急进高原健康成人急性轻症高原病评分情况分析

The Assessment of Acute High Altitude Response Scores in Healthy Adults Acute Exposed to High Altitude

目的:通过对急进高原健康成人急性轻症高原病评分情况的调查,初步探讨了急进高原时健康人急性轻症高原病评分的变化趋势和各项症状指标在评估急性轻症高原病中的重要性。方法:对由海拔2260m急进到海拔3500m和4600m地区身体健康的成年人随机分组,在3天内、7天和15天3个时间段进行急性轻症高原病评分,观察其变化情况。分析各项症状指标的发生率。结果:急性轻症高原病评分在4600m海拔地区,3天内组和7天组与15天组对比均有显著性差别(P<0.01),急性轻症高原病评分随着留驻时间的延长而降低。与3500m15天组比较,只有4600m7天组有差别(P<0.05)。在同一海拔地区,随着时间的延长,无反应率先降后升;轻度反应发生率先略有升高,而后降至初进高原的水平;中度反应发生率先轻度升高,而后降低至最低。在各组16项症状中,发生率排名前四位的共有7项——头痛、头昏、心慌、气短、胸闷、腹胀和口唇发绀;在4600m的3组中,症状发生率排名第一的均为头痛;3500m组症状发生率的排名与4600m各组有较大的区别。结论:健康青壮年人在急进到高海拔或特高海拔地区后,开始习服至少需要2周以上时间。急性轻症高原病首先是较为敏感的脑组织发生病理生理改变所致,人体急进高原后,主要以心、脑、肺器官发生应激性改变为主。建议急性轻症高原病评分研究中,宜采用Kappa一致性检验法对急性轻症高原病评分调查者和被检者进行诊断的统计学处理。

Objective：To discuss the changes and their important of the acute mild altitude disease scores in healthy adults acute exposed to high altitudes through investigating the relative cases of scores and degrees. Methods：A total of 239 healthy adults, age range from 20-45 year old, who were exposed to 3 500mor 4 600m high altitudes acutely from 2 260m by the bus were randomly sampled as subjects and their acute mild altitude disease scores were evaluated after 3, 7, 15 days at 4 600m and 15 days at 3 500m. The changes of every symptom index were observed then the incidence rates of them were analyze＆ Resuits：At the altitude of 4 600 meters, the acute mild altitude disease scores had an obviously difference between 3, 7 and 15 exposed altitude days （P〈0. 01）. And there was a significant difference between 15 days at 3 500m and 7 days at 4 600m. In the same elevation areas, with the extension of time, the non--response rate changed from increase to decrease; the mild response rate ascended a little first then descended to the prior values before altitude exposure; and the moderate response rates ascended slightly first then descended to the lowest point. Headache, dizziness, palpitation, shortness of breath, chest tightness, abdominal distension and lips cyanosis were ranged on top four in 16 altitude symptoms but headache was a top symptom at 4 600m altitudes. There was greater distinction between 3 500m and 4 600m altitudes on incidence rates range of symptom. Conclusions：The healthy adults need to take not less than two weeks to accommodate themselves after acute exposure to altitude or extreme high altitudes.The acute mountain response results in primarily pathophysiologic changes of the more sensitive brain tissues, and the stress changes of heart, brain and lung are leading in all changes of human body. As a conclusion, it is appropriate to adopt Kappa consistency method to deal statistically with the investigators and the subjects during evaluating the acute mild altitude disease scores.