再论急性高原肺水肿家族易感性问题(跟踪一家族在40年里祖孙三代病例摘要)

DISCUSSIN ON FAMILY'S SENSIBILITY OF HIGH ALTITUDE PULMONARY EDEMA (A abstract on a case of 40-year research in a family)

高原肺水肿家族易感性问题在世界范围内尚属探讨过程。作者曾于1987年第三届国际高原医学大会(日本.松本)报告了五个家庭20例病例的家族易感性问题。病例均在两代人或同代人身上发生,对其中一个家族在长达40年的追踪中发现祖孙三代人共6例先后发生12次急性高原肺水肿。其父亲在1968年首次乘机进藏既患急性高原肺水肿,经抢救治愈。在之后往返拉萨、成都20余次之中,还有两次发生肺水肿,既是乘机进藏在翻越海拔5000米的雀儿山时也发生肺水肿。在其余的进藏中由于采取预防措施及进藏立即吸氧,也有轻度症状发生,但未达到肺水肿的病情。其两儿一女均在乘机首次进藏后发生急性高原肺水肿。其中一人患过三次,另两人各一次。其孙辈:一人曾发生三次肺水肿,另一人的女儿也发生一次肺水肿。在本家族中其母亲多次进出藏均未发生病,只有父亲、儿子、女儿和孙子及外孙相继发生肺水肿。在遗传学上肯定可以得到答案,有关DNA研究部门已着手进行研究,待后将公布于众。本文重点从临床角度对这一罕见家族易感病例作出报告。据此可以推断,高原肺水肿有家族易感性。

Discussion on infectious high altitude pulmonary edema（HAPE） is still new in the world. I reported five families＇20 cases on family＇s sensitivity problems in 1 987, while thethird international plateau medical conference was held in Manse Hongin in Japan. All the cases caused among two generations or the same generation. Among them, there were six cases caused in one family after they immigrated to China in land. The father had it in 1 968 when he first flew to Tibet and was cured later on. He had had the same diseases twice during his twenty times trips from Lhasa to Chengdu. He had it even on his way to Lhasa by bus when the bus was climbing the 5 000 meters＇ Querar Mountain. During his other trips he had only got slight symptomsfor he made prevention. He has two .sons and one daughter. They all sufferd from HAPE when they first time came to Tibet by air. The oldest one had HAPE for three times and the second and third child each had once. His grandson, who is the son of his oldest son had HAPE three times too. His granddaughter, the daughter of his daughter also had it for once. However, his wife had never got it in her many trips to Tibet. It only caused among the father,sons, daughter and grandson and granddaughter. I＇ m sure there should be an answer in genetics. Researchers on DNA have begun the study on it and will publish the answer later on. I＇ ve mainly reported this rare case on family sensitivity from clinical site. We can get conclusion that there must be family sensitivity for HAPE.