and 24 h after cold exposure （morning of 29 April 2013）. The variations in each biochemical indicator were analyzed before, during, and after the cold exposure. The results showed that cold air exposure increased the low and midst shear of whole blood viscosity and the low and high shear of whole blood reduced viscosity. This phenomenon led to excessive blood clotting and high aggregation and viscosity state in cardiovascular disease patients and healthy subjects. In addition, cold air exposure evidently increased serum triglyceride and very low density lipoprotein cholesterol but decreased high density lipoprotein cholesterol and Apo lipoprotein A1. These indicators caused blood viscosity, increasing cholesterol and platelet granules, which are deposited in the vascular wall, thus further aggravating atherosclerosis. During the cold air exposure, the concentration of vascular endothelin 1 significantly increased. Moreover, Mb and cardiac troponin I gradually increased and caused vasoconstriction and damage to myocardial cells. The main conclusions are that the cold air can affect both cardiovascular disease patients and healthy subjects. Firstly, the effect of cold air can make excessive blood clotting and high aggregation and viscosity state, impacting the blood rheology. Secondly, the cold air can promote the occurrence and development of atherosclerosis. Thirdly, the cold air can vasoconstriction and damage to myocardial cells. In addition, the mechanism of the effect of cold air on cardiovascular disease risk factors in humans were also investigated from three aspects.
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基金项目:国家自然科学基金项目（40975069和41375121）共同资助
引用文本：
张书余,张夏琨,崔世杰,林朝旭,2016.冷空气对人心血管系统及相关影响因素的自然实验研究[J].气象,42(10):1256-1262.
ZHANG Shuyu,ZHANG Xiakun,CUI Shijie,LIN Chaoxu,2016.Cold Air to the Cardiovascular System and Related Influence Factors of Natural Experiment Research[J].Meteor Mon,42(10):1256-1262.
张书余,张夏琨,崔世杰,林朝旭,2016.冷空气对人心血管系统及相关影响因素的自然实验研究[J].气象,42(10):1256-1262.
ZHANG Shuyu,ZHANG Xiakun,CUI Shijie,LIN Chaoxu,2016.Cold Air to the Cardiovascular System and Related Influence Factors of Natural Experiment Research[J].Meteor Mon,42(10):1256-1262.