高原低氧应激和适应过程中人群症状反应分析

Highland hypoxia stress and adaptation response there of ： analysis of 1244 cases

目的评价高原低氧环境对部队官兵健康的影响。方法分组调查由平原入伍到高原地区的男性官兵1244人。其中A组486人，地区海拔2260～2800m；B组675人，海拔3800～4300m；C组83人，海拔〉4500m。对比分析各组症状反应及与入住时间和海拔高度的关系。结果总体症状阳性率70．98％。其中A组60．49％、B组75．11％、C组98．8％，组间比较差异显著（P〈0．01）；B组、C组各症状阳性率均显著高于A组，其中心慌、气短、头痛、头晕和失眠的阳性率占前5位；各组入住≥1年者中，记忆力减退、视力下降、指甲凹陷和脱发现象显著增加（P〈0．05），而其他症状均显著减少。结论低氧应激性症状反应与海拔高度成正比，尤其海拔3800m以上地区的症状反应阳性率陡然升高，但随入住时间的延长而下降。慢性症状反应与入住时间成正比。

Objective To evaluate the influence of high altitude on the manifestations of hypoxic stress. Methods 1 244 military officers and soldiers, all males, aged 17-26, were dispatched to different altitudes for a period shorter than one month to longer than one year： 486 to the altitude of 2 260-2 800 m （Group A）, 675 to the altitude of 3 800-4 300 m （Group B）, and 83 to the altitude 〉4 500 m （Group C）. The incidence rates of manifestations of high altitude stress were observed and the relationship between these manifestations and check-in time was analyzed. Results The overall positive rate of manifestations of high altitude stress was 70.98%, and the positive rates of Groups A, B, and C were 60.49%, 75.11%, and 98.8% respectively, becoming significantly higher group by group （all P〈0.01）. The incidence rates of headache, dizziness, dyspnea, chest distress, cough, palpitation, shortness of breath, etc, of the subjects who stayed for more than 1 year wee all lower than those of the subjects who stayed there for less than 1 year or just went to the high altitude regions, and the incidence rates of dysmnesia, visual disturbance, nail excavation, and alopecia of the subjects who stayed for more than 1 year wer all lower than those of the subjects who stayed there for less than 1 year or just went there （all P〈0.01）. Conclusion The manifestations of hypoxic stress response are in direct proportion with altitude, and the incidence rates of these manifestations increase sharply in the areas above 3 800 m above sea level. However, along with the extension of stay time, the incidence rates of acute symptoms gradually decrease and those of the chronic symptoms increase.